Information intended for UK healthcare professionals only.

The production and printing of this Guidelines summary card has been commissioned by Sandoz Ltd. Sandoz Ltd has reviewed the card for technical accuracy and regulatory compliance and supplied the prescribing information. This summary card only displays the concise guidance; readers are strongly advised to refer to the full guidance at www.nice.org.uk/guidance/TA651.

View prescribing information

Download a PDF of the Guidelines summary card

Rizmoic®(naldemedine): NICE TA651

1   Recommendations1

1.1 Naldemedine is recommended, within its marketing authorisation, as an option for treating opioid-induced constipation in adults who have had laxative treatment. 

2   Information about naldemedine1

Marketing authorisation indication

2.1 Naldemedine (Rizmoic, Shionogi) has a marketing authorisation in the UK for ‘the treatment of opioid-induced constipation in adult patients who have previously been treated with a laxative’.

3   Committee discussion1

3.1 …Naldemedine is an alternative oral PAMORA taken as a single daily dose. The clinical expert explained that opioid-induced constipation is very common in people with non-cancer and cancer pain, and continues regardless of the type of opioid used. The expert estimated that over 80% of patients with cancer pain will have opioid-induced constipation, while the prevalence is likely to be lower in patients with non-cancer pain. The clinical expert also highlighted that in clinical practice, many patients taking a PAMORA have mixed aetiology constipation and so need a combination treatment to target the different causes of constipation. For some patients the burden of opioid-induced constipation on quality of life is greater than the pain that needs an opioid. This often means patients stop opioid treatment. The clinical expert said that a key benefit of a PAMORA is that patients can have a normal stool, while those taking conventional laxatives often experience a continual back and forth of being constipated and then having diarrhoea. This is a huge burden for both patients and carers in terms of continually managing bowel function. The committee concluded that people with opioid-induced constipation would welcome a new treatment that improves their constipation symptoms and quality of life.

PAMORA=peripherally acting μ-opioid receptor antagonist

Reference

1. NICE. Naldemedine for treating opioid-induced constipation. NICE Technology Appraisal Guidance 651. NICE, September 2020. www.nice.org.uk/guidance/TA651.

When NICE recommends a treatment, the NHS must make sure it is available to those people it could help, normally within 3 months of the guidance being issued.

The production and printing of this Guidelines summary card has been commissioned by Sandoz Ltd. Sandoz Ltd has reviewed the card for technical accuracy and regulatory compliance and supplied the prescribing information. This summary card only displays the concise guidance; readers are strongly advised to refer to the full guidance at www.nice.org.uk/guidance/TA651

©NICE 2020 Technology Appraisal 651: Naldemedine for treating opioid-induced constipation. Available from: www.nice.org.uk/guidance/TA651. All rights reserved. Subject to notice of rights. 

NICE guidance is prepared for the National Health Service in England. All NICE guidance is subject to regular review and may be updated or withdrawn. NICE accepts no responsibility for the use of its content in this publication.  

MGP Ltd owns copyright of the Guidelines brand, logo, and the design and format of this summary card. 

The views and opinions expressed are not necessarily those of Sandoz Ltd, or of Guidelines, its publisher, advisers, or advertisers. 

UK/P/RZM/20-0016b

Date of preparation: September 2020