Drug intelligence / Profile preview

naloxegol + ketoconazole

Development stage
Unknown
Lead developer
AstraZeneca
Modality
Small Molecules
Administration
Oral
01

Overview

naloxegol + ketoconazole is an *unbranded combination* of naloxegol (NKTR-118), a peripherally acting mu-opioid receptor antagonist, and ketoconazole, a strong CYP3A4 and P-glycoprotein (P-gp) inhibitor. Naloxegol (developed as NKTR-118) is indicated for opioid-induced constipation and works by blocking opioid action in the gut without affecting central analgesia. Ketoconazole, an antifungal agent, is not used therapeutically in direct combination with naloxegol, but is clinically important due to its drug-drug interaction; when co-administered, ketoconazole dramatically increases plasma concentrations of naloxegol by inhibiting its metabolism (up to approximately 13-fold increase in exposure), increasing the risk of adverse effects. The combination is contraindicated because of this potentiation, and such coadministration is not recommended due to safety concerns, including significant risk of QTc prolongation and increased naloxegol toxicity[1][7].

Brand names
Movantik
Other names
naloxegol oxalateketoconazole (no unique brand for the combo)
02

Targets

DOR (Opioid Receptor Delta 1)ABCB1 (P-glycoprotein)KOR (Kappa opioid receptor)MOR (Mu opioid receptor)CYP3A4 (Cytochrome P450 3A4)

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