Managing Severe Cancer Pain with Oxycodone/Naloxone Treatment: A Literature Review Update

Abstract

Severe cancer pain substantially affects patients' quality of life, increasing the burden of the disease and reducing the disability-adjusted life years. Although opioid analgesics are effective, they may induce opioid-induced bowel dysfunction (OIBD). Oxycodone/naloxone combination therapy has emerged as a promising approach to mitigate opioid-induced constipation (OIC) while providing effective pain relief. This review provides an updated analysis of the literature of the last decade regarding the use of oxycodone/naloxone in the management of severe cancer pain. Through a comprehensive search of databases, studies focusing on the efficacy, safety, and patient experience of oxycodone/naloxone's prolonged release in severe cancer pain management were identified. Furthermore, the literature discusses the mechanism of action of naloxone in mitigating OIC without compromising opioid analgesia. Overall, the evidence suggests that oxycodone/naloxone combination therapy offers a valuable option for effectively managing severe cancer pain while minimizing opioid-induced constipation, thereby improving patients' quality of life. However, further research is needed to optimize dosing regimens, evaluate long-term safety, and assess patient outcomes in diverse cancer populations.

Keywords: oxycodone/naloxone 2; pain management 3; severe cancer pain 1.

Figure 1

Schematic diagram of mechanism involved in Oxycodone/naloxone PR. Overall, the schematic diagram illustrates how the combination of oxycodone and naloxone in a 2:1 ratio addresses both pain relief and opioid-induced constipation by targeting specific opioid receptors in different areas of the body.

Figure 2

Mechanisms of cancer pain as a direct or indirect consequence of the tumor. Cancer pain arises from tissue damage, nerve compression, and inflammatory effects. This can lead to peripheral and central neuropathy, exacerbating pain severity. Additionally, medical interventions like radiation therapy can worsen the pain experience.