Methylnaltrexone subcutaneous: Formulary, Restricted to patients who have had an inadequate response to a combination of 2 scheduled laxatives (one osmotic: PEG or lactulose; one stimulant: senna or bisacodyl) for 48 hours, followed by a 3 day trial of naloxegol. (exception on trial of naloxegol for patients that are NPO or taking a CYPP3A4 inhibitor/inducer, and pediatrics) 

Methylnaltrexone tablet: NON-formulary

Other Policies/Procedures:

Adult ICU Bowel Protocol: See Protocol 901.6065

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