Naldemedine Disease Interactions

The use of naldemedine should be avoided in patients with severe hepatic impairment. No dose adjustment is required in patients with mild or moderate hepatic impairment.

Peripheral opioid receptor antagonists are contraindicated in patients with known or suspected gastrointestinal obstruction, and in patients at increased risk of recurrent obstruction, due to the potential for gastrointestinal perforation. Cases of gastrointestinal 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. It is recommended to monitor for the development of severe, persistent, or worsening abdominal pain and to discontinue treatment in patients who develop symptoms. The overall risk- benefit profile should be carefully evaluated before using these agents in patients with these conditions.

Naldemedine is not removed from the blood by hemodialysis. Plasma concentrations of naldemedine in subjects with ESRD requiring hemodialysis were similar when the drug was administered either pre- or post-hemodialysis.