Is opioid therapy possibile without opioid bowel disorder? Evidence for use of combined preparation of oxycodone and naloxone

Cancer pain treatment is aimed to provide the greatest pain relief possible with the fewest number of adverse events using the most convenient mode of administration of a medicine. The use of opioids often results in refractory adverse events, amongst which constipation is the most frequent problem in palliative care. In 2009 the Working Expert Group of the Polish Society of Palliative Medicine (PTMP) drew up the guidelines for prevention and treatment of constipation in palliative care patients, which recommends use of the composed formulation of an opioid and its antagonist. The pharmacological features and selected high quality clinical studies were discussed in this article. It may be concluded that the prolonged release tablets of oxycodone/naloxone pre-sents the progress in providing effective analgesia in moderate to severe pain at limited gastrointestinal adverse events rate.