Subcutaneous methylnaltrexone to restore postoperative bowel function in a long-term opiate user

Int J Gynecol Cancer. 2010 Feb;20(2):308-10. doi: 10.1111/IGC.0b013e3181cd1828.


Introduction: One of the most common undesired effects of analgesic opioid use and addiction is constipation. Numerous pharmacologic agents have been used to treat opioid-induced bowel hypomotility with limited success. Methylnaltrexone bromide (MNTX) selectively targets the peripheral adverse effects of opioids while preserving the central analgesic effects of opioid agonist treatment.

Case: While it is indicated for use in nonsurgical patients in the palliative care setting, here we report the use of MNTX for the alleviation of postoperative ileus in a heroin user with recurrent cervical cancer undergoing diverting colostomy and urinary conduit placement.

Conclusions: Results suggest that MNTX may accelerate postoperative gastrointestinal recovery in opioid-dependent patients. Further studies are warranted to evaluate its role in the pharmacologic management of postoperative ileus.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Analgesics, Opioid / adverse effects*
  • Female
  • Heroin Dependence / complications
  • Humans
  • Ileus / chemically induced
  • Ileus / drug therapy*
  • Injections, Subcutaneous
  • Middle Aged
  • Naltrexone / analogs & derivatives*
  • Naltrexone / therapeutic use
  • Narcotic Antagonists / therapeutic use*
  • Postoperative Complications / drug therapy*
  • Quaternary Ammonium Compounds / therapeutic use


  • Analgesics, Opioid
  • Narcotic Antagonists
  • Quaternary Ammonium Compounds
  • methylnaltrexone
  • Naltrexone