Naloxegol for Treatment of Opioid-Induced Constipation in the Pediatric Intensive Care Unit.

Abstract

Opioid-induced constipation is a common problem in critically ill children requiring sedation. Naloxegol is an oral U.S. Food and Drug Administration (FDA)-approved peripherally acting mu-opioid receptor antagonist for chronic opioid-induced constipation use in adults, but data on its use in children are lacking. We performed a retrospective analysis of critically ill children that had received naloxegol for opioid-induced constipation at our institution. Of the 45 patients studied, mean stool frequency increased significantly from 0.63 ± 0.12 stools per day to 1.71 ± 0.13 stools per day after starting naloxegol (95% confidence interval [CI]: [0.75, 1.4], P < .001). There was no significant difference in the mean Withdrawal Assessment Tool 1 (WAT-1) score in the 24 hours before and after receiving the first dose (95% CI: [-0.25, 0.40], P = .63). This suggests naloxegol is effective in increasing stool output in critically ill children receiving opioids without an increase in opioid-withdrawal symptoms. It may be an effective adjunctive therapy for this population.

• Authors: Ethan L Gillett, Clint A Layes, Lee Crawley, Stephen M Schexnayder
• Journal: Clinical pediatrics (Clin Pediatr (Phila)) Vol. 62 Issue 7 Pg. 721-724 (Jul 2023) ISSN: 1938-2707 [Electronic] United States
• PMID: 36475875 (Publication Type: Journal Article)

Chemical References

• naloxegol
• Analgesics, Opioid
• Polyethylene Glycols

Topics

• Adult
• Child
• Humans
• Analgesics, Opioid (adverse effects)
• Constipation (chemically induced, drug therapy)
• Opioid-Induced Constipation (drug therapy)
• Retrospective Studies
• Critical Illness
• Polyethylene Glycols (adverse effects)
• Intensive Care Units, Pediatric