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Symproic
Symproic (generic name: naldemedine) is an oral medication used to treat opioid-induced constipation (OIC) in adults with chronic pain not caused by cancer. Naldemedine is a peripherally acting mu-opioid receptor antagonist (PAMORA), which works by blocking opioid effects in the gut without affecting pain relief in the central nervous system.
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Frequently Asked Questions
How long does it take for Symproic to work?
Symproic typically starts working within a few hours to a few days after starting treatment. Patients usually experience relief from constipation within the first few days of therapy.
Can Symproic be used long-term?
Yes, Symproic is intended for long-term use in patients who require opioid pain medications for chronic pain. It is important to follow your healthcare provider’s instructions for continued use.
What should I do if I miss a dose of Symproic?
If you miss a dose, take it as soon as you remember, unless it is close to the time of your next dose. Do not double up to make up for a missed dose.
Can Symproic cause opioid withdrawal?
While Symproic is designed to work in the gut and avoid systemic effects, there is a small risk of opioid withdrawal symptoms in some patients. Contact your healthcare provider if you experience symptoms like chills, sweating, or irritability.
Can Symproic be taken with food?
Yes, Symproic can be taken with or without food. If you experience stomach upset, taking it with food may help.
Does Symproic interfere with opioid pain relief?
No, Symproic is designed to block opioid receptors in the gut without affecting opioid receptors in the brain, so it does not interfere with pain relief provided by opioids.
Comprehensive Drug Guide
How Does Symproic Work?
Naldemedine works by blocking opioid receptors in the gastrointestinal tract. While opioids effectively relieve pain, they often cause constipation by binding to mu-opioid receptors in the gut, slowing down bowel movement. Symproic counteracts this effect without interfering with the pain-relieving actions of opioids in the brain.
Common Dosages
- 0.2 mg oral tablet
Typical Dosing
- The typical dose for opioid-induced constipation is 0.2 mg taken once daily with or without food.
Typical Dosing
FDA Approved Indications
- Treatment of opioid-induced constipation (OIC) in adults with chronic non-cancer pain.
Who Shouldn't Take Symproic?
- Known hypersensitivity to naldemedine or any of its components.
- Gastrointestinal obstruction or patients at risk of bowel perforation.
Advice From The Pharmacist
- Take Symproic once daily, with or without food.
- Monitor bowel movement patterns: Symproic should help normalize bowel movements within a few days. Contact your healthcare provider if constipation persists or if you experience severe diarrhea.
- Continue opioid pain medications as prescribed, but discuss any changes in your pain regimen with your healthcare provider, as this may affect the effectiveness of Symproic.
- Avoid use in cancer-related pain: Symproic is not recommended for patients with opioid use for cancer-related pain, as safety in this population has not been established.
Side Effects of Symproic
Common Side Effects
- Abdominal pain
- Diarrhea
- Nausea
- Vomiting
- Flatulence
Uncommon/Severe Side Effects
- Severe abdominal pain or symptoms of bowel perforation, which require immediate medical attention.
- Severe diarrhea, which could lead to dehydration or electrolyte imbalances if left untreated.
Risks and Warnings of Symproic
- Gastrointestinal Perforation: Patients with a history of gastrointestinal issues, including bowel obstructions, ulcers, or Crohn’s disease, should be monitored closely. Symproic may increase the risk of bowel perforation in patients with these conditions.
- Severe Diarrhea: While Symproic is intended to relieve constipation, it may cause severe diarrhea in some cases, potentially leading to dehydration or electrolyte imbalances.
- Opioid Withdrawal: Although Symproic primarily acts in the gut, there is a small risk of opioid withdrawal symptoms in certain patients. Symptoms include chills, sweating, irritability, and anxiety. Contact your healthcare provider if you experience these symptoms.
Interactions with Symproic
Common Drug Interactions
- Opioids: Symproic is specifically used in patients taking opioids for chronic pain. However, changes in opioid use may impact the effectiveness of Symproic. Notify your healthcare provider of any changes in your opioid regimen.
- Strong CYP3A inducers (e.g., rifampin, carbamazepine): These medications can decrease the levels of Symproic, making it less effective.
- Strong CYP3A inhibitors (e.g., ketoconazole, clarithromycin): These medications can increase the levels of Symproic in the body, leading to increased risk of side effects.
Alternatives to Symproic
- Movantik (Naloxegol): Another PAMORA used to treat opioid-induced constipation.
- Amitiza (Lubiprostone): A medication used to treat chronic idiopathic constipation, opioid-induced constipation, and irritable bowel syndrome (IBS).
- Relistor (Methylnaltrexone): A PAMORA used to treat opioid-induced constipation in patients with advanced illness or chronic pain.
