Relistor relieves constipation of palliative care patients on opioids

June 16, 2008

Patients who are taking opioids to relieve their severe pain and who are constipated can now use the new drug Relistor.

Tips to remember: Relistor

The rates of discontinuation due to adverse events during the two studies were comparable between methylnaltrexone-treated patients and the placebo group. The most frequently reported adverse events in the clinical trials were abdominal pain, flatulence, nausea, dizziness, and diarrhea. The manufacturer recommends that patients discontinue therapy if they experience severe or persistent diarrhea during treatment.

"Clinicians should be aware of Relistor's dosing based on weight.? Weight-based dosing presents a unique issue with a palliative care population as a patient's weight can change dramatically in a short period of time," explained Runyon. The recommended dose of methylnaltrexone is 8 mg for patients weighing 38-<62 kg (84-<136 lb) or 12 mg for patients weighing 62-114 kg (136-251 lb). Patients whose weights fall outside of these ranges should be dosed at 0.15 mg/kg. "Additionally, renal dosing is required in patients with severe renal impairment, a condition common among this population," Runyon noted.? The manufacturer recommends a dose reduction by one-half in patients with a creatinine clearance less than 30 mL/min.

Methylnaltrexone will be supplied as 12mg/0.6 mL single-use vials or as a kit containing seven trays. Each tray contains one 12mg/0.6mL single-use vial, one 1-mL syringe with a retractable (27 gauge) needle, and two alcohol swabs. The manufacturer states that the methylnaltrexone vial should not be used more than one time even if there is medication left over. If medication has been drawn into a syringe and the patient is unable to use it right away, the manufacturer states that it should be stored at room temperature for no more than 24 hours.

THE AUTHOR is a writer based in New Jersey.