Naloxegol, Oral

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KEY POINTS

• This medicine is taken by mouth to treat constipation caused by taking narcotics. Take it exactly as directed.
• This medicine may cause unwanted side effects. Tell your healthcare provider if you have any side effects that are serious, continue, or get worse.
• Tell all healthcare providers who treat you about all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take.

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What are other names for this medicine?

Type of medicine: narcotic (opioid) antagonist

Generic and brand names: naloxegol, oral; Movantik

What is this medicine used for?

This medicine is taken by mouth to treat constipation caused by taking narcotics in adults with long-term pain that is not caused by cancer.

This medicine may be used to treat other conditions as determined by your healthcare provider.

What should my healthcare provider know before I take this medicine?

Before taking this medicine, tell your healthcare provider if you have ever had:

• An allergic reaction to any medicine
• A blockage in the intestines, Crohn's disease, or ulcerative colitis
• Kidney or liver disease

Females of childbearing age: Talk with your healthcare provider if you are pregnant or plan to become pregnant. Regular use of this medicine during pregnancy or while breastfeeding may cause withdrawal symptoms in your baby. Tell your healthcare provider right away if you become pregnant during treatment with this medicine. Do not breast-feed while taking this medicine without your healthcare provider's approval.

How do I use it?

Read the Medication Guide that comes in the medicine package when you start taking this medicine and each time you get a refill.

Check the label on the medicine for directions about your specific dose. Take this medicine exactly as your healthcare provider prescribes. Do not take more or less or for a longer period of time than directed by your healthcare provider.

Check with your healthcare provider before using this medicine in children under age 18 years.

Take this medicine on an empty stomach at least 1 hour before the first meal of the day or 2 hours after the meal. Swallow tablets whole. If you are unable to swallow the tablets whole, tell your healthcare provider.

You should stop taking other laxatives before you start treatment with this medicine or as instructed by your healthcare provider. Your healthcare provider may prescribe other laxatives if this medicine does not work after 3 days of treatment. Ask your healthcare provider about this.

What if I miss a dose?

If you miss a dose, take it as soon as you remember unless it is almost time for the next scheduled dose. In that case, skip the missed dose and take the next one as directed. Do not take double doses. If you are not sure of what to do if you miss a dose, contact your healthcare provider.

What if I overdose?

If you or anyone else has intentionally taken too much of this medicine, call 911 or go to the emergency room right away. If you pass out, have seizures, weakness or confusion, or have trouble breathing, call 911. If you think that you or anyone else may have taken too much of this medicine, call the poison control center. Do this even if there are no signs of discomfort or poisoning. The poison control center number is 800-222-1222.

Symptoms of an acute overdose may include: nausea, stomach pain, diarrhea.

What should I watch out for?

If you stop taking the narcotic pain medicine, you should also stop taking this medicine. Talk with your healthcare provider about this.

You may have symptoms of narcotic withdrawal while you are taking this medicine, including sweating, chills, diarrhea, stomach pain, anxiety, irritability, and yawning. Tell your healthcare provider if you have these symptoms.

This medicine is a controlled substance. It is illegal for you to give it to anyone else.

If you need emergency care, surgery, lab tests, or dental work, tell the healthcare provider or dentist you are taking this medicine.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help.): Allergic reaction (hives; itching; rash; trouble breathing; chest pain or tightness in your chest; swelling of your lips, tongue, and throat).

Serious (Report these to your healthcare provider right away.): Severe stomach pain or stomach pain lasting more than a few days; severe diarrhea, nausea, or vomiting; bloody, black, or tarry bowel movements; vomiting blood.

