Comparative Pharmacology
Head-to-head clinical analysis: NALOXEGOL versus VIVITROL.
Peer-Reviewed Evidence
Head-to-head clinical analysis: NALOXEGOL versus VIVITROL.
NALOXEGOL vs VIVITROL
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.
Naltrexone, as the active moiety of VIVITROL, is a competitive antagonist at opioid receptors (mu, kappa, and delta), blocking the euphoric effects of alcohol and opioids. It also modulates the hypothalamic-pituitary-adrenal axis and dopamine pathways implicated in alcohol craving.
25 mg orally once daily in the morning, with or without food; may increase to 50 mg once daily if tolerated and needed.
380 mg intramuscularly every 4 weeks, alternating gluteal injections.
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.
Naltrexone terminal half-life: 4-13 hours (mean 9.7 h). Active metabolite 6-β-naltrexol: 10-15 hours. Clinically, naltrexone concentrations are sustained for ~30 days after IM injection.
Primarily fecal (approximately 66%) and renal (approximately 33%) as unchanged drug; <1% as metabolites.
Naltrexol (6-β-naltrexol) and naltrexone: primarily renal (60-70% as metabolites, <5% as unchanged drug); biliary/fecal (minor route, <10%).
Category C
Category C
Opioid Antagonist
Opioid Antagonist
"The serum concentration of Hydrocortisone can be increased when it is combined with Naloxegol."