Journal of Pain and Symptom Management
Volume 38, Issue 5 , Pages 683-690 , November 2009

Methylnaltrexone Treatment of Opioid-Induced Constipation in Patients with Advanced Illness

  • Bruce H. Chamberlain, MD

      Affiliations

    • Palliative Consulting LLC, Orem, Utah, USA
    • Corresponding Author InformationAddress correspondence to: Bruce H. Chamberlain, MD, Palliative Consulting LLC, 1927 N. Skyline Drive, Orem, UT 84097, USA.
    • ,
  • Karen Cross, MD

      Affiliations

    • Hospice & Palliative Care Center, Winston-Salem, North Carolina, USA
    • ,
  • Jaron L. Winston, MD

      Affiliations

    • Senior Adult Specialty Healthcare, Austin, Texas, USA
    • ,
  • Jay Thomas, MD

      Affiliations

    • City of Hope National Medical Center, Duarte, California, USA
    • ,
  • Wenjin Wang, PhD

      Affiliations

    • Wyeth Pharmaceuticals, Collegeville, Pennsylvania, USA
    • ,
  • Chinyu Su, MD

      Affiliations

    • Wyeth Pharmaceuticals, Collegeville, Pennsylvania, USA
    • ,
  • Robert J. Israel, MD

      Affiliations

    • Progenics Pharmaceuticals, Inc., Tarrytown, New York, USA

,Accepted 3 March 2009.

References 

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  4. Swegle JM, Logemann C. Management of common opioid-induced adverse effects. Am Fam Physician. 2006;74:1347–1354
  5. Pappagallo M. Incidence, prevalence, and management of opioid bowel dysfunction. Am J Surg. 2001;182(5A Suppl):11S–18S
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  7. Yuan CS. Methylnaltrexone mechanisms of action and effects on opioid bowel dysfunction and other opioid adverse effects. Ann Pharmacother. 2007;41:984–993
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  12. Slatkin N, Thomas J, Lipman AG, et al. Methylnaltrexone for treatment of opioid-induced constipation in advanced illness patients. J Support Oncol. 2009;7:39–46
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  14. Portenoy RK, Thomas J, Moehl Boatwright ML, et al. Subcutaneous methylnaltrexone for the treatment of opioid-induced constipation in patients with advanced illness: a double-blind, randomized, parallel group, dose-ranging study. J Pain Symptom Manage. 2008;35:458–468
  15. Rhiner M, Iyer S, Slatkin NE, Stambler N. Impact of therapy with methylnaltrexone on Global Clinical Impression of Change (GCIC) in bowel status scores in patients with advanced illness and opioid induced constipation. [abstract] Support Care Cancer. 2007;15:729
  16. Rhiner M, Iyer S, Slatkin NE, Stambler N. Effect of methylnaltrexone on Global Clinical Impression of Change (GCIC) in bowel status scores in patients with advanced illness and opioid induced constipation (OIC). Presented at the American Academy of Pain Medicine 24th Annual Meeting, February 12–16, 2008, Orlando, FL.
  17. Kolb L, Himmelsbach CK. Clinical studies of drug addiction, III: a critical review of the withdrawal treatments with method of evaluating abstinence syndromes. Am J Psychiatry. 1983;94:759–799
  18. Slatkin NE, Haines S, Rhiner M, et al. Methylnaltrexone for the treatment of opioid-induced constipation in patients with advanced illness: results of a 3-month open-label study. Support Care Cancer. 2007;15:793–794
  19. Dalal S, Del Fabbro E, Bruera E. Symptom control in palliative care—Part I: oncology as a paradigmatic example. J Palliat Med. 2006;9:391–408
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 This research was supported by Progenics Pharmaceuticals, Inc. Drs. K.C., J.L.W., and J.T. report receiving lecture and/or consulting fees from Wyeth Pharmaceuticals; Drs. W.W. and C.S. report being employees of Wyeth Pharmaceuticals and having an equity interest in the company; and Dr. R.J.I. reports being an employee of Progenics Pharmaceuticals and having an equity interest in the company. No other potential conflict of interest relevant to this article was reported.

PII: S0885-3924(09)00641-1

doi: 10.1016/j.jpainsymman.2009.02.234

Journal of Pain and Symptom Management
Volume 38, Issue 5 , Pages 683-690 , November 2009

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