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Heroin Addiction and Related Clinical Problems: 2024, 26, 8

Efficacy and safety of naldemedine in the long-term treatment of opioid-induced constipation in patients on methadone agonist therapy monitored for three consecutive months

Emanuele Corbucci, and Piero Pierucci

Digital Object Identifier:
https://doi.org/10.62401/2531-4122-2024-8

Summary: Background. Opioid drugs are widely used in clinical practice both for the treatment of moderate-to-severe pain and for agonist therapy in drug addiction. When used over a prolonged period, opioids risk a series of undesirable side effects that may reduce patients’ quality of life; in particular, constipation is one of the most frequent symptoms of the so-called opioid-induced bowel dysfunction. Methods. The present study evaluated a group of patients undergoing methadone agonist therapy concomitant to naldemedine, a state-of-the-art drug that improves both small and large bowel movements in the presence of chronic opioid-induced constipation. Patients were monitored for a continuous period of 3 months and after 1 year to measure the potential benefits of naldemedine therapy and any concomitant adverse effects. Results. Naldemedine significantly increased the number of spontaneous, complete, and effortless bowel movements after 14 days from the treatment initiation. This improvement remained constant throughout the three months of monitoring and was confirmed for 4 of the patients who underwent a one-year follow. No noteworthy side effects were recorded for treatment monitoring. Conclusions. The present results qualify naldemedine as an effective and safe drug in the long-term treatment of chronic opioid-induced constipation in patients on methadone agonist therapy.

Keywords: opioid agonist therapy; opioid-induced constipation; PAMORA