Medical Information

Naldemedine, as an opioid receptor antagonist, is mainly used to treat constipation caused by opioid drugs. Its side effects are mainly gastrointestinal reactions, and special attention should be paid to medication contraindications, special population adjustments, and potential drug interactions to ensure medication safety and effectiveness.

1. Common side effects

(1) Abdominal pain: The incidence rate is about 11%, usually mild to moderate, and it often occurs in the early stages of medication.

(2) Diarrhea: The incidence rate is about 7%, and in severe cases, it may lead to dehydration, requiring timely fluid replacement.

(3) Nausea and vomiting: The incidence rate is about 5%, and it is recommended to take it after meals to alleviate symptoms.

(4) Gastrointestinal bloating: The incidence rate is about 3%, and it usually resolves on its own.

2. Serious adverse reactions

(1) Opioid withdrawal symptoms: sweating, anxiety, palpitations, etc. may occur, and medication should be stopped immediately and medical attention sought.

(2) Gastrointestinal perforation: rare but severe, especially in patients with a history of digestive disorders who have an increased risk.

(3) Allergic reactions: rash, angioedema, etc., requiring permanent discontinuation of medication and anti allergic treatment.

3. Medication precautions

(1) Taboo population: Known or suspected intestinal obstruction patients, and those allergic to active ingredients are contraindicated.

(2) Liver dysfunction: Mild to moderate cases do not require dose adjustment, and severe patients should be used with caution and closely monitored.

(3) Renal insufficiency: When creatinine clearance rate is less than 30mL/min, it should be reduced to once every other day.

(4) Drug interactions: Avoid combination with potent CYP3A4 inhibitors as it may increase blood drug concentrations.

4. Medication for special populations

(1) Pregnant women: Animal tests have shown fetal toxicity and should only be used when the benefits outweigh the risks.

(2) Breastfeeding period: Medications can be secreted into breast milk. It is recommended to suspend breastfeeding or use alternative therapies.

(3) Elderly: No need to adjust dosage, but need to strengthen adverse reaction monitoring.

5. Medication management recommendations

(1) Fixed time medication: taken at the same time every day, without considering bowel movements.

(2) Efficacy evaluation: Evaluate the improvement of symptoms within 4 weeks of medication, and if ineffective, re evaluate the plan.

(3) Long term medication: Regularly review liver and kidney function, and evaluate the necessity of continuing medication every 3-6 months.