Other: Mild nausea or vomiting, gas, headache.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• Alvimopan (Entereg)
• Antibiotics such as azithromycin (Zithromax, Zmax), clarithromycin (Biaxin), erythromycin (E.E.S., Ery-Tab, Erythrocin), rifabutin (Mycobutin), rifampin (Rifadin), rifapentine (Priftin), telithromycin (Ketek), and tetracycline
• Antifungal medicines such as fluconazole (Diflucan), isavuconazonium (Cresemba), itraconazole (Sporanox), ketoconazole (Nizoral), posaconazole (Noxafil), and voriconazole (Vfend)
• Antiseizure medicines such as carbamazepine (Carbatrol, Epitol, Equetro, Tegretol), eslicarbazepine (Aptiom), oxcarbazepine (Trileptal), phenobarbital, phenytoin (Dilantin, Phenytek), and primidone (Mysoline)
• Antiviral medicines such as daclatasvir (Daklinza), ledipasvir/sofosbuvir (Harvoni), ombitasvir/paritaprevir/ritonavir/dasabuvir (Viekira), ombitasvir/paritaprevir/ritonavir (Technivie), simeprevir (Olysio), and sofosbuvir/velpatasvir (Epclusa)
• Cancer medicines such as abiraterone (Zytiga), bexarotene (Targretin), ceritinib (Zykadia), crizotinib (Xalkori), dabrafenib (Tafinlar), enzalutamide (Xtandi), ibrutinib (Imbruvica), idelalisib (Zydelig), imatinib (Gleevec), lapatinib (Tykerb), mitotane (Lysodren), nilotinib (Tasigna), sunitinib (Sutent), tamoxifen, vandetanib (Caprelsa), and vemurafenib (Zelboraf)
• Cholesterol-lowering medicines such as atorvastatin (Lipitor) and lomitapide (Juxtapid)
• Conivaptan (Vaprisol)
• Eliglustat (Cerdelga)
• Flibanserin (Addyi)
• Heart medicines such as amiodarone (Cordarone, Pacerone), carvedilol (Coreg), diltiazem (Cardizem, Cartia, Tiazac), dronedarone (Multaq), nicardipine (Cardene), propafenone (Rythmol), quinidine, ranolazine (Ranexa), and verapamil (Calan, Covera, Verelan)
• HIV medicines such as atazanavir (Reyataz), cobicistat (Tybost), darunavir (Prezista), delavirdine (Rescriptor), efavirenz (Sustiva), elvitegravir/cobicistat/emtricitabine/tenofovir (Stribild), etravirine (Intelence), fosamprenavir (Lexiva), indinavir (Crixivan), lopinavir/ritonavir (Kaletra), nelfinavir (Viracept), ritonavir (Norvir), and saquinavir (Invirase)
• Immunosuppressants such as cyclosporine (Gengraf, Neoral, Sandimmune) and tacrolimus (Astagraf, Prograf, Protopic)
• Laxatives
• Lumacaftor/ivacaftor (Orkambi)
• Medicines to treat or prevent blood clots such as dipyridamole, dipyridamole/aspirin (Aggrenox), and ticagrelor (Brilinta)
• Mefloquine
• Mirabegron (Myrbetriq)
• Methadone (Dolophine, Methadose)
• Methylnaltrexone (Relistor)
• Mifepristone (Korlym, Mifeprex)
• Modafinil (Provigil)
• Naltrexone (ReVia, Vivitrol)
• Nausea medicines such as aprepitant (Emend), netupitant/palonosetron (Akynzeo), and rolapitant (Varubi)
• Nefazodone
• Propranolol (Hemangeol, Inderal, InnoPran)
• Quinine
• St. John’s wort

Do NOT eat or drink products that contain grapefruit, Seville oranges, and tangelos at any time while you are taking this medicine. These fruits and juices affect the way this medicine works and increase your risk of serious side effects. Talk with your healthcare provider or pharmacist about this.

If you are not sure if your medicines might interact, ask your pharmacist or healthcare provider. Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

How should I store this medicine?

Store the tablets at room temperature. Keep the container tightly closed. Protect it from heat, high humidity, and bright light.

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This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicine in the trash.

Keep all medicines out of the reach of children.

Do not share medicines with other people.