纳地美定(Naldemedine)的禁忌和注意事项有哪些?

Naldemedine Contraindications

Naldemedine is contraindicated in patients with known or suspected gastrointestinal obstruction and in patients at risk for recurrent obstruction due to the potential risk of gastrointestinal perforation.

It is contraindicated in patients with a history of hypersensitivity to Naldemedine and reactions including bronchospasm and rash.

Naldemedine Precautions

1. Cases of gastrointestinal perforation have been reported when using another peripherally acting opioid antagonist in patients with diseases that may be associated with localized or diffuse reductions in the structural integrity of the gastrointestinal wall (e.g., peptic ulcer disease, Ogilvie syndrome, diverticulosis, invasive gastrointestinal malignancy, or peritoneal metastases).

The overall risk-benefit should be considered when using naldemedine in patients with these conditions or other conditions that may result in compromised gastrointestinal wall integrity (such as Crohn's disease). Monitor for the development of severe, persistent, or worsening abdominal pain; patients who develop such symptoms should discontinue medication.

2. The symptom cluster is consistent with opioid withdrawal, including excessive sweating, chills, increased tearing, hot flashes, fever, sneezing, feeling cold, abdominal pain, diarrhea, nausea and vomiting. If these symptoms occur, you need to contact a doctor for treatment in time.

Patients with a compromised blood-brain barrier may be at risk for opioid withdrawal or reduced analgesic efficacy. The overall risk-benefit should be considered when using in such patients. Monitor such patients for symptoms of opioid withdrawal.

3. Inform women of reproductive potential who are pregnant or planning to become pregnant that using this product during pregnancy may cause fetal opioid withdrawal because the blood-brain barrier is not fully developed.

4. Women are advised not to breastfeed during treatment with naldimedine and within 3 days after the last dose.

Instructions for taking Naldemedine

Before taking the drug, please inform the doctor of all the patient's conditions, including the following:

1. Any stomach or intestinal (intestinal) problems, including gastric ulcer, Crohn's disease, diverticulitis, stomach or bowel cancer, or Ogilvy's syndrome.

2. Liver problems.

3. Already pregnant or planning to become pregnant. Taking Naldemedine during pregnancy may cause opioid withdrawal symptoms in the fetus. If you become pregnant during treatment with Naldemedine, tell your doctor immediately.

4. Currently breastfeeding or planning to breastfeed. It's unclear whether the symptoms pass into breast milk. Breastfeeding should not be performed during treatment with Naldemedine and for 3 days after the last dose. Taking Naldemedine while breastfeeding may cause opioid withdrawal symptoms in the baby.

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