Movantik (Naloxegol)
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Fact Table
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| Formula | C34H51NO11 |
| License | FDA and EMA approved (2014) |
| Bioavailability | ~60% (oral; reduced by high-fat meals) |
| Legal status | Prescription only (Rx) |
| Chemical Name | (5a,6a)-17-allyl-6-(hydroxy)-4,5-epoxy-3,14-dihydroxymorphinan-17-carboxylic acid polyethylene glycol ether |
| Elimination half-life | ~6–11 hours |
| Dosage (Strength) | 12.5 mg and 25 mg oral tablets (once daily on empty stomach) |
| Pregnancy | Category C – Use only if clearly needed |
| Brands | Movantik (originally AstraZeneca; now marketed by Karo Pharma), generics available |
| Protein binding | ~4.2% |
| PubChem CID | 71239263 |
| MedlinePlus | a614036 |
| ChEBI | 85031 |
| ATC code | A06AH04 |
| DrugBank | DB09076 |
| KEGG | D10440 |
| Routes of administration | By mouth (oral tablets) |
Movantik (naloxegol) is a medication used to treat constipation caused by long-term opioid use in adults with chronic, non-cancer pain. It’s an opioid antagonist that works by blocking opioid effects in the digestive system. Movantik helps improve regular bowel movements when standard laxatives do not work well. It works without interfering with the pain-relieving effects of opioids.
Directions
Movantik is taken by mouth once daily on an empty stomach, at least one hour before the first meal of the day or two hours after eating. The standard dosage is 25 mg, though the dose may be reduced to 12.5 mg if patients can't tolerate the higher strength or if they're taking certain medications that may interact with naloxegol. Swallow the tablet whole with water, and do not cut, crush, or chew it.
Ingredients
The active ingredient in Movantik is naloxegol.
Cautions
Before using this medication, you may want to consult a healthcare provider about the following:
- Any existing health conditions
- Any allergies
- A list of all medications currently being taken
Movantik can trigger symptoms similar to opioid withdrawal, such as sweating, chills, diarrhea, stomach pain, anxiety, irritability, and yawning, even though it is taken for constipation.
People taking methadone for pain may be more likely to experience stomach-related side effects or withdrawal-like symptoms while using Movantik. Patients with conditions that affect the blood and brain barrier may be at higher risk for opioid withdrawal symptoms or reduced pain control.
Rare but serious cases of gastrointestinal perforation, including fatal cases, have occurred in people using Movantik, especially those with underlying bowel conditions or recent gastrointestinal surgery.
Contraindications
Avoid taking or using this medication if any of the following apply:
- Known or suspected gastrointestinal obstruction or patients at increased risk of recurrent obstruction
- History of a serious or severe hypersensitivity reaction to naloxegol or any of its ingredients
- Concomitant use of strong CYP3A4 inhibitors such as ketoconazole, itraconazole, or clarithromycin
Side Effects
Common side effects of Movantik include:
- Stomach (abdominal) pain
- Diarrhea
- Nausea
- Gas
- Vomiting
- Headache
These side effects are generally related to increased bowel activity and may occur shortly after starting Movantik. Abdominal pain and diarrhea are the most commonly reported and are usually mild. Some people may notice symptoms within the first few days of treatment.
More serious side effects can include opioid withdrawal symptoms such as sweating, chills, anxiety, irritability, yawning, and diarrhea. Movantik may also cause severe abdominal pain, severe diarrhea, or both, which can require hospitalization.
In rare cases, a tear in the stomach or intestinal wall (perforation) can occur. Stop taking Movantik and contact a healthcare provider if you develop severe or worsening stomach pain, persistent diarrhea, or signs of opioid withdrawal.
Frequently Asked Questions about Movantik (Naloxegol)
What is Movantik (naloxegol) used for?
Movantik is a prescription medication used to treat opioid-induced constipation in adults who have chronic, non-cancer pain and are taking opioid pain medicines regularly.
How does Movantik work?
Movantik works by blocking opioid effects in the gut without affecting pain relief in the brain, allowing bowel function to improve while opioid pain control is maintained.
How should Movantik be taken?
Movantik is taken once daily on an empty stomach, usually in the morning, at least one hour before the first meal of the day.
How long does it take for Movantik to work?
Many people notice improved bowel movements within the first few days of treatment, although response time can vary between individuals.
What are the most common side effects of Movantik?
Common side effects include abdominal pain, diarrhea, nausea, gas, vomiting, and headache, especially during the first few days of treatment.
Can Movantik cause opioid withdrawal symptoms?
In some cases, Movantik may cause symptoms similar to opioid withdrawal, such as sweating, chills, anxiety, irritability, or abdominal cramping.
Who should not take Movantik?
Movantik should not be used by people with known or suspected gastrointestinal blockage or those at high risk for bowel perforation.
Does Movantik interact with other medications?
Movantik can interact with certain medications, especially strong CYP3A4 inhibitors or inducers, which may affect how the drug works in the body.
Can Movantik be used long-term?
Movantik may be used long-term if effective and well tolerated, but ongoing use should be regularly evaluated by a healthcare professional.
What should I do if I miss a dose of Movantik?
If a dose is missed, it should be skipped and the next dose taken at the regular time the following day without taking an extra dose.
