eISSN: 2081-2833
ISSN: 2081-0016
Medycyna Paliatywna/Palliative Medicine
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vol. 9
Case report

Use of high doses of oxycodone-naloxone combination in the treatment of pain in patients with advanced cancer suffering from opioid bowel dysfunction (OBD) – case reports

Łukasz Pietrzyński, Mateusz Rajchel, Tatiana Pietrzyńska

Online publish date: 2018/02/01
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Introduction: Long-term opioid therapy for severe, chronic cancer pain is associated with a number of side effects. One of the most common is opioid bowel dysfunction (OBD). In this article, the authors present one of the options for treatment of this adverse effect by a combination of opioid analgesic formulation and opioid receptor antagonist (oxycodone and naloxone).

Case reports: The authors present reports of two patients suffering from bowel dysfunction due to long-term, high-dose, opioid chronic cancer-pain treatment. In both cases, strong opioid pharmacotherapy was changed to treatment with a combination of oxycodone and naloxone controlled-release tablets. It resulted in reduction of opioid bowel dysfunction symptoms and an increase in patient’s quality of life.

Conclusions: The presented cases illustrate the efficacy of high-dose oxycodone-naloxone combination therapy in reducing opioid bowel dysfunction while maintaining effective analgesia and good toleration of treatment.

oxycodone, naloxone, chronic pain, constipation

van den Beuken-van Everdingen MH, de Rijke JM, Kessels AG i wsp. Prevalence of pain in patients with cancer: a systematic review of the past 40 years. Ann Oncol 2007; 18: 1437-1449.
Ripamonti CI, Santini D, Maranzano E i wsp. Management of cancer pain: ESMO Clinical Practice Guidelines. Ann Oncol 2012; 23 Suppl 7: vii139-154.
World Health Organization. Cancer Pain Relief (2nd ed). World Health Organization; Geneva 1996.
Lucero M, Von Scheele B, Blackard R i wsp. The incidence and impact of gastrointestinal adverse events (GIAEs) associated with opioid analgesic use: A review of the literature. J Pain 2006; 7: S89.
Sykes NP. The relationship between opioid use and laxative use in terminally ill cancer patients. Palliat Med 1998; 12: 375-382.
Villars P, Dodd M, West C i wsp. Differences in the prevalence and severity of side effects based on type of analgesic prescription in patients with chronic cancer pain. J Pain Symptom Manage 2007; 33: 67-77.
Dennison C, Prasad M, Lloyd A i wsp. The health-related quality of life and economic burden of constipation. Pharmacoeconomics 2005; 23: 461-476.
Penning-van Beest FJ, van den Haak P, Klok RM i wsp. Quality of life in relation to constipation among opioid users. J Med Econ 2010; 13: 129-135.
Dzierżanowski T, Jarosz J. Zaparcia u chorych leczonych opioidami. Onkol Prakt Klin 2009; 5: 47-54.
Villars P, Dodd M, West C i wsp. Differences in the Prevalence and Severity of Side Effects Based on Type of Analgesic Prescription in Patients with Chronic Cancer Pain. J Pain Symptom Manage 2007; 33: 67-77.
Camilleri M. Opioid-induced constipation: challenges and therapeutic opportunities. Am J Gastroenterol 2011; 106: 835-842.
Leppert W, Dzierżanowski T, Ciałkowska-Rysz A i wsp. Postępowanie u chorych z zaparciem stolca w medycynie paliatywnej – zalecenia Grupy Roboczej Ekspertów Polskiego Towarzystwa Medycyny Paliatywnej. Med Paliat 2009; 1: 1-8.
Smith K, Hopp M, Anderson BJ i wsp. Single and multiple dose pharmacokinetics evaluation of pxycodone and naloxone in an opioid agonist/antagonist prolong – release combination in heatlhy adult volunteers. Clin Therap 2008; 30: 2051-2068.
Löwenstein O, Leyendecker P, Lux EA i wsp. Efficacy and safety of combined prolonged-release oxycodone and naloxone in the management of moderate/severe chronic non-malignant pain: results of a prospectively designed pooled analysis of two randomized, double-blind clinical trials. BMC Clin Pharmacol 2010; 10: 12.
Ahmedzai SH, Nauck F, Bar-Sela G i wsp. A randomized, double-blind, active-controlled, double-dummy, parallel-group study to determine the safety and efficacy of oxycodone/naloxone prolonged-release tablets in patients with moderate/severe, chronic cancer pain. Palliat Med 2012; 26: 50-60.
Amato F, Ceniti S, Mameli S i wsp. High dosage of a fixed combination oxycodone/naloxone prolonged release: efficacy and tolerability in patients with chronic cancer pain. Support Care Cancer 2017; 25: 3051-3058.
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