Gastroenterology Book

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Methylnatrexone

Aka: Methylnatrexone, Relistor
  1. See Also
    1. Opioid Adverse Effect Management
    2. Bowel Regimen in Chronic Narcotic Use
  2. Indications
    1. Severe refractory Constipation due to Cancer Pain Opioid
  3. Mechanism
    1. Mu-Opioid receptor mediated bowel paralysis
  4. Dosing
    1. Methylnaltrexone 5 mg or 0.15 mg/kg SQ
  5. Advantages
    1. Does not cross blood-brain barrier
  6. Efficacy: Terminally ill patients
    1. Bowel Movement occurs within 4 hours of dose in 48% of patients (15% wiith Placebo)
    2. Median time to Bowel Movement is 45 minutes (>6 hours for Placebo)
  7. References
    1. Portenoy (2008) J Pain Symptom Manage 35(5): 458-68
    2. Thomas (2008) N Engl J Med 358(22): 2332-43

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