Naloxegol

Naloxegol is used to treat constipation caused by opiate (narcotic) pain medications in adults with chronic (ongoing) pain that is not caused by cancer. Naloxegol is in a class of medications called peripherally acting mu-opioid receptor antagonists. It works by protecting the bowel from the effects of opiate (narcotic) medications.

Naloxegol comes as a tablet to take by mouth. It is usually taken once a day, at least 1 hour before or 2 hours after the first meal of the day. Take naloxegol at around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take naloxegol exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

If you are unable to swallow the tablets whole, crush the tablet to a powder and mix it in a glass with 4 ounces (120 mL) of water. Drink the mixture immediately. Then, refill the glass with 4 ounces (120 mL) of water, stir the contents, and drink the remaining mixture contents.

If you have a nasogastric (NG) tube, your doctor or pharmacist will explain how to prepare naloxegol tablets to give through a NG tube.

You should stop taking other laxative medications before you start taking naloxegol. Be sure to let your doctor know if naloxegol does not work for you after taking it for 3 days. Your doctor may tell you to take other laxative medication(s).

Tell your doctor if you stop taking opiate (narcotic) medications. Your doctor will probably tell you to stop taking naloxegol.

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

Before taking naloxegol,

• tell your doctor and pharmacist if you are allergic to naloxegol, any other medications, or any of the ingredients in naloxegol tablets. Ask your pharmacist or check the Medication Guide for a list of the ingredients.
• some medications should not be taken with naloxegol. Other medications may cause dosing changes or extra monitoring when taken with naloxegol. Make sure you have discussed any medications you are currently taking or plan to take before starting naloxegol with your doctor and pharmacist. Before starting, stopping, or changing any medications while taking naloxegol, please get the advice of your doctor or pharmacist..
• the following herbal product may interact with naloxegol: St. John's wort. Be sure to let your doctor and pharmacist know that you are taking this medication before you start taking naloxegol. Do not start this medication while taking naloxegol without discussing with your healthcare provider.
• tell your doctor if you have or have ever had an intestinal obstruction (a blockage in your intestine). Your doctor will probably tell you not to take naloxegol.
• tell your doctor if you have or have ever had stomach or bowel problems such as stomach ulcers (sores in the lining of the stomach), Crohn's disease (a condition in which the body attacks the lining of the digestive tract, causing pain, diarrhea, weight loss, and fever), diverticulitis (inflamed bulges in the lining of the large intestine), cancer of the stomach or bowel, or Ogilvie's syndrome (a condition in which there is a bulge in the bowel); or kidney or liver disease.
• tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you become pregnant while taking naloxegol, call your doctor.

Do not eat grapefruit or drink grapefruit juice while taking this medication.

Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

Naloxegol may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• diarrhea
• nausea
• gas
• stomach pain
• vomiting
• headache
• sweating
• chills
• anxiety
• irritability
• yawning

Some side effects can be serious. If you experience this symptom, stop taking naloxegol and call your doctor immediately :

• severe or worsening stomach pain and diarrhea
• rash; hives; swelling of the face, lips, throat, tongue, hands, or feet

Naloxegol may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (https://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom).

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. https://www.upandaway.org

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (https://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

Symptoms of overdose may include the following:

• stomach pain
• diarrhea
• nausea
• chills
• runny nose
• sweating

Keep all appointments with your doctor.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

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