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Movantik
Movantik, the brand name for naloxegol, is a medication used to treat opioid-induced constipation (OIC) in adults with chronic pain who are using opioids for pain management. Opioids can cause constipation by reducing gastrointestinal motility, and Movantik works by counteracting this effect. Naloxegol is an opioid antagonist that specifically targets receptors in the gastrointestinal tract, helping to restore normal bowel movements without affecting the pain-relieving properties of opioids.
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Frequently Asked Questions
How long does it take for Movantik to work?
Movantik typically works within 6 to 12 hours after taking it. For some people, relief may occur sooner.
Can I take Movantik if I am still taking opioids?
Yes, Movantik is designed to treat constipation while you continue taking opioid medications. It specifically targets opioid-induced constipation without affecting the pain-relieving effects of opioids.
What should I do if I experience severe diarrhea while taking Movantik?
If you experience severe or persistent diarrhea, stop taking Movantik and contact your healthcare provider immediately, as you may be at risk for dehydration.
Can I take Movantik with food?
Movantik is best taken on an empty stomach for optimal absorption. Take it 1 hour before your first meal of the day or 2 hours after eating.
Can I stop taking Movantik if my constipation improves?
Consult your doctor before discontinuing Movantik. While it is designed for ongoing management of opioid-induced constipation, your treatment plan may vary depending on your response to the medication and opioid use.
Comprehensive Drug Guide
How Does Movantik Work?
Movantik works by blocking mu-opioid receptors in the gastrointestinal tract, preventing opioids from binding to these receptors and slowing bowel movements. This action helps to restore normal bowel function in patients experiencing constipation due to opioid use. Movantik does not cross the blood-brain barrier, meaning it does not interfere with the pain-relieving effects of opioids on the central nervous system.
Common Dosages
- 12.5 mg and 25 mg oral tablets
The typical starting dose is 25 mg once daily, but for patients who cannot tolerate this dose, a 12.5 mg daily dose may be used.
Typical Dosing
- For opioid-induced constipation: The usual starting dose is 25 mg once daily, taken on an empty stomach at least 1 hour before the first meal of the day or 2 hours after a meal. If side effects occur, the dose can be reduced to 12.5 mg once daily.
Typical Dosing
FDA Approved Indications
- The treatment of opioid-induced constipation (OIC) in adults with chronic non-cancer pain who are taking opioid medications for pain relief.
Who Shouldn't Take Movantik?
- Gastrointestinal obstruction (blocked intestine) or a history of recurrent obstructions.
- Known hypersensitivity or allergy to naloxegol or any of the components of the formulation.
- Use of strong CYP3A4 inhibitors, such as clarithromycin or ketoconazole, as these can significantly increase the levels of naloxegol in the blood and lead to severe side effects.
Advice From The Pharmacist
- Movantik should be taken on an empty stomach for best absorption, either 1 hour before breakfast or 2 hours after eating.
- If you miss a dose, take it as soon as you remember. If it is close to the next dose, skip the missed dose and continue with your regular schedule.
- Avoid taking grapefruit or grapefruit juice while on Movantik, as this can increase the risk of side effects by affecting the metabolism of the medication.
- Ensure you drink plenty of water and maintain a high-fiber diet to help alleviate constipation.
Side Effects of Movantik
Common Side Effects
- Abdominal pain
- Diarrhea
- Nausea
- Flatulence (gas)
- Headache
Uncommon/Severe Side Effects
- Severe abdominal pain or worsening of constipation (could indicate a bowel obstruction)
- Severe diarrhea leading to dehydration
- Allergic reactions such as rash, itching, or swelling
Risks and Warnings of Movantik
- Gastrointestinal Perforation: Movantik may increase the risk of gastrointestinal perforation in patients with conditions that affect the structure or integrity of the gastrointestinal wall (e.g., Crohn’s disease, diverticulitis). If you experience severe abdominal pain or signs of perforation, seek medical attention immediately.
- Severe Diarrhea: Diarrhea is a common side effect of Movantik and can sometimes be severe. If you experience persistent or severe diarrhea, contact your doctor to avoid dehydration.
- Drug Interactions: Strong inhibitors of CYP3A4, such as clarithromycin or ketoconazole, can increase the levels of Movantik and lead to severe side effects. Use caution and avoid these medications unless directed by your doctor.
Interactions with Movantik
Common Drug Interactions
- Strong CYP3A4 inhibitors (e.g., clarithromycin, ketoconazole): These medications can significantly increase the levels of Movantik in your blood, leading to an increased risk of side effects like severe abdominal pain and diarrhea.
- Grapefruit juice: Grapefruit and grapefruit juice can increase the amount of naloxegol in your blood, leading to side effects.
- CYP3A4 inducers (e.g., rifampin, St. John's wort): These drugs can reduce the effectiveness of Movantik by lowering its levels in the body.
- Other laxatives: Using additional laxatives may increase the risk of severe diarrhea. Consult your doctor before adding other constipation treatments.
Alternatives to Movantik
- Relistor (methylnaltrexone): Another peripherally acting mu-opioid receptor antagonist used to treat opioid-induced constipation.
- Amitiza (lubiprostone): A chloride channel activator used to treat opioid-induced constipation and chronic idiopathic constipation.
- Senna or bisacodyl: Over-the-counter stimulant laxatives used to treat constipation, though not specific for opioid-induced constipation.
- MiraLAX (polyethylene glycol 3350): An osmotic laxative used to treat occasional constipation.
