Comparative Pharmacology
Head-to-head clinical analysis: NALOXEGOL versus NALTREXONE HYDROCHLORIDE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: NALOXEGOL versus NALTREXONE HYDROCHLORIDE.
NALOXEGOL vs NALTREXONE HYDROCHLORIDE
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Naloxegol is a PEGylated derivative of naloxone, a mu-opioid receptor antagonist. As a peripherally acting mu-opioid receptor antagonist (PAMORA), it binds to and inhibits mu-opioid receptors in the gastrointestinal tract, reducing opioid-induced constipation without crossing the blood-brain barrier to affect central analgesia.
Competitive antagonist at mu, kappa, and delta opioid receptors, with highest affinity for mu receptors. Also acts as an antagonist at the toll-like receptor 4 (TLR4).
25 mg orally once daily in the morning, with or without food; may increase to 50 mg once daily if tolerated and needed.
50 mg orally once daily for opioid dependence; 25 mg orally once daily for alcohol dependence, may increase to 50 mg after one week.
None Documented
None Documented
Clinical Note
moderateNaloxegol + Digoxin
"The serum concentration of Digoxin can be increased when it is combined with Naloxegol."
Clinical Note
moderateNaloxegol + Levofloxacin
"The serum concentration of Levofloxacin can be increased when it is combined with Naloxegol."
Clinical Note
moderateNaloxegol + Prednisone
"The serum concentration of Prednisone can be increased when it is combined with Naloxegol."
Clinical Note
moderateNaloxegol + Hydrocortisone
Terminal elimination half-life is approximately 11-13 hours in patients with normal renal function; may be prolonged in severe renal impairment.
Terminal elimination half-life: ~4 hours for naltrexone; its major active metabolite, 6-β-naltrexol, has a half-life of ~13 hours. The longer half-life of the metabolite contributes to sustained receptor blockade.
Primarily fecal (approximately 66%) and renal (approximately 33%) as unchanged drug; <1% as metabolites.
Renal: primarily as unchanged drug (<2%) and metabolites (mainly 6-β-naltrexol, glucuronide conjugates); approximately 60% of dose excreted in urine (including metabolites) and about 30% in feces via biliary excretion.
Category C
Category A/B
Opioid Antagonist
Opioid Antagonist
"The serum concentration of Hydrocortisone can be increased when it is combined with Naloxegol."