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Meeting the Challenge of Constipation From Opioid Use

If you or a loved one is living with an advanced illness such as cancer, heart and blood vessel problems (eg, cardiovascular disease), lung problems (eg, emphysema or COPD), or Alzheimer’s disease, the doctor may have prescribed an opioid medication.1

Opioids can help alleviate pain. But many patients receiving opioid treatment will probably develop constipation.2 Your healthcare provider may call this opioid-induced constipation, or OIC. If left untreated, this type of constipation can cause you stomach pain and vomiting, and it may even cause your stools to become large or hard enough to become stuck.1 To avoid side effects such as these, some people may decrease their pain medication (opioids) or even stop taking it—even though they may not get as much relief from pain.3

Only RELISTOR treats the source of constipation from opioid use

RELISTOR works by precisely treating the source of opioid-induced constipation without affecting the pain relief you get from opioid treatment. You and your doctor can continue to manage your pain with opioids to give you relief.

When laxative therapy is not enough to give you relief from constipation from opioid use, you may want to ask your doctor about RELISTOR.4

Important Safety Information

*RELISTOR® is a prescription medicine used to treat constipation that is caused by prescription pain medicines, called opioids, in patients receiving supportive care for their advanced illness, when other medicines for constipation, called laxatives, have not worked well enough.

Do not take RELISTOR if you have or may have a blockage in your intestines called a mechanical bowel obstruction. Symptoms of this blockage are vomiting, stomach pain, and swelling of your abdomen. Talk to your healthcare provider if you have any of these symptoms before taking RELISTOR. If you get diarrhea that is severe or does not stop while taking RELISTOR, stop taking RELISTOR and call your healthcare provider.

Tell your healthcare provider if you have kidney problems, are pregnant, plan to become pregnant, are breast-feeding, or plan to breast feed. It is not known if RELISTOR can harm your unborn baby or passes into your breast milk.

Use of RELISTOR has not been studied in patients with catheters in their abdominal wall. Safety and efficacy of RELISTOR have not been established in children.

Rare cases of holes or openings in your gastrointestinal (GI) tract have been reported in advanced illness patients with conditions that may be associated with localized or widely spread reduction of structural integrity in the wall of the GI tract (i.e., cancer, peptic ulcer, Ogilvie’s syndrome). These holes or openings have involved varying regions of the GI tract (e.g., stomach, intestines).

Use RELISTOR with caution if you have a known or suspected wound or injury to the GI tract. If you get abdominal pain that is severe or will not go away or nausea or vomiting that is new or worse, stop taking RELISTOR and call your healthcare provider.

Common side effects of RELISTOR include: abdominal (stomach) pain, gas, nausea, dizziness, diarrhea, and sweating. These are not all of the possible side effects of RELISTOR. Tell your healthcare provider if you have any side effect that bothers you or does not go away.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/safety/medwatch or call 1-800-FDA-1088.

Complete Prescribing Information

References: 1. RELISTOR® (methylnaltrexone bromide) Prescribing Information, Salix Pharmaceuticals, Inc. 2. Michna E, Blonsky ER, Schulma S, et al. Subcutaneous methylnaltrexone for treatment of opioid-induced constipation in patients with chronic, nonmalignant pain: a randomized controlled study. J Pain. 2011;12(5):554-562. 1. Emanuel EJ, Emanuel LL. Palliative and end-of-life care. In: Kasper DL, Braunwald E, Fauci AS, et al, eds. Harrison’s Principles of Internal Medicine. 16th ed. New York, NY: McGraw-Hill; 2005:53-66. 2. Thorpe DM. Management of opioid-induced constipation. Curr Pain Headache Rep. 2001;5(3):237-240. 3. Panchal SJ, Muller-Schwefe P, Wurzelman JI. Opioid-induced bowel dysfunction: prevalence, pathophysiology and burden. Int J Clin Pract. 2007;61(7):1181-1187. 4. RELISTOR® (methylnaltrexone bromide) Prescribing Information, Salix Pharmaceuticals, Inc.

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