As prostate cancer progresses so does the pain we will suffer. In the normal course we will also progress on to different drugs to help control the pain. Opioids are one of the most common of these drugs prescribed to help control pain.
As with all drugs opioids have many side effects. One of the most common side effect and one of the side effects that significantly impair our quality of life is severe constipation.
Recently, the U.S. Food and Drug Administration (FDA) approved a new drug, Movantik (naloxegol), an oral treatment for opioid-induced constipation in adults with chronic non-cancer pain.
Opioids reduce the gastrointestinal tract’s motility, making bowel movements difficult and causing patients taking them to strain, have hard or lumpy stools or experience a sensation of incomplete evacuation. Movantik can now be used to decrease the constipating effects of opioids, but technically only in pain that is not caused by cancer.
“Supportive care products such as Movantik can lessen the constipating side effects of opioids,” said Julie Beitz, M.D., director of the Office of Drug Evaluation III in the FDA’s Center for Drug Evaluation and Research.
The safety and effectiveness of Movantik was established in two clinical trials of 1,352 participants who had taken opioids for at least four weeks for non-cancer related pain and had opioid-induced constipation.
Common side effects of Movantik include abdominal pain, diarrhea, headache and the experience of excessive gas in the stomach or intestinal area (flatulence).
The FDA is requiring a post-marketing study to further evaluate the potential risk of cardiovascular adverse events in patients taking Movantik.
AstraZeneca Pharmaceuticals LP, based in Wilmington, Delaware, distributes Movantik.
So, what about using Movanik (you have to like that name) for opioid use resulting in cancer pain? We don’t know if it will work and we do not know if it is safe, until a trial is conducted this information will remain unknown. Perhaps developing diarrhea will not allow some of our drugs like chemotherapy (docetaxel) to remain in our bodies. However, even without FDA approval there is no reason that you should not have a conversation with your doctor about the possible role this new drug might have in your treatment.
Joel T. Nowak, M.A., M.S.W.