1.6.6 Peripheral opioid-receptor antagonists

Methylnaltrexone bromide
  • Injection 20mg/ml (£21.05 = 0.6ml vial)


  • Opioid-induced constipation in patients receiving palliative care, when response to other laxatives is inadequate


  • Body-weight under 38kg, 150 micrograms/kg on alternate days; body-weight 38–62kg, 8mg on alternate days; body-weight 62–114kg, 12mg on alternate days; body-weight over 114kg, 150 micrograms/kg on alternate days (may be given less frequently)
  • Tablets 12.5mg, 25mg (£51.52 = 25mg daily)


  1. For use in accordance with NICE TA345 Naloxegol for treating opioid induced constipation (July 2015)
  2. For use in primary care following recommendation from a member of the palliative care team only. In all other indications, naloxegol should be restricted to secondary care use
  3. Should only be initiated in patients in whom opioids are effectively treating the pain.


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