Naloxegol Dosing and Efficacy in Opioid-Induced Constipation

Standard Dosing and Efficacy

• The standard recommended dose of naloxegol for opioid-induced constipation (OIC) is 25 mg once daily in the morning, as recommended by the American Society of Clinical Oncology, based on evidence from Annals of Oncology 1, 2, 3
• Naloxegol has demonstrated efficacy in treating OIC with response rates significantly higher than placebo, with a response rate of 41.9% compared to 29.4% with placebo in non-cancer pain patients, according to Gastroenterology 4, 5
• Naloxegol improves spontaneous bowel movement (SBM) frequency and reduces straining during defecation, as reported in Gastroenterology 4, 5

Safety and Adverse Effects

• The most common adverse effects of naloxegol include abdominal pain (17.8%), diarrhea (12.9%), nausea (9.4%), headache (9.0%), and flatulence (6.9%), as reported in Gastroenterology 5
• Adverse events leading to discontinuation occur in approximately 9.4% of patients on naloxegol compared to 4.2% on placebo, according to Gastroenterology 5

Opioid-Induced Constipation Management

Treatment Approach

• The National Comprehensive Cancer Network recommends trying conventional laxatives (stimulant laxatives, stool softeners) as the first step in managing opioid-induced constipation 6, 7
• If constipation persists despite laxative therapy, the National Comprehensive Cancer Network suggests considering naloxegol 25 mg once daily 6, 7