Opioid-Induced Constipation

CONSTIPATION associated with the use of OPIOIDS.

Also Known As:

Bowel Dysfunction, Opioid-Induced; Bowel Syndrome, Narcotic; Constipation, Opiate-Induced; Constipation, Opioid-Induced; Dysfunction, Opioid-Induced Bowel; Narcotic Bowel Syndromes; Opiate Induced Constipation; Opiate-Induced Constipations; Opioid Induced Bowel Dysfunction; Opioid Induced Constipation; Opioid-Induced Bowel Dysfunctions; Opioid-Induced Constipations; Narcotic Bowel Syndrome; Opiate-Induced Constipation; Opioid-Induced Bowel Dysfunction

Networked: 667 relevant articles (100 outcomes, 123 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Pain (Aches)
2.	Neoplasms (Cancer)
3.	Cancer Pain
4.	Opioid-Induced Constipation
5.	Constipation

Experts

1.	Israel, Robert J: 16 articles (01/2022 - 05/2008)
2.	Camilleri, Michael: 14 articles (01/2022 - 04/2011)
3.	Stambler, Nancy: 14 articles (01/2022 - 05/2008)
4.	Sostek, Mark: 14 articles (01/2018 - 09/2013)
5.	Webster, Lynn R: 13 articles (01/2020 - 01/2015)
6.	Slatkin, Neal E: 12 articles (01/2022 - 05/2008)
7.	Tack, Jan: 11 articles (02/2022 - 01/2014)
8.	Webster, Lynn: 10 articles (01/2022 - 07/2008)
9.	Datto, Catherine: 10 articles (02/2019 - 03/2016)
10.	Brenner, Darren M: 9 articles (01/2022 - 10/2013)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Opioid-Induced Constipation:

