Relistor — Medical Mutual

Opioid-Induced Constipation (OIC) in adults with advanced illness receiving palliative care

Initial criteria

Diagnosis of chronic non-cancer pain OR diagnosis of advanced illness and receiving palliative care
Age ≥ 18 years
Taking opioids for ≥ 4 weeks
Failed on or intolerant to at least 2 of the following within the past 3 months (with or without a stool softener): at least one stimulant laxative (e.g. bisacodyl), OR at least one osmotic laxative (e.g. PEG 3350), OR at least one saline laxative (e.g. magnesium citrate)
Not using another opioid antagonist (e.g. naloxone)
No known or suspected gastrointestinal obstruction and not at increased risk of recurrent obstruction
Failed on or intolerant to BOTH lubiprostone AND Movantik

Demonstrated a beneficial response to Relistor, per the prescribing physician (e.g. increased number of bowel movements from baseline)
Continues to meet all criteria above for initial therapy

4 months for patients with advanced illness receiving palliative care; 1 year for patients with chronic non-cancer pain