Derm: ↑ sweating.
GI: abdominal pain, flatulence, nausea, diarrhea.
Neuro: dizziness.
Misc: opioid withdrawal.
Opioid-Induced Constipation in Patients with Advanced Illness
- SC (Adults >114 kg): 0.15 mg/kg every other day, as needed (not to exceed 1 dose every 24 hr).
Renal Impairment
(Adults): CCr <60 mL/min: use 50% of recommended dose based on weight.
- SC (Adults 62–114 kg): 12 mg every other day, as needed (not to exceed 1 dose every 24 hr).
- SC (Adults 38–62 kg): 8 mg every other day, as needed (not to exceed 1 dose every 24 hr).
- SC (Adults <38 kg): 0.15 mg/kg every other day, as needed (not to exceed 1 dose every 24 hr).
Renal Impairment
- SC (Adults >114 kg): CCr <60 mL/min: 0.075 mg/kg every other day, as needed (not to exceed 1 dose every 24 hr).
Renal Impairment
- SC (Adults 62–114 kg): CCr <60 mL/min: 6 mg every other day, as needed (not to exceed 1 dose every 24 hr).
Renal Impairment
- SC (Adults 38–<62 kg): CCr <60 mL/min: 4 mg every other day, as needed (not to exceed 1 dose every 24 hr).
Renal Impairment
- SC (Adults <38 kg): CCr <60 mL/min: 0.15 mg/kg every other day, as needed (not to exceed 1 dose every 24 hr).
Opioid-Induced Constipation in Patients with Non-Cancer Pain
- SC (Adults): 12 mg once daily.
- PO (Adults): 450 mg once daily.
Renal Impairment
- SC (Adults): CCr <60 mL/min: 6 mg once daily.
Renal Impairment
- PO (Adults): CCr <60 mL/min: 150 mg once daily.
Hepatic Impairment
- SC (Adults >114 kg): Severe hepatic impairment: 0.075 mg/kg once daily.
Hepatic Impairment
- SC (Adults 62–114 kg): Severe hepatic impairment: 6 mg once daily.
Hepatic Impairment
- SC (Adults 38–<62 kg): Severe hepatic impairment: 4 mg once daily.
Hepatic Impairment
- SC (Adults <38 kg): Severe hepatic impairment: 0.075 mg/kg once daily.
Hepatic Impairment
- PO (Adults): Moderate or severe hepatic impairment: 150 mg once daily.
Therapeutic Classification: laxatives
Pharmacologic Classification: opioid antagonists
Absorption: Rapidly absorbed after SUBQ and oral administration; oral absorption delayed by high-fat meal by 2 hr.
Distribution: Moderate tissue distribution, does not cross the blood-brain barrier.
Metabolism/Excretion: Some metabolism; 85% excreted unchanged in urine.
Half-life: 15 hr (oral).