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

Naloxegol is a prescription medication designed to help people who experience constipation caused by opioid pain medications. If you've been taking opioids for chronic pain and finding yourself struggling with uncomfortable bowel movements, this medicine might offer the relief you've been seeking.

This medication works differently from regular laxatives because it specifically targets the constipation that comes from opioid use. Let's walk through everything you need to know about naloxegol in a way that feels clear and manageable.

What is Naloxegol?

Naloxegol is a specialized medication that belongs to a class of drugs called opioid antagonists. Think of it as a helper that works specifically in your digestive system to counteract the constipating effects of opioid pain medications.

Unlike regular opioid blockers that can interfere with your pain relief, naloxegol is designed to stay mostly in your intestines. This means it can help restore normal bowel function without reducing the pain-relieving benefits of your opioid medication.

The medication comes in tablet form and is taken by mouth once daily. Your doctor will typically consider this option when other constipation treatments haven't provided adequate relief.

What is Naloxegol Used For?

Naloxegol is specifically prescribed for opioid-induced constipation in adults with chronic non-cancer pain. This type of constipation happens because opioids slow down the natural movement of your intestines, making it difficult to have regular bowel movements.

Your doctor might recommend naloxegol if you've been taking opioid pain medications for conditions like chronic back pain, arthritis, or other long-term pain conditions. The medication is particularly helpful when you need to continue taking opioids for pain management but want relief from the uncomfortable digestive side effects.

It's important to understand that naloxegol isn't used for general constipation or constipation caused by other medications. This medicine is specifically designed for the unique type of constipation that opioids create in your digestive system.

How Does Naloxegol Work?

Naloxegol works by blocking opioid receptors specifically in your digestive tract while leaving the pain-relieving opioid receptors in your brain and spinal cord largely untouched. This selective action helps restore normal bowel function without interfering with your pain management.

When you take opioids, they bind to receptors throughout your body, including ones in your intestines that control bowel movements. Naloxegol acts like a gentle shield, preventing opioids from slowing down your digestive system while still allowing them to provide pain relief where you need it most.

The medication typically begins working within hours to days of starting treatment. You might notice improvements in your bowel movement frequency and comfort as your digestive system starts functioning more normally again.

How Should I Take Naloxegol?

Take naloxegol exactly as your doctor prescribes, typically once daily on an empty stomach. This means taking it at least one hour before your first meal of the day or two hours after eating.

Swallow the tablet whole with a glass of water. Don't crush, break, or chew the tablet, as this can affect how the medication works in your body. If you have trouble swallowing tablets, talk with your doctor about your options.

Try to take naloxegol at the same time each day to help establish a routine. Many people find it helpful to take it first thing in the morning before breakfast, but work with your doctor to find the timing that works best for your schedule and other medications.

How Long Should I Take Naloxegol For?

The duration of naloxegol treatment typically depends on how long you need to continue taking opioid pain medications. Since this medication specifically addresses opioid-induced constipation, you'll likely need to take it as long as you're using opioids for pain management.

Your doctor will regularly evaluate whether naloxegol is still necessary and effective for your situation. Some people may need short-term treatment if they're recovering from surgery or an injury, while others with chronic pain conditions might need longer-term use.

Never stop taking naloxegol suddenly without talking to your doctor first. If you need to discontinue the medication, your healthcare provider will guide you through the process and may suggest alternative approaches for managing constipation.

What Are the Side Effects of Naloxegol?

Like all medications, naloxegol can cause side effects, though many people tolerate it well. Understanding what to expect can help you feel more confident about your treatment and know when to contact your doctor.

The most common side effects are generally mild and often improve as your body adjusts to the medication:

• Stomach pain or abdominal discomfort
• Diarrhea
• Nausea
• Flatulence or gas
• Vomiting
• Headache
• Excessive sweating

These digestive side effects often occur because your bowel function is returning to normal after being slowed by opioids. Many people find these symptoms manageable and temporary.

More serious side effects are less common but require immediate medical attention. Contact your doctor right away if you experience:

• Severe stomach pain or cramping
• Persistent vomiting
• Signs of severe dehydration
• Symptoms that might indicate bowel perforation (extremely rare but serious)

Some people may experience withdrawal-like symptoms if they have high levels of opioids in their system when starting naloxegol. These can include anxiety, chills, sweating, or feeling generally unwell.

Who Should Not Take Naloxegol?

Naloxegol isn't suitable for everyone, and certain conditions or situations make it unsafe to use. Your doctor will carefully review your medical history before prescribing this medication.

You should not take naloxegol if you have a known or suspected blockage in your digestive tract. This includes conditions like bowel obstruction, where the medication could potentially make the situation worse rather than better.

People with severe kidney or liver problems may need dose adjustments or might not be able to take naloxegol safely. Your doctor will likely run blood tests to check your organ function before starting treatment.

If you're taking certain medications that interact with naloxegol, your doctor may need to adjust doses or choose a different treatment approach. This is particularly important with some antibiotics, antifungal medications, and other drugs that affect how your body processes medications.

Pregnant or breastfeeding women should discuss the risks and benefits carefully with their healthcare provider, as the safety of naloxegol during pregnancy and nursing isn't fully established.

Naloxegol Brand Names

Naloxegol is primarily available under the brand name Movantik in the United States. This is the most commonly prescribed form of the medication that you'll likely encounter at your pharmacy.

Some countries may have different brand names for naloxegol, but the active ingredient and how it works remain the same. Always make sure you're getting the correct medication by checking with your pharmacist if you have any questions about what you're receiving.

Generic versions of naloxegol may become available over time, which can offer the same benefits at a potentially lower cost. Your doctor or pharmacist can help you understand your options and what might work best for your situation and budget.

Naloxegol Alternatives

If naloxegol isn't the right fit for you, several other options exist for managing opioid-induced constipation. Your doctor can help you explore these alternatives based on your specific needs and medical history.

Methylnaltrexone (Relistor) is another opioid antagonist that works similarly to naloxegol but is given as an injection. Some people prefer this option, especially if they have trouble with oral medications or need more immediate relief.

Lubiprostone (Amitiza) works differently by increasing fluid in your intestines to help soften stools and promote bowel movements. This medication can be effective for people who don't respond well to opioid antagonists.

Traditional approaches like increased fiber intake, stool softeners, or stimulant laxatives might be appropriate for some people, though they're often less effective for opioid-induced constipation specifically.

Your healthcare provider might also consider adjusting your pain management approach, such as changing opioid medications or incorporating non-opioid pain management strategies to reduce the constipation issue at its source.

Is Naloxegol Better Than Methylnaltrexone?

Both naloxegol and methylnaltrexone are effective medications for opioid-induced constipation, but they have different advantages that might make one more suitable for your particular situation.

Naloxegol offers the convenience of being taken by mouth once daily, which many people find easier to incorporate into their daily routine. The oral form also allows for more gradual, steady relief throughout the day.

Methylnaltrexone, given as an injection, may work more quickly for some people and can be helpful if you have severe nausea or vomiting that makes it difficult to keep oral medications down. However, many people prefer to avoid injections if possible.

The choice between these medications often comes down to your personal preferences, how well you tolerate each option, and practical considerations like convenience and cost. Your doctor can help you weigh these factors and may even suggest trying one and switching to the other if needed.