Abstract
Background:
Opioid-induced constipation (OIC) limits opioid titration in cancer care. Before the use of peripherally acting μ-opioid receptor antagonists (PAMORAs), OIC often required switching from oxycodone to lower-risk opioids, such as transdermal fentanyl. Whether naldemedine allows oxycodone escalation without switching remains unclear. We evaluated the maximum scheduled daily oxycodone dose as a surrogate for maintaining therapy without constipation-driven switching.
Methods:
We retrospectively reviewed adults with cancer pain who initiated oral oxycodone at Toyama University Hospital between June 2017 and December 2018. Patients receiving naldemedine were classified as Group A; others as Group B. The primary endpoint was the maximum scheduled controlled-release oxycodone dose during follow-up; rescue doses were excluded.
Results:
Among 217 patients, the median maximum dose was higher with naldemedine (40 mg/day [range 10–480] versus 20 mg/day [10–320]; p < 0.0001).
Conclusions:
Naldemedine enabled higher oxycodone dosing, suggesting OIC management reduces opioid switching.
Get full access to this article
View all access options for this article.