Formulary
Naldemedine: Indications, Dosing, Side Effects and Interactions
Naldemedine is a peripherally acting opioid receptor antagonist.
MedNext Academy | 3 min read
Naldemedine: Indications, Dosing, Side Effects and Interactions
Naldemedine is a peripherally acting opioid receptor antagonist.
Drug action
Naldemedine is a peripherally acting opioid receptor antagonist. It therefore decreases the constipating effects of opioids without altering their central analgesic effects.
Indications and dose
**Opioid-induced constipation [previous treatment with a laxative]**
- **Adult** (By Mouth): 200 micrograms once daily.
Cautions
Conditions with impaired integrity of the gastro-intestinal wall (risk of gastro-intestinal perforation); treatment initiation in patients aged 75 years and over (limited information available) Cautions, further information Disruptions to blood-brain barrier Manufacturer advises caution in patients with clinically important disruptions to the blood-brain barrier (e.g. advanced Alzheimer's disease, active multiple sclerosis, primary brain malignancies)-risk of opioid withdrawal or reduced analgesia. Cardiovascular disorders Safety and efficacy has not been established in patients with these conditions.
Contraindications
Increased risk of recurrent obstruction (risk of gastro-intestinal perforation); known or suspected gastro-intestinal obstruction (risk of gastro-intestinal perforation)
Side effects
Common or very common Diarrhoea; gastrointestinal discomfort; nausea; vomiting
Pregnancy
Manufacturer advises avoid unless potential benefit outweighs risk- animal studies do not indicate toxicity; risk of opioid withdrawal in fetus.
Breast feeding
Manufacturer advises avoid-present in milk in animal studies; theoretical risk of opioid withdrawal in breast-fed neonate.
Hepatic impairment
Manufacturer advises avoid in severe impairment (no information available).
Medicinal forms
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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