Meissner, W., Schmidt, U., Hartmann, M., Kath, R., & Reinhart, K. (2000). Oral naloxone reverses opioid-associated constipation. Pain, 84, 105–109.
To evaluate the use of oral naloxone for the management of opiate-associated constipation in patients with cancer.
Patients were observed for six days without intervention. Afterward, oral naloxone was titrated as follows: 3 mg TID (day 1), 6 mg TID (day 2), 9 mg TID (day 3), 12 mg TID (day 4; maximum). Titration was stopped with laxation or increased peristalsis.
Hospital in Germany
This was a controlled study with a control period, but not a control group.
Starting with a low dose of naloxone and titrating up is recommended.