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Relistor vs. Symproic

Head-to-head comparisons of medication uses, side effects, warnings, and more.

Key takeaways

Relistor (methylnaltrexone) and Symproic (naldemedine) are both opioid antagonists used to treat constipation caused by opioid pain medications. Relistor is available in both oral and injectable forms, while Symproic is only available as an oral tablet. You need to take Relistor on an empty stomach, but you can take Symproic with or without food. Relistor can work quickly, especially in its injectable form, often within 4 hours, whereas Symproic's timing isn't specified. Relistor is also used for people with advanced illnesses, but Symproic can't be used for those taking opioids for cancer pain. Both medications can be expensive since they are brand-name only. Common side effects for both include abdominal pain, diarrhea, and nausea.

Relistor

(methylnaltrexone)

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Symproic

(naldemedine)

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Summary for Relistor

Prescription only

Relistor (methylnaltrexone) is a good oral or injectable option for treating constipation due to opioid pain medications, but it can cause opioid withdrawal symptoms and diarrhea, and is quite expensive if it's not covered by insurance.

Indications for Relistor

  • Constipation due to opioid pain medications

Pros and Cons for Relistor

Pros

  • Improves your chances of having bowel movements while you're on opioid medications
  • Available in injection form if you're unable to take medications by mouth or if you have an advanced illness
  • Injection form works pretty quickly (about 4 hours)
  • Directly targets the receptors that are causing constipation

Cons

  • Usually reserved for more severe constipation, after you have tried other medications first
  • Oral form must be taken daily, cannot be used "as needed"
  • Abdominal pain, diarrhea, and nausea are fairly common side effects.
  • Brand-name only and may be very expensive

Common Side Effects for Relistor

  • Abdominal pain (14-29%)
  • Diarrhea (5-6%)
  • Nausea (9-12%) - mainly with injection form

Warnings for Relistor

  • Gastrointestinal (stomach or intestinal) injury
  • Diarrhea
  • Opioid withdrawal

Summary for Symproic

Prescription only

Symproic (naldemedine) is a prescription opioid antagonist. More specifically, it's a peripherally acting mu-opioid receptor antagonist (PAMORA) that targets opioid receptors in the gut. It's a first-choice treatment option for opioid-induced constipation in adults. It comes as a tablet that's taken by mouth once per day with or without food. Side effects include stomach pain, diarrhea, and nausea. Symproic (naldemedine) is brand name only and not available as a generic.

Indications for Symproic

Pros and Cons for Symproic

Pros

Cons

  • Tablet only; might be hard to take for people who have trouble swallowing
  • Only for adults
  • Raises your risk for opioid withdrawal

Common Side Effects for Symproic

  • Stomach pain (11%)
  • Diarrhea (7%)
  • Nausea (6%)

Warnings for Symproic

  • Gastrointestinal (stomach or intestinal) injury
  • Opioid withdrawal

Prices with our coupons for Relistor vs. Symproic

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Relistor90 tablets / 150mg
$2,295.63$3,328.32
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Price Card Drug Icon
Symproic30 tablets / 0.2mg
$470.03$582.71
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