Naldemedine for the management of opioid-induced constipation in patients with cancer pain: A narrative review.

The prevalence of chronic pain in patients with cancer ranges from 23% to 36%. Opioids are effective in relieving severe pain; however, they also cause side effects, such as physical dependence, tolerance, sedation, and hyperalgesia. The prevalence of opioid-induced constipation (OIC) increases with a rise in the duration of opioid analgesic use. When OIC develops, opioid treatment satisfaction decreases, and many patients tend to discontinue treatment. Naldemedine is an opioid receptor antagonist that improves OIC in patients with cancer by acting on the gastrointestinal tract. It does not inhibit opioid analgesia or cause withdrawal symptoms. Therefore, this review aims to provide a comprehensive overview of OIC management in patients with cancer pain, with a focus on naldemedine. This narrative review also reports recent findings on the efficacy and safety of naldemedine and provides comparisons based on cancer type. A comprehensive search was conducted to identify primary articles on the clinical effectiveness and adverse effects of naldemedine in patients with cancer with OIC. Naldemedine is a well-tolerated and effective drug for treatment of OIC in patients with cancer, and its use is expected to increase.