Stephen J.LurieMD, PhD, Senior EditorIndividualAuthorPhil B.FontanarosaMD, Executive Deputy EditorIndividualAuthor
To the Editor: Constipation is a common adverse
effect of opioid pain medication used to treat cancer patients.1
Conventional therapy may not provide sufficient relief of constipation, which
can be severe enough to limit opioid use or dose.2
We previously reported that intravenous methylnaltrexone (N-methylnaltrexone bromide; Mallinckrodt Specialty Chemicals, St Louis,
Mo), the first quaternary ammonium opioid receptor antagonist that does not
cross the blood-brain barrier in humans, reversed chronic opioid-induced constipation
in patients in a methadone maintenance program.3
However, oral medication is a safer and more convenient way to deliver the
drug. In this study, we evaluated the efficacy of oral methylnaltrexone for
patients receiving long-term methadone therapy.
Yuan C, Foss JF. Oral Methylnaltrexone for Opioid-Induced Constipation. JAMA. 2000;284(11):1383–1384. doi:10.1001/jama.284.11.1378
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