Injection Eases Opioid-Induced Constipation | Arthritis Information
SAN DIEGO, May 12 -- Subcutaneous injections of methylnaltrexone (Relistor) can relieve constipation caused by opioid treatment for noncancer pain -- often within four hours -- researchers said here.
"As many as 40% of people who are taking opioids for pain relief experience constipation that is severe enough to cause major limitations to their quality of life," said E. Richard Blonsky, M.D., director of the Pain and Rehabilitation Clinic of Chicago and clinical professor of neurology at Northwestern University's Feinberg School of Medicine.
The problem is especially severe during social occasions, because patients must always be near toilet facilities to deal with the uncertainty of the condition, Dr. Blonsky told colleagues here at the American Pain Society annual meeting.
Dr. Blonsky reported that, overall, 34.3% of patients in his study accomplished laxation within four hours of a subcutaneous methylnaltrexone injection, compared with 9.9% of patients on placebo (P<0.001).
Some 46% in the methylnaltrexone group accomplished laxation within 24 hours, compared to 25% placebo, he reported.
He said methylnaltrexone decreases the constipating effects of opioids without affecting centrally mediated analgesia. The drug is currently FDA approved for treatment of opioid-induced constipation among patients with advanced illness who are receiving palliative care.
To determine if methylnaltrexone can relieve opioid-induced constipation in patients with noncancer pain, researchers enrolled 460 patients in a double-blind, placebo-controlled phase 3 randomized trial.
They were randomized to subcutaneous methylnaltrexone daily, the same drug every other day, or placebo.
Among the 150 patients taking methylnaltrexone every day, 28.9% achieved laxation within four hours, compared with 9.4% of the 162 patients on placebo (P<0.001). Likewise, 30.2% of 148 patients taking methylnaltrexone every other day achieved laxation within four hours (p<.001).
Geez, another med to increase bowel motility. What happened to old fashioned fiber, fruit, veggies, water, and exercise. Metamucil? Miralax? Colace? Why an injectable?Pain meds slow down your digestive track. You can live off fiber, but it's the contractions of the muscles that are messed with. I never appreciated this fact since I never took pain meds for more than a day(broken bones and stuff). When I had the jaw surgery and had the meds in the hospital-found out all the fun that comes with them.
I can't imagine having to be on pain meds long term and what that would do to the GI system.
Lorster if you actually read the article you woud have seen that this med is FDA approved for seriously ill people undergoing pallative care. These people are unable exercise and may not be able to handle enough fiber to keep good bowel health. As a nurse with 20 years experience you of course would understand the pain that severe constipation can add to a seriously ill patientI wish this had been available a couple years back when my dad was suffering with a kidney stone and an abdominal aortic aneurysm at the same time. He had gone to the hospital to get the kidney stone blasted, but they discovered the AAA during the pre-op evaluation. Naturally the AAA took precedence and that was repaired right away. They had to leave the kidney stone for about 2 months. They put a stent in the ureter to prevent total blockage, but it still hurt like you wouldn't believe. Plus he had ongoing pain issues from a 4-vertebrae fusion (complete with 2 titanium rods) a couple years before that. For a few months, he was taking lots of opiates. The man eats a lot of fiber but sometimes it's just not enough. In addition he was unable to exercise (like buckeye mentioned) due to his many medical conditions.
In the ideal world people would not need opiates but last time I checked this place ain't Eden.
Oh - and it would have been nice to have this option for a couple of days after hemorrhoid surgery
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