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Peripheral μ-opioid receptor antagonist

Naloxegol

Brand names: Moventig

Naloxegol is an orally administered, peripherally acting mu-opioid receptor antagonist used for opioid-induced constipation in adults with an inadequate response to laxatives.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

Clinical monograph

How it works

A pegylated derivative of naloxone, it antagonises mu-opioid receptors in the gut while its minimal central penetration preserves opioid analgesia.

Prescribing in practice

  • Contraindicated in known or suspected gastrointestinal obstruction and where there is increased risk of perforation.
  • It is a CYP3A4 substrate, so avoid strong inhibitors and inducers and grapefruit, and take it on an empty stomach as directed in the SPC.
  • Stop if the opioid is discontinued and review if severe gastrointestinal symptoms occur.

Monitoring

Monitor for severe abdominal pain, diarrhoea and possible opioid withdrawal symptoms, and review concomitant medicines for CYP3A4 interactions.

Counselling the patient

  • Advise patients to take the medicine on an empty stomach, typically before the first meal of the day, and to avoid grapefruit.
  • Tell patients to report severe or persistent abdominal pain and to seek advice before adding new medicines.

Evidence & guidelines

Naloxegol is recommended by NICE for opioid-induced constipation in adults who have not responded adequately to laxatives.

Reference: NICE TA651; SmPC; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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