II. Indications

  1. Severe refractory Constipation due to Cancer Pain Opioid

III. Mechanism

  1. Mu-Opioid receptor mediated bowel paralysis

IV. Dosing

  1. Methylnaltrexone 5 mg or 0.15 mg/kg SQ

V. Advantages

  1. Does not cross blood-brain barrier

VI. 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)

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Cost: Medications

relistor (on 9/11/2015 at Medicaid.Gov Survey of pharmacy drug pricing)
RELISTOR 12 MG/0.6 ML SYRINGE $159.26 per ml
RELISTOR 12 MG/0.6 ML VIAL $159.44 per ml
RELISTOR 8 MG/0.4 ML SYRINGE $241.77 per ml