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A preliminary study of the effect of naldemedine tosylate on opioid-induced nausea and vomiting

  • Junya SatoEmail author
  • Rei Tanaka
  • Hiroshi Ishikawa
  • Tsutomu Suzuki
  • Michihiro Shino
Original Article
  • 97 Downloads

Abstract

Background

Opioid-induced nausea and vomiting (OINV) is induced by opioid receptor stimulation of chemoreceptor trigger zones and vestibular apparatus by opioids. Naldemedine tosylate (NALD) is a peripherally acting non-selective opioid receptor antagonist, used for opioid-induced constipation (OIC). However, the effect of NALD on OINV had not yet been investigated. In this retrospective study, we investigated the secondary effects of NALD on OINV.

Method

Patients who received sustained-release oral morphine or oxycodone preparation were enrolled in the study. Patients who used NALD (0.2 mg) within 2 days of opioid initiation were included in the analysis. The use of rescue antiemetics within 7 days from opioid initiation was defined as OINV expression. Patients who received antiemetics before opioid initiation or those who received chemotherapy around 4 days from opioid initiation were excluded from the analysis. The incidence of OINV was compared between patients who used and did not use NALD.

Results

In total, 982 patients were included in the study. Among them, 89 patients who received NALD and 614 patients who did not receive NALD were analyzed. The incidence of OINV in patients who used NALD was significantly lower than that of patients who did not use NALD (36.0% vs. 47.2%, p = 0.046).

Conclusion

For patients with constipation, using NALD at an early stage of opioid initiation might have secondary benefits, such as relief from OINV, besides improvement of OIC. To confirm the effectiveness of NALD for OINV, the symptom grade and intensity during concomitant use of NALD should be observed in a future study.

Keywords

Naldemedine tosylate Opioid-induced nausea and vomiting Opioid-induced constipation Peripherally acting morphine antagonists Antiemetics 

Notes

Compliance with ethical standards

This study was performed in accordance with the Helsinki standard and approved by the Ethical Review Board of the Shizuoka Cancer Center (30-J90-30-1-3S).

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of PharmacyShizuoka Cancer CenterNagaizumi-cho, Sunto-gunJapan
  2. 2.Addiction Research LaboratoryHoshi UniversityTokyoJapan

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