Letters To The Editor
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World J Gastroenterol. Aug 7, 2012; 18(29): 3921-3922
Published online Aug 7, 2012. doi: 10.3748/wjg.v18.i29.3921
Opioid/naloxone prolonged release combinations for opioid induced constipation
Shailendra Kapoor
Shailendra Kapoor, Formerly University of Illinois at Chicago, Mechanicsville, VA 23111, United States
Author contributions: Kapoor S soley contributed to the manuscript.
Correspondence to: Shailendra Kapoor, MD, Formerly University of Illinois at Chicago, 74 crossing, Mechanicsville, VA 23111, United States. shailendrakapoor@yahoo.com
Telephone: +1-804-3454567 Fax: +1-804-7786789
Received: March 29, 2012
Revised: May 18, 2012
Accepted: May 26, 2012
Published online: August 7, 2012

I read with great interest the recent article by Chen et al in a recent issue of your esteemed journal. The article is highly thought provoking. One emerging therapeutic alternative for opioid induced constipation is the emergence of opioid/naloxone prolonged release combinations. For instance, naloxone when administered in a 1:2 ratio with oxycodone reverses the inhibitory effect of oxycodone on the gastrointestinal tract. The advantage of oxycodone/naloxone prolonged release (OXN) is that while its anti-nociceptive efficacy is equivalent to that of oxycodone prolonged release (OXC), it significantly decreases the “Bowel Function Index” thereby ameliorating symptoms of opioid induced constipation to a large extent. Schutter et al in a recent study have reported a decrease in the bowel function index from 38.2 to 15.1. Similarly, Löwenstein et al in another recent study have reported that following a month of therapy, complete spontaneous bowel movements per week is increased from one in OXC therapy to three in OXN therapy.

Keywords: Opiod naloxone, Cancer, Morphine, Carcinogenesis