Managing Severe Cancer Pain with Oxycodone/Naloxone Treatment: A Literature Review Update

Author:

Formenti Paolo1ORCID,Umbrello Michele2ORCID,Pignataro Mauro3,Sabbatini Giovanni1,Dottorini Lorenzo4,Gotti Miriam1,Brenna Giovanni1,Menozzi Alessandro5,Terranova Gaetano6,Galimberti Andrea1,Pezzi Angelo1ORCID

Affiliation:

1. SC Anestesia, Rianimazione e Terapia Intensiva, ASST Nord Milano, Ospedale Bassini, Cinisello Balsamo, 20097 Milan, Italy

2. Department of Intensive Care, New Hospital of Legnano (Ospedale Nuovo di Legnano), 20025 Legnano, Italy

3. Contenuto Ed Net Communications SL, 20131 Milan, Italy

4. Oncology Unit, ASST Bergamo Ovest, 20047 Treviglio, Italy

5. School of Medicine and Surgery, University of Milano-Bicocca, 20126 Milano, Italy

6. Anaesthesia and Intensive Care Department, Asst Gaetano Pini, 20100 Milano, Italy

Abstract

Severe cancer pain substantially affects patients’ quality of life, increasing the burden of the disease and reducing the disability-adjusted life years. Although opioid analgesics are effective, they may induce opioid-induced bowel dysfunction (OIBD). Oxycodone/naloxone combination therapy has emerged as a promising approach to mitigate opioid-induced constipation (OIC) while providing effective pain relief. This review provides an updated analysis of the literature of the last decade regarding the use of oxycodone/naloxone in the management of severe cancer pain. Through a comprehensive search of databases, studies focusing on the efficacy, safety, and patient experience of oxycodone/naloxone’s prolonged release in severe cancer pain management were identified. Furthermore, the literature discusses the mechanism of action of naloxone in mitigating OIC without compromising opioid analgesia. Overall, the evidence suggests that oxycodone/naloxone combination therapy offers a valuable option for effectively managing severe cancer pain while minimizing opioid-induced constipation, thereby improving patients’ quality of life. However, further research is needed to optimize dosing regimens, evaluate long-term safety, and assess patient outcomes in diverse cancer populations.

Publisher

MDPI AG

Reference66 articles.

1. Cancer Pain Management: A Narrative Review of Current Concepts, Strategies, and Techniques;Mestdagh;Curr. Oncol.,2023

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3. Sizar, O., Genova, R., and Gupta, M. (2023). StatPearls, StatPearls Publishing.

4. Opioid-Induced Bowel Dysfunction: Epidemiology, Pathophysiology, Diagnosis, and Initial Therapeutic Approach;Dorn;Am. J. Gastroenterol. Suppl.,2014

5. Oral Prolonged-Release Oxycodone/Naloxone for Managing Pain and Opioid-Induced Constipation: A Review of the Evidence;Morlion;Pain. Pract.,2018

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