Naloxegol belongs to a group of medications known as opioid receptor antagonists. It is used by adults with non-cancer pain to treat constipation caused by prescription pain medications called opioids (e.g., codeine, morphine, hydromorphone). If laxatives are not working, naloxegol can be used to help produce a bowel movement.

It works by preventing opioid medications from binding to certain receptors in the intestinal tract. It generally does not reduce the pain-relieving effects of opioid pain medications.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

The recommended dose of naloxegol is 25 mg taken by mouth, once daily. Depending on any side effects you experience, your doctor may suggest a lower dose.

It is recommended that naloxegol be taken on an empty stomach in the morning. Therefore, it should be taken 1 hour before the first meal of the day or 2 hours after.

Swallow the tablets whole with a glass of water. If you have trouble swallowing, you can crush the tablet to a powder and dissolve it in half a glass of water (room temperature and non-carbonated). Stir it and drink it immediately. Rinse the glass with another half glass of water and drink the contents to make sure there is no medicine left in the glass.

When you first start taking naloxegol, stop taking other laxatives until you determine how well this medication works for you. You may have a bowel movement within 12 hours after taking the first dose of this medication.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important to take this medication exactly as prescribed by your doctor.

If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is less than 12 hours until your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature, protect it from light and moisture, and keep it out of the reach of children.

12.5 mg
Each oval, biconvex, mauve, film-coated tablet, intagliated with "12.5" on one side and "nGL" on the other, contains 12.5 mg of naloxegol. Nonmedicinal ingredients: mannitol, microcrystalline cellulose, croscarmellose sodium, propyl gallate, and magnesium stearate. Tablet coating: hypromellose, titanium dioxide, macrogol 400, iron oxide red, and iron oxide black.

25 mg
Each oval, biconvex, mauve, film-coated tablet, intagliated with "25" on one side and "nGL" on the other, contains 25 mg of naloxegol. Nonmedicinal ingredients: mannitol, microcrystalline cellulose, croscarmellose sodium, propyl gallate, and magnesium stearate. Tablet coating: hypromellose, titanium dioxide, macrogol 400, iron oxide red, and iron oxide black.

Do not take this medication if you:

• are allergic to naloxegol or any ingredients of the medication
• have or may have a blockage in the digestive tract
• have a history of blockage in the digestive tract
• are taking any of the following medications:
• "azole" antifungals (e.g., ketoconazole, voriconazole)
• HIV protease inhibitors (e.g., ritonavir, lopinavir)
• macrolide antibiotics (e.g., clarithromycin, erythromycin)

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• diarrhea
• excessive sweating
• headache
• nausea
• passing gas
• runny or stuffy nose
• stomach pain
• vomiting

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• symptoms of opioid withdrawal (e.g., nausea, vomiting, diarrhea, excess sweating, muscle aches, increased tearing, insomnia, yawning)

Stop taking the medication and seek immediate medical attention if any of the following occur:

• severe or persistent stomach pain
• severe diarrhea (watery, bloody, or persistent)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Gastrointestinal perforation: People with advanced illness who use naloxegol may be at increased risk of gastrointestinal perforation (a hole that forms in the wall of the gastrointestinal tract, such as through the stomach or intestines). People are especially at risk if they also have a weakened gastrointestinal wall due to conditions such as cancer, intestinal cancer, or gastrointestinal cancer. If you experience severe, worsening, or persistent abdominal pain that's intensified by movement, or accompanied by fever, chills, nausea or vomiting, seek immediate medical attention. These could be symptoms of gastrointestinal perforation, which is a medical emergency.

Kidney Function: Kidney disease or reduced kidney function may cause this medication to build up in the body, causing side effects. If you have reduced kidney function or kidney disease, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Opioid withdrawal: Very rarely, this medication may block the effects of opioids on the nervous system. This can result in symptoms of withdrawal. If you experience unusual sweating, mood swings, nausea or vomiting, muscle aches, tearing, diarrhea, yawning, or difficulty sleeping, contact your doctor.

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: It is not known if naloxegol passes into breast milk. If you are a breast-feeding mother and are taking this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using this medication have not been established for children.

There may be an interaction between naloxegol and any of the following:

• amiodarone
• apalutamide
• aprepitant
• "azole" antifungals (e.g., itraconazole, ketoconazole, voriconazole)
• bosentan
• calcium channel blockers (e.g., diltiazem, verapamil)
• carbamazepine
• carvedilol
• cobicistat
• conivaptan
• cyclosporine
• deferasirox
• dronedarone
• enzalutamide
• eslicarbazepine
• flibanserin
• grapefruit juice
• HIV non-nucleoside reverse transcriptase inhibitors (NNRTIs; e.g., efavirenz, etravirine, nevirapine)
• HIV protease inhibitors (e.g., atazanavir, indinavir, ritonavir, saquinavir)
• ledipasvir
• macrolide antibiotics (e.g., clarithromycin, erythromycin)
• methadone
• methylnaltrexone
• mifepristone
• mitotane
• modafinil
• naloxone
• naltrexone
• phenobarbital
• phenytoin
• primidone
• protein kinase inhibitors (e.g., crizotinib, dabrafenib, imatinib, lapatinib, nilotinib)
• quinidine
• rifabutin
• rifampin
• St. John's wort

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.