Methylnaltrexone is used to treat constipation caused by opioid (narcotic) pain medications in people with chronic (ongoing) pain that is not caused by cancer but may be related to a previous cancer or cancer treatment. Methylnaltrexone is in a class of medications called peripherally acting mu-opioid receptor antagonists. It works by protecting the bowel from the effects of opioid (narcotic) medications.

🔔 How should this medicine be used?

Methylnaltrexone comes as a tablet to take by mouth. It is usually taken once a day with water, at least 30 minutes before the first meal of the day. Take methylnaltrexone at around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take methylnaltrexone exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Methylnaltrexone is to be taken by people who are taking opioid (narcotic) medications. Talk to your doctor if you change how much or how often you take your opioid medication. If you stop taking opioid medications, you should stop taking methylnaltrexone as well.

You should stop taking other laxative medications when you start taking methylnaltrexone. However, be sure to let your doctor know if methylnaltrexone does not work for you after taking it for 3 days. Your doctor may tell you to take other laxative medication(s).

Your doctor or pharmacist will give you the manufacturer’s patient information sheet (Medication Guide) when you begin treatment with methylnaltrexone and each time you refill your prescription. Read the information carefully and ask your doctor or pharmacist if you have any questions. You can also visit the Food and Drug Administration (FDA) website ( to obtain the Medication Guide.

🔔 Other uses for this medicine

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

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🔔 What special precautions should I follow?

Before taking methylnaltrexone,

  • tell your doctor and pharmacist if you are allergic to methylnaltrexone, any other medications, or any of the ingredients in methylnaltrexone tablets. Ask your pharmacist or check the Medication Guide for a list of the ingredients.
  • tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: alvimopan (Entereg), naldemedine (Symproic), naloxegol (Movantik), naloxone (Evzio, Narcan, in Bunavail, Suboxone, Zubsolv), or naltrexone (Vivitrol, in Contrave, Embeda). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
  • tell your doctor if you have or have ever had a gastrointestinal obstruction (a blockage in your bowel). Your doctor will probably tell you not to take methylnaltrexone.
  • tell your doctor if you have or have ever had stomach or bowel problems including stomach ulcer (sores in the lining of the stomach), cancer of the stomach or bowel, Crohn’s disease (a condition in which the body attacks the lining of the digestive tract, causing pain, diarrhea, weight loss, and fever), diverticulitis (small pouches in the lining of the large intestine that can become inflamed), Ogilvie’s syndrome (a condition in which there is a bulge in the bowel), or kidney or liver disease.
  • tell your doctor if you are pregnant or plan to become pregnant.If you become pregnant while taking methylnaltrexone, call your doctor. If you take methylnaltrexone during your pregnancy, your baby may experience opioid withdrawal symptoms.
  • tell your doctor if you are breastfeeding. Do not breastfeed while you are taking methylnaltrexone.
  • you should know that most people have a bowel movement within a few minutes to a few hours after taking methylnaltrexone. Make sure that you are close to a bathroom when you take this medication.
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🔔 What special dietary instructions should I follow?

Unless your doctor tells you otherwise, continue your normal diet.