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Improved Home Blood Pressure Control by CT-guided Ozone-mediated Renal Denervation for Patients with Resistant Hypertension
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Can Naldemedine Allow Higher Oxycodone Dosing in Patients with Cancer? A Single-Center Retrospective Study
Shinya Kajiura1,2,3, Shingo Chikaoka2, Yuta Yagi2
1Department of Medical Oncology and Palliative Medicine, Toyama University Hospital, Toyama, Japan.
Journal of Palliative Medicine
|February 17, 2026
Summary
Naldemedine, a peripherally acting μ-opioid receptor antagonist (PAMORA), enables higher oxycodone dosing in cancer patients by managing opioid-induced constipation (OIC). This suggests PAMORAs reduce the need to switch opioids during cancer pain management.
Area of Science:
- Oncology
- Pharmacology
- Gastroenterology
Background:
- Opioid-induced constipation (OIC) is a significant challenge in cancer pain management, often necessitating opioid dose reduction or switching.
- Historically, managing OIC involved switching to less effective opioids, limiting pain control.
- Peripherally acting μ-opioid receptor antagonists (PAMORAs) offer a new approach to managing OIC without compromising central analgesia.
Purpose of the Study:
- To evaluate if naldemedine, a PAMORA, allows for increased oxycodone dosing in cancer patients without constipation-related treatment changes.
- To assess the maximum scheduled oxycodone dose as a surrogate marker for successful OIC management and continued opioid therapy.
Main Methods:
- A retrospective review of adult cancer patients initiating oral oxycodone between June 2017 and December 2018.
- Patients were divided into two groups: Group A (receiving naldemedine) and Group B (not receiving naldemedine).
- The primary endpoint was the maximum scheduled daily dose of controlled-release oxycodone, excluding rescue doses.
Main Results:
- The median maximum oxycodone dose was significantly higher in patients receiving naldemedine (40 mg/day) compared to those not receiving it (20 mg/day).
- This difference was statistically significant (p < 0.0001).
Conclusions:
- Naldemedine facilitates higher oxycodone dosing in cancer patients, indicating effective management of OIC.
- The findings suggest that PAMORAs can reduce the incidence of opioid switching due to OIC, improving pain management strategies.
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