What is a pink pill with nGL 25 on it?
A pink, oval tablet with the imprint 'nGL 25' is the brand-name prescription medication Movantik (naloxegol) 25 mg. The identification is critical because a similar imprint, 'nGL 12.5', is for the same drug but a different dosage and color (purple). This pill is prescribed specifically for adults suffering from opioid-induced constipation (OIC). It is not a traditional laxative but a targeted treatment designed to counteract the constipating effects of opioid pain medication.
Pharmacology of Naloxegol (Movantik)
Naloxegol belongs to a class of drugs known as peripherally acting mu-opioid receptor antagonists (PAMORAs). To understand how it works, it is important to know that opioids bind to mu-opioid receptors throughout the body, including in the central nervous system (CNS) to produce pain relief and in the gastrointestinal (GI) tract, which causes constipation.
Unlike traditional opioid antagonists like naloxone, which can reverse both central and peripheral opioid effects, naloxegol is designed to primarily block the opioid receptors in the gut. Because naloxegol has a low ability to cross the blood-brain barrier, it can effectively alleviate constipation without interfering with the pain-relieving effects of the opioid medication in the CNS.
Uses and Indications
Movantik is used to treat opioid-induced constipation in adults with chronic non-cancer pain. It is important to note that it is not intended for use in patients with constipation not caused by opioids. The medication is taken orally and acts within the intestines to help restore normal bowel function.
Administration and Dosage
- Dosage: Movantik is available in different strengths, and a healthcare professional will determine the appropriate dosage for each individual.
- Timing: The tablet should be taken on an empty stomach, at least one hour before or two hours after the first meal of the day.
- Swallowing: Swallow the tablet whole. Do not crush, break, or chew it. If swallowing is difficult, you can crush the tablet and mix it with water.
- Discontinuation: If you stop taking opioid pain medication, you should also stop taking Movantik.
Important Safety Information and Drug Interactions
Like all medications, Movantik can have side effects and interacts with other substances. Patients should be aware of potential issues, and their doctor will provide a Medication Guide.
Potential Side Effects
Common side effects of naloxegol include:
- Stomach pain
- Diarrhea
- Nausea
- Gas
- Headache
- Sweating and chills (potential signs of withdrawal)
Serious Side Effects
Contact a doctor immediately if you experience serious side effects, such as:
- Severe or worsening stomach pain and diarrhea, which could signal a serious gastrointestinal issue like a tear or perforation.
- Symptoms of opioid withdrawal, such as anxiety, irritability, and sweating.
- Signs of an allergic reaction, including rash, hives, or swelling of the face, tongue, or throat.
Drug Interactions and Contraindications
- CYP3A4 Inhibitors: Certain medications that affect the enzyme CYP3A4, such as clarithromycin and itraconazole, can interact with naloxegol and may require a dosage adjustment.
- Grapefruit: Do not consume grapefruit or grapefruit juice while taking Movantik, as it can increase the drug's concentration and risk of side effects.
- Gastrointestinal Obstruction: Patients with a known or suspected gastrointestinal obstruction should not take Movantik.
Movantik vs. Other Constipation Treatments
| Feature | Movantik (Naloxegol) | Traditional Stimulant Laxatives (e.g., Bisacodyl) | Other PAMORAs (e.g., Relistor - Methylnaltrexone) |
|---|---|---|---|
| Mechanism | Targets peripheral mu-opioid receptors in the gut to counteract opioid-induced constipation. | Stimulates the nerves in the intestines to increase bowel movements. | Also a PAMORA, blocks opioid receptors in the gut, similar action to Movantik. |
| Indication | Specifically treats opioid-induced constipation in adults with chronic non-cancer pain. | Treats various forms of short-term constipation. | Treats opioid-induced constipation, but available as an oral tablet and an injection. |
| Effect on Pain Relief | Does not interfere with the pain-relieving effects of opioids in the brain. | No effect on opioid analgesia. | Does not affect opioid pain relief. |
| Administration | Oral tablet, taken once daily on an empty stomach. | Oral tablet, typically taken as needed for constipation. | Oral tablet or subcutaneous injection. |
| Considerations | Requires a prescription. Potential for severe GI issues, especially with pre-existing conditions. | Available over-the-counter. Long-term use can lead to dependency. | Requires a prescription. Has similar side effects and indications. |
How to safely identify your medication
If you find an unidentified pill, it is crucial to use a reliable pill identification tool and follow safety precautions. Always consult a healthcare professional or pharmacist to confirm the identity of any medication. Online resources like Drugs.com and the FDA's databases are valuable tools.
Steps to take:
- Do not ingest the pill. Never take a medication you cannot positively identify.
- Use the imprint code. The 'nGL 25' marking is the most important identifier. The shape and color (pink, oval) are also key.
- Compare with an image. Look up the pill using an online pill identifier and compare your pill with the image provided.
- Check with your pharmacist. A pharmacist can confirm the medication using the imprint code and your prescription history.
- Consider safe disposal. If you are still unsure or the medication is old, dispose of it properly according to local guidelines.
Conclusion
The pink pill with 'nGL 25' on it is the brand-name prescription medication Movantik (naloxegol), used to treat opioid-induced constipation. Its specific mechanism of action allows it to alleviate constipation without compromising the central pain-relieving effects of opioid medication. Proper administration and awareness of potential side effects and drug interactions, particularly with grapefruit and other medications, are essential for its safe and effective use. When identifying unknown pills, always rely on professional resources and never self-medicate.
Authoritative Outbound Link: MedlinePlus - Naloxegol
