What is Naldemedine: Uses, Dosage, Side Effects and More

Naldemedine is a prescription medication that helps treat constipation caused by opioid pain medications. If you're taking opioids for chronic pain and struggling with constipation, naldemedine works by blocking opioid receptors in your digestive system without affecting pain relief. This targeted approach allows your bowel movements to return to a more normal pattern while your pain medication continues to work effectively.

What is Naldemedine?

Naldemedine belongs to a class of medications called opioid antagonists. It's specifically designed to counteract the constipating effects of opioid medications without interfering with their pain-relieving benefits. Think of it as a selective blocker that only works in your digestive tract.

The medication was developed because opioid-induced constipation affects nearly everyone who takes opioid pain medications regularly. Unlike regular constipation, this type doesn't usually respond well to typical remedies like fiber supplements or over-the-counter laxatives.

What is Naldemedine Used For?

Naldemedine treats opioid-induced constipation in adults with chronic non-cancer pain. Your doctor will typically prescribe it when you've been taking opioid medications regularly and experiencing persistent constipation as a result.

The medication is specifically for people whose constipation hasn't improved with other treatments like dietary changes, increased fluid intake, or over-the-counter laxatives. It's important to understand that naldemedine only works for constipation caused by opioids, not other types of constipation.

How Does Naldemedine Work?

Naldemedine works by blocking opioid receptors in your digestive system. When you take opioid pain medications, they bind to receptors throughout your body, including in your intestines, which slows down digestion and causes constipation.

This medication acts like a key that fits into those same receptors in your gut, preventing opioids from binding there. However, naldemedine doesn't cross into your brain or spinal cord, so it doesn't interfere with pain relief. This selective action makes it an effective solution for maintaining pain management while restoring normal bowel function.

How Should I Take Naldemedine?

Take naldemedine exactly as your doctor prescribes, usually once daily with or without food. The typical adult dose is 0.2 mg (one tablet) taken at the same time each day. Swallow the tablet whole with water and don't crush, break, or chew it.

You can take naldemedine with meals if it upsets your stomach, though food doesn't significantly affect how the medication works. Try to establish a routine by taking it at the same time each day to help you remember and maintain consistent levels in your system.

If you have trouble swallowing tablets, talk to your doctor about alternatives. Don't stop taking your opioid pain medication when starting naldemedine unless your doctor specifically tells you to do so.

How Long Should I Take Naldemedine For?

You'll typically take naldemedine for as long as you're taking opioid pain medications and experiencing constipation. Most people continue taking it throughout their opioid treatment period, which could be weeks, months, or longer depending on your pain management needs.

Your doctor will monitor your response to the medication and may adjust your treatment plan based on how well it's working. Some people notice improvement in their bowel movements within a few days, while others may take up to a week to see full benefits.

Don't stop taking naldemedine suddenly without talking to your doctor first. If you need to discontinue the medication, your doctor will guide you through the process and discuss alternative treatments for managing opioid-induced constipation.

What Are the Side Effects of Naldemedine?

Like all medications, naldemedine can cause side effects, though not everyone experiences them. Most side effects are mild and tend to improve as your body adjusts to the medication.

The most common side effects you might experience include stomach pain, diarrhea, nausea, and gastroenteritis (stomach flu-like symptoms). These digestive effects make sense given how the medication works to restore normal bowel function.

Here are the more common side effects to be aware of:

• Abdominal pain or cramping
• Diarrhea
• Nausea
• Vomiting
• Gastroenteritis symptoms

These symptoms are usually temporary and mild. However, if diarrhea becomes severe or persistent, contact your doctor as you may need to adjust your dose or temporarily stop the medication.

Less common but more serious side effects can occur, though they're rare. These include severe stomach pain, signs of bowel obstruction, or allergic reactions. If you experience severe abdominal pain, persistent vomiting, or signs of an allergic reaction like rash, difficulty breathing, or swelling, seek medical attention immediately.

Who Should Not Take Naldemedine?

Naldemedine isn't suitable for everyone. You shouldn't take this medication if you have a known bowel obstruction or blockage, as it could worsen these conditions.

Your doctor will carefully evaluate your medical history before prescribing naldemedine. People with certain digestive conditions may need special monitoring or may not be candidates for this medication.

Here are conditions that may prevent you from taking naldemedine:

• Known or suspected bowel obstruction
• Severe liver problems
• Allergy to naldemedine or its ingredients
• Certain digestive disorders that affect gut motility

Pregnant or breastfeeding women should discuss the risks and benefits with their doctor, as the safety of naldemedine during pregnancy and breastfeeding hasn't been fully established. Your doctor will weigh the potential benefits against any possible risks.

Naldemedine Brand Names

Naldemedine is available under the brand name Symproic in the United States. This is the most commonly prescribed form of the medication and comes in 0.2 mg tablets.

The generic version of naldemedine may become available in the future, but currently, Symproic is the primary brand name you'll encounter. Always use the exact medication your doctor prescribes and don't substitute with other brands without medical approval.

Naldemedine Alternatives

If naldemedine doesn't work well for you or causes troublesome side effects, several other medications can treat opioid-induced constipation. Your doctor might consider methylnaltrexone (Relistor) or naloxegol (Movantik), which work similarly by blocking opioid receptors in the digestive system.

Some people find success with traditional laxatives like polyethylene glycol (MiraLAX) or stimulant laxatives, though these are generally less effective for opioid-induced constipation. Your doctor might also recommend lifestyle changes such as increased fiber intake, more physical activity, and adequate hydration as complementary approaches.

The choice of alternative depends on your specific situation, other medications you're taking, and your body's response to different treatments. Never switch medications without consulting your healthcare provider first.

Is Naldemedine Better Than Methylnaltrexone?

Both naldemedine and methylnaltrexone effectively treat opioid-induced constipation, but they have different advantages. Naldemedine is taken orally once daily, making it more convenient for many people, while methylnaltrexone is typically given as an injection.

The choice between these medications often depends on your preferences, lifestyle, and how your body responds to each one. Some people prefer the convenience of a daily pill, while others might respond better to the injection form.

Your doctor will consider factors like your other medications, kidney function, and personal preferences when deciding which option is best for you. Both medications have similar effectiveness rates, so the decision often comes down to practical considerations and individual response.