TY - JOUR
KW - Analgesics, Opioid/adverse effects/therapeutic use
KW - Chronic Pain/drug therapy
KW - Clinical Trials as Topic
KW - Constipation/drug therapy/etiology
KW - Government Regulation
KW - Half-Life
KW - Humans
KW - Naltrexone/analogs & derivatives/chemistry/pharmacokinetics/therapeutic use
KW - Quality of Life
KW - Quaternary Ammonium Compounds/chemistry/pharmacokinetics/therapeutic use
KW - Treatment Outcome
KW - Bowel dysfunction
KW - constipation
KW - cost-effectiveness
KW - methylnaltrexone bromide
KW - mu-opioid receptor
KW - Opioid
KW - peripherally acting opioid receptor antagonist
AU - Shilan Mozaffari
AU - Shekoufeh Nikfar
AU - Mohammad Abdollahi
A1 - 
AB - INTRODUCTION: The extensive and alarming use of opioids for pain management in patients with chronic pain receiving palliative care is associated with non-tolerable gastrointestinal (GI) adverse effects. Opioid-induced constipation (OIC) is the most common adverse effect impairing patient quality of life (QOL). In addition, OIC is one of the treatment limiting consequences of opioid analgesics. Management of OIC is becoming a challenge since traditional laxatives have limited efficiency. Peripherally acting mu-opioid receptor antagonists (PAMORA) have been developed for the treatment of OIC with methylnaltrexone bromide being the first approved to treat OIC in adults with advanced illness undergoing palliative care. Areas covered: The authors systematically review the clinical evidence for methylnaltrexone bromide including a review of the pharmacokinetic and pharmacodynamic data along with clinical effectiveness and cost-effectiveness. Though there is a need for further long-term clinical investigation, there is a large body of evidence for both its efficacy and safety in the treatment of OIC. Expert opinion: Methylnaltrexone has both subcutaneous injection and oral dosage forms available in the market. The lack of more evidence in specific populations such as pregnant women, pediatrics and elderly still remains. The global consumption of methylnaltrexone shows a projection of increased use since its approval worldwide in 2008.
AD - a Division of Pharmaceutical and Narcotic Affaire, Vice Chancellor for Food and Drug , Kurdistan University of Medical Sciences , Sanandaj , Iran.; b Department of Pharmacoeconomics and Pharmaceutical Administration, Faculty of Pharmacy and Pharmaceutical Policy Research Center , Tehran University of Medical Sciences , Tehran , Iran.; c The Institute of Pharmaceutical Sciences (TIPS) , Tehran University of Medical Sciences , Tehran , Iran.; c The Institute of Pharmaceutical Sciences (TIPS) , Tehran University of Medical Sciences , Tehran , Iran.; d Department of Toxicology and Pharmacology, Faculty of Pharmacy , Tehran University of Medical Sciences , Tehran , Iran.
BT - Expert opinion on pharmacotherapy
C5 - Healthcare Disparities; Opioids & Substance Use
CP - 10
CY - England
DO - 10.1080/14656566.2018.1491549
IS - 10
JF - Expert opinion on pharmacotherapy
LA - eng
M1 - Journal Article
N2 - INTRODUCTION: The extensive and alarming use of opioids for pain management in patients with chronic pain receiving palliative care is associated with non-tolerable gastrointestinal (GI) adverse effects. Opioid-induced constipation (OIC) is the most common adverse effect impairing patient quality of life (QOL). In addition, OIC is one of the treatment limiting consequences of opioid analgesics. Management of OIC is becoming a challenge since traditional laxatives have limited efficiency. Peripherally acting mu-opioid receptor antagonists (PAMORA) have been developed for the treatment of OIC with methylnaltrexone bromide being the first approved to treat OIC in adults with advanced illness undergoing palliative care. Areas covered: The authors systematically review the clinical evidence for methylnaltrexone bromide including a review of the pharmacokinetic and pharmacodynamic data along with clinical effectiveness and cost-effectiveness. Though there is a need for further long-term clinical investigation, there is a large body of evidence for both its efficacy and safety in the treatment of OIC. Expert opinion: Methylnaltrexone has both subcutaneous injection and oral dosage forms available in the market. The lack of more evidence in specific populations such as pregnant women, pediatrics and elderly still remains. The global consumption of methylnaltrexone shows a projection of increased use since its approval worldwide in 2008.
PP - England
PY - 2018
SN - 1744-7666; 1465-6566
SP - 1127
EP - 1135
EP - 
T1 - Methylnaltrexone bromide for the treatment of opioid-induced constipation
T2 - Expert opinion on pharmacotherapy
TI - Methylnaltrexone bromide for the treatment of opioid-induced constipation
U1 - Healthcare Disparities; Opioids & Substance Use
U2 - 29979903
U3 - 10.1080/14656566.2018.1491549
VL - 19
VO - 1744-7666; 1465-6566
Y1 - 2018
Y2 - Jul
ER -