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Methylnaltrexone Disease Interactions

There are 3 disease interactions with methylnaltrexone:

Major

Peripheral Opioid Receptor Antagonists (Includes Methylnaltrexone) ↔ Intestinal Obstruction

Severe Potential Hazard, Moderate plausibility

Applies to: Gastrointestinal Obstruction, Diverticulitis, Peptic Ulcer, Inflammatory Bowel Disease

Peripheral opioid receptor antagonists such as methylnaltrexone and naloxegol are contraindicated in patients with known or suspected gastrointestinal obstruction, and in patients at increased risk of recurrent obstruction, due to the potential for GI perforation. Cases of GI perforation have been reported in patients with opioid-induced constipation and advanced illness with conditions that may be associated with localized or diffuse reduction of structure integrity in the wall of the GI tract such as peptic ulcer, diverticular disease, Crohn's disease, infiltrative GI tract malignancies or peritoneal metastases. The overall risk- benefit profile should be carefully evaluated before using these agents in patients with these conditions.

Moderate

Methylnaltrexone (Includes Methylnaltrexone) ↔ Hepatic Impairment

Moderate Potential Hazard, Moderate plausibility

Applies to: Liver Disease

Studies have shown a significant increase in systemic exposure of methylnaltrexone in patients with moderate and severe hepatic impairment, compared to subjects with normal hepatic function. A dosage reduction is recommended in these patients. No dose adjustment is needed in patients with mild hepatic impairment.

Moderate

Peripheral Opioid Receptor Antagonists (Includes Methylnaltrexone) ↔ Renal Impairment

Moderate Potential Hazard, Moderate plausibility

Applies to: Renal Dysfunction

Patients with moderate, severe and end-stage renal disease have shown to exhibit markedly higher systemic exposure to peripheral opioid receptor antagonists such as methylnaltrexone and naloxegol, compared to subjects with normal renal function. A dose reduction is recommended for these patients. No dosage adjustment is needed in patients with mild renal impairment.

Drug Interaction Classification

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.
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 information available.

Do not stop taking any medications without consulting your healthcare provider.

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