Comprehensive medication guide to Symproic including estimated pricing, availability information, side effects, and how to find it in stock at your local pharmacy.
Estimated Insurance Pricing
With commercial insurance, eligible patients may pay as little as $0 using the Symproic Savings Program copay card.
Estimated Cash Pricing
Without insurance, Symproic typically costs $484–$746 for a 30-day supply of 0.2 mg tablets.
Medfinder Findability Score
45/100
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Symproic (Naldemedine) is a prescription medication approved by the FDA to treat opioid-induced constipation (OIC) in adults with chronic non-cancer pain. It belongs to a class of drugs called peripherally-acting mu-opioid receptor antagonists (PAMORAs). Symproic helps restore normal bowel function in patients taking opioid pain medications without reducing the pain-relieving effects of those opioids. It was originally developed by Shionogi Inc. and is marketed in the U.S. by Collegium Pharmaceutical. Outside the U.S., it is sold under the brand name Rizmoic.
Symproic works by blocking mu-opioid receptors in the gastrointestinal (GI) tract. Opioid pain medications bind to these receptors in the gut, which slows down bowel motility and causes constipation. Naldemedine selectively targets these peripheral opioid receptors without significantly crