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Management of Opioid-Induced Constipation in Patients with Malignancy

  • Jose M. Garcia
    Affiliations
    Department of Medicine, Division of Gerontology & Geriatric Medicine, University of Washington School of Medicine, Seattle

    Geriatric Research, Education and Clinical Center, VA Puget Sound Health Care System, Seattle, Wash
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  • Tatyana A. Shamliyan
    Correspondence
    Requests for reprints should be addressed to Tatyana A. Shamliyan, MD, MS, Quality Assurance, Evidence-Based Medicine Center, Elsevier, 1600 JFK Blvd, Philadelphia, PA 19103.
    Affiliations
    Quality Assurance, Evidence-Based Medicine Center, Elsevier, Philadelphia, Pa
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      Children and adults with malignancies often require opioids for pain, which commonly cause constipation. The resulting effect on quality of life can be significant.
      • Thomas J.R.
      • Cooney G.A.
      • Slatkin N.E.
      Palliative care and pain: new strategies for managing opioid bowel dysfunction.
      As no drugs have been approved for patients with malignancies and opioid-induced constipation, several drugs approved for opioid-induced constipation in noncancer pain (including opioid antagonists such as prolonged-release naloxone combined with oxycodone, methylnaltrexone, naloxegol, naldemedine, or alvimopan) are chosen when laxatives fail.
      • Ahmedzai S.H.
      • Boland J.W.
      Constipation: opioid antagonists in people prescribed opioids.
      The goal of this rapid review was to determine the effectiveness of off-label agents in treating opioid-induced constipation, specifically in patients with malignancies.
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