1.	methylnaltrexone FDA Link 10/01/2013 - "This case series suggests that methylnaltrexone is safe and may be effective when given subcutaneously as a 0.15 mg/kg single dose to pediatric oncology patients with opioid-induced constipation." 02/01/2012 - "Methylnaltrexone has been shown to be effective for treating opioid-induced constipation (OIC) in chronic settings, but its effects on acute OIC have not been studied. " 05/01/2011 - "Methylnaltrexone is effective for opioid-induced constipation (OIC) in advanced illness patients. " 01/01/2009 - "How safe and effective is methylnaltrexone for the treatment of opioid-induced constipation in advanced illness?" 02/01/2011 - "This pharmacology update will review the etiology, pathophysiology, and treatment of opioid-induced constipation, focused on methylnaltrexone as a novel treatment for refractory cases."
2.	Opioid Analgesics (Opioids)IBA 05/01/2012 - "This patient experienced significant improvement of opioid-induced constipation and reduction in opioid requirements and it is possible that other patients would benefit as well. " 01/01/2006 - "A better understanding of the pathophysiological mechanisms of opioid-induced bowel dysfunction should lead to the development of newer opioid analgesics and improved regimens resulting in reduced gastrointestinal adverse effects." 02/01/2008 - "Although peripheral κ opioid agonists are promising, clinical studies are needed to assess their efficacy in treating opioid-induced bowel dysfunction." 08/01/1995 - "Selective antagonism of the intestinal actions of opioids might be useful in the treatment of opioid-induced constipation. " 10/01/2017 - "However, the inhibitory effects of opioids are not confined to the colon, but also affect higher segments of the gastrointestinal tract, leading to the coining of the term "opioid-induced bowel dysfunction." A literature search was conducted using Medline, EMBASE, and EMBASE Classic, and the Cochrane Central Register of Controlled Trials. "
3.	naldemedineIBA 01/01/2021 - "Naldemedine treatment was associated with a rapid and sustained clinically relevant improvement in patient-reported outcomes, indicating improvement in opioid-induced constipation-related symptoms and QOL. " 03/01/2019 - "Naldemedine 0.2 mg daily significantly improved symptoms in patients with opioid-induced constipation and was generally well tolerated. " 05/01/2018 - "Naldemedine significantly increased bowel movement frequency, improved symptomatic burden of opioid-induced constipation, and increased patients' quality of life vs placebo." 01/01/2017 - "Naldemedine effective in treating opioid-induced constipation." 03/01/2019 - "Efficacy of naldemedine for the treatment of opioid-induced constipation: A meta-analysis."
4.	Naloxone (Narcan)FDA LinkGeneric 10/01/2014 - "Enteral naloxone may be effective in treating opioid-induced constipation; however, further studies are warranted." 10/01/2014 - "To determine the safety and efficacy of enteral naloxone for the treatment of opioid-induced constipation in the medical intensive care unit (MICU). " 03/01/1997 - "In conclusion, it was found that the treatment of opioid-induced constipation by administration of oral naloxone produced positive results. " 03/01/1997 - "Several studies have attempted to reverse opioid-induced constipation by the use of oral naloxone. " 10/16/2022 - "We were also able to confirm, in our cohort, the well known positive effect of naloxone in terms of opioid-induced bowel dysfunction incidence reduction."
5.	Oxycodone (Oxycontin)FDA LinkGeneric 01/01/2022 - "There was a strong association between objective and subjective measures of opioid-induced constipation when participants were treated with oxycodone (r=0.676, p=0.006). " 01/01/2016 - "Although effective in managing chronic pain, oxycodone is associated with high rates of opioid-induced constipation (OIC). " 01/01/2020 - "This double-blind randomized controlled trial investigated OXN PR (N = 116) versus prolonged-release oxycodone (OXY PR, N = 115) for 8 weeks at doses up to 50 mg/day in patients with moderate-to-severe, chronic, non-malignant musculoskeletal pain and opioid-induced constipation recruited in China. " 12/01/2017 - "Treatment with prolonged-release oxycodone/naloxone (PR OXN) has been shown to improve opioid induced constipation (OIC) in constipated patients. " 01/01/2016 - "The efficacy of standard laxative use for the prevention and treatment of opioid induced constipation during oxycodone use: a small Dutch observational pilot study."
6.	Narcotic Antagonists (Opioid Antagonists)IBA 09/15/2015 - "Peripherally acting mu-opioid antagonists are effective for opioid-induced constipation but are expensive. " 01/01/2019 - "Assessing the efficacy of peripherally acting µ-opioid receptor antagonists (PAMORAs) in the treatment of opioid-induced constipation: authors reply." 09/01/2008 - "Efficacy and safety of mu-opioid antagonists in the treatment of opioid-induced bowel dysfunction: systematic review and meta-analysis of randomized controlled trials." 01/01/2023 - "Mu-Opioid Antagonists for the Treatment of Opioid-Induced Bowel Dysfunction." 07/01/2021 - "Efficacy and Safety of Peripherally Acting μ-Opioid Receptor Antagonist (PAMORAs) for the Management of Patients With Opioid-Induced Constipation: A Systematic Review."
7.	naloxegolIBA 01/01/2023 - "This study evaluates the onset, magnitude, and consistency of improvement of opioid-induced constipation (OIC) symptoms with naloxegol treatment. " 10/01/2017 - "Population Exposure-Response Modeling Supported Selection of Naloxegol Doses in Phase III Studies in Patients With Opioid-Induced Constipation." 09/01/2013 - "A phase 2, double-blind, randomized, placebo-controlled, dose-escalation study to evaluate the efficacy, safety, and tolerability of naloxegol in patients with opioid-induced constipation." 11/15/2023 - "Naloxegol has been shown to be an efficient alternative to treat opioid-induced constipation (OIC). " 07/01/2023 - "Naloxegol for Treatment of Opioid-Induced Constipation in the Pediatric Intensive Care Unit."
8.	mu Opioid Receptors (mu Opioid Receptor)IBA 01/01/2019 - "Assessing the efficacy of peripherally acting mu-opioid receptor antagonists (PAMORAs) in the treatment of opioid-induced constipation." 07/01/2023 - "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. " 01/01/2022 - "These probes allow us to demonstrate that the mu-opioid receptors in the central nervous system have a fundamental role in precipitating opioid-induced constipation. " 01/01/2022 - "Peripherally acting mu-opioid receptor antagonists for the treatment of opioid-induced constipation." 01/01/2022 - "Medical benefits of peripherally acting mu-opioid receptor antagonists other than improving opioid-induced constipation remain unclear. "
9.	Lubiprostone FDA Link 05/01/2020 - "Compared with the placebo groups in idiopathic and opioid-induced constipation, the lubiprostone groups significantly improved in 24-h SBM frequency [relative risk: 1.28, 95% confidence interval, 1.11-1.49, and 1.23, 1.14-1.32] and weekly frequency >3 SBM/week (1.68, 1.41-2.01, and 1.43, 1.01-2.04), respectively. " 05/01/2020 - "It is unclear whether the efficacy of lubiprostone for spontaneous bowel movement (SBM) and the adverse events are similar between idiopathic and opioid-induced constipation and between East-Asian and Western populations. " 05/01/2020 - "We conducted a meta-analysis to compare efficacy and safety of lubiprostone in two populations with idiopathic vs opioid-induced constipation. " 05/01/2020 - "Differences in efficacy and safety of lubiprostone used for idiopathic vs opioid-induced constipation: meta-analysis of East Asian and Western populations." 05/01/2015 - "Adults with opioid-induced constipation (OIC; <3 spontaneous bowel movements [SBMs] per week) were randomized 1:1 to double-blind lubiprostone 24 μg or placebo twice daily for 12 weeks. "
10.	alvimopan FDA Link 02/01/2011 - "This double-blind, placebo-controlled trial was conducted as part of a recently discontinued clinical program, in which alvimopan was being developed for opioid-induced constipation (OIC). " 02/01/2011 - "The opioid-induced bowel dysfunction Symptoms Improvement Scale (SIS) responder rate was 40.4% in the alvimopan .5 mg twice daily group, versus 18.6% with placebo (P < .001). " 02/01/2011 - "Secondary efficacy analyses indicated that alvimopan was numerically superior to placebo in improving opioid-induced bowel dysfunction symptoms and patients' global assessment of opioid-induced bowel dysfunction, and reduced the requirement for rescue laxatives. " 02/01/2011 - "Alvimopan was under clinical development for long-term treatment of opioid-induced constipation (OIC) but this program has been discontinued. " 02/01/2011 - "A randomized, placebo-controlled phase 3 trial (Study SB-767905/012) of alvimopan for opioid-induced bowel dysfunction in patients with non-cancer pain."

Therapies and Procedures

1.	Therapeutics 01/01/2019 - "Efficacy of pharmacological therapies for the treatment of opioid-induced constipation: systematic review and network meta-analysis." 10/01/2013 - "Efficacy of pharmacological therapies for the treatment of opioid-induced constipation: systematic review and meta-analysis." 07/01/2019 - "Until recently, conclusive data on clinical presentation, diagnosis and therapy of the opioid-induced constipation (OIC) were not available. " 01/01/2019 - "Pharmacological therapies to treat opioid-induced constipation (OIC) are available, but their relative efficacy is unclear. " 01/01/2018 - "Incomplete Systematic Meta-analysis of Pharmacological Therapies for Opioid-Induced Constipation."
2.	Analgesia 01/01/2008 - "Studies to date show promise that these agents may relieve opioid-induced bowel dysfunction in a well-tolerated manner without reversing central analgesia." 02/01/2007 - "Clinical studies have proved the concept that these drugs prevent opioid-induced bowel dysfunction without interfering with analgesia. " 01/01/2014 - "Opioid-induced bowel dysfunction (OIBD) is a burdensome condition which limits the therapeutic benefit of analgesia. " 01/01/2020 - "OXN PR provided clinically meaningful improvements in bowel function and effective analgesia in Chinese patients with moderate-to-severe musculoskeletal pain and pre-existing opioid-induced constipation. " 01/01/2018 - "Novel agents to reduce opioid-induced bowel dysfunction (OIBD) that do not reverse peripherally mediated pain analgesia are of great interest. "
3.	Palliative Care (Palliative Therapy) 06/01/2015 - "Management of opioid-induced constipation for people in palliative care." 01/01/2014 - "Opioid-induced constipation (OIC) is one of the major symptoms in palliative care with a prevalence of 30-50%. " 01/01/2013 - "It is licensed for the treatment of opioid-induced constipation in palliative care in more than 50 countries. " 10/01/2011 - "This article looks at novel approaches to managing opioid-induced constipation that are beginning to come to the fore, although there is limited reference to their use in children's palliative care." 10/01/2011 - "Opioid-induced constipation in children's palliative care."
4.	Orthopedic Procedures 03/01/2022 - "Future multi-centered, randomized controlled trials are necessary to evaluate the differences in efficacy and safety between common bowel regimens in treating opioid-induced constipation in patients who undergo elective orthopedic surgery." 11/21/2014 - "Lubiprostone vs Senna in postoperative orthopedic surgery patients with opioid-induced constipation: a double-blind, active-comparator trial." 02/01/2012 - "Subcutaneous methylnaltrexone for treatment of acute opioid-induced constipation: phase 2 study in rehabilitation after orthopedic surgery." 03/01/2022 - "Our purpose was to determine if docusate monotherapy is effective in preventing opioid-induced constipation in patients receiving opioids following orthopedic surgery. "
5.	Acupressure (Shiatsu) 01/01/2022 - "Potential Value of Acupuncture and Acupressure in Alleviating Opioid-induced Constipation." 06/01/2022 - "The efficacy of acupressure in managing opioid-induced constipation in patients with cancer: A single-blind randomized controlled trial." 06/01/2022 - "Findings of this trial suggested that a 4-week acupressure was an effective way to improve the quality of life and to reduce both the subjective and the objective constipation symptoms in patients with opioid-induced constipations. " 06/01/2022 - "This randomized-controlled trial aimed to investigate the effects of acupressure therapy on the management of opioid-induced constipation in patients with cancer. "