Skip to main content

Drug Interactions between methylnaltrexone and naltrexone

This report displays the potential drug interactions for the following 2 drugs:

Edit list (add/remove drugs)

Interactions between your drugs

Moderate

naltrexone methylnaltrexone

Applies to: naltrexone and methylnaltrexone

GENERALLY AVOID: Concomitant use of peripherally-acting mu-opioid receptor antagonists, such as methylnaltrexone, naldemedine and naloxegol, with other opioid antagonists may result in additive pharmacologic effects and increased risk of opioid withdrawal. Symptoms consistent with opioid withdrawal including hyperhidrosis, chills, diarrhea, abdominal pain, nausea, vomiting, anxiety, irritability, increased lacrimation, rhinorrhea, and yawning have occurred in patients treated with peripherally-acting mu-opioid receptor antagonists. Patients with disruptions to the blood-brain barrier may be at increased risk.

MANAGEMENT: Concomitant use of peripherally-acting mu-opioid receptor antagonists with other opioid antagonists should generally be avoided.

References

  1. (2008) "Product Information. Relistor (methylnaltrexone)." Wyeth Laboratories
  2. (2014) "Product Information. Movantik (naloxegol)." Astra-Zeneca Pharmaceuticals
  3. (2017) "Product Information. Symproic (naldemedine)." Shionogi USA Inc

Switch to consumer interaction data

Drug and food interactions

Moderate

methylnaltrexone food

Applies to: methylnaltrexone

ADJUST DOSING INTERVAL: Food may reduce the rate and extent of absorption of methylnaltrexone following oral administration. When a single 450 mg oral dose of methylnaltrexone was administered with a high-fat breakfast (approximately 800 to 1000 calories; 60% from fat, 25% from carbohydrate, and 15% from protein) in healthy study subjects, methylnaltrexone peak plasma concentration (Cmax) and systemic exposure (AUC) decreased by 60% and 43%, respectively, while time to reach Cmax delayed by 2 hours.

MANAGEMENT: Oral methylnaltrexone should be taken with water on an empty stomach at least 30 minutes before the first meal of the day.

References

  1. (2008) "Product Information. Relistor (methylnaltrexone)." Wyeth Laboratories

Switch to consumer interaction data

Moderate

naltrexone food

Applies to: naltrexone

GENERALLY AVOID: Coadministration of naltrexone with other agents known to induce hepatotoxicity may potentiate the risk of liver injury. Naltrexone, especially in larger than recommended doses (more than 50 mg/day), has been associated with hepatocellular injury, hepatitis, and elevations in liver transaminases and bilirubin. Other potential causative or contributory etiologies identified include preexisting alcoholic liver disease, hepatitis B and/or C infection, and concomitant usage of other hepatotoxic drugs.

MANAGEMENT: The use of naltrexone with other potentially hepatotoxic agents should be avoided whenever possible (e.g., acetaminophen; alcohol; androgens and anabolic steroids; antituberculous agents; azole antifungal agents; ACE inhibitors; cyclosporine (high dosages); disulfiram; endothelin receptor antagonists; interferons; ketolide and macrolide antibiotics; kinase inhibitors; minocycline; nonsteroidal anti-inflammatory agents; nucleoside reverse transcriptase inhibitors; proteasome inhibitors; retinoids; sulfonamides; tamoxifen; thiazolidinediones; tolvaptan; vincristine; zileuton; anticonvulsants such as carbamazepine, hydantoins, felbamate, and valproic acid; lipid-lowering medications such as fenofibrate, lomitapide, mipomersen, niacin, and statins; herbals and nutritional supplements such as black cohosh, chaparral, comfrey, DHEA, kava, pennyroyal oil, and red yeast rice). Patients should be advised to seek medical attention if they experience potential signs and symptoms of hepatotoxicity such as fever, rash, itching, anorexia, nausea, vomiting, fatigue, malaise, right upper quadrant pain, dark urine, pale stools, and jaundice. Periodic monitoring of hepatic function is advisable.

References

  1. (2001) "Product Information. ReVia (naltrexone)." DuPont Pharmaceuticals

Switch to consumer interaction data

Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

See also

Report options

Loading...
QR code containing a link to this page

Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer