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A peripherally acting μ-opioid receptor antagonist for treating opioid-associated tinnitus: A case report

Satoru Ogawa1, Fumimasa Amaya1

  • 1Department of Pain Management and Palliative Care Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan.

Palliative Medicine
|July 29, 2024
PubMed
Abstract

Insights

Peripherally acting μ-opioid receptor antagonists effectively treated opioid-associated tinnitus in a cancer patient. This approach managed tinnitus without impacting pain control, offering a new therapeutic option.

Area of Science:

  • Oncology
  • Pharmacology
  • Pain Management

Background:

  • Opioid use can cause tinnitus, a condition with limited research regarding management in cancer patients.
  • Opioid-induced tinnitus poses a challenge, as discontinuing opioids may compromise pain management in cancer care.

Observation:

  • A pancreatic cancer patient developed tinnitus during opioid therapy (oxycodone, hydromorphone, tapentadol).
  • Tinnitus resolved upon opioid cessation but recurred with re-administration, indicating a direct drug effect.

Findings:

  • Naldemedine, a peripherally acting μ-opioid receptor antagonist, was administered at 200 μg/day for tinnitus relief.
  • Tinnitus resolved immediately upon naldemedine initiation, and pain control was maintained.

Implications:

  • Peripherally acting μ-opioid receptor antagonists may offer a viable strategy for managing opioid-associated tinnitus in cancer patients.
  • This treatment allows for continued opioid analgesia while addressing tinnitus, improving patient quality of life.
  • Further research is needed to explore the broader effects of these antagonists on opioid-related complications beyond constipation.
Keywords:
Opioidnaldemedineperipherally acting μ-opioid receptor antagoniststinnitus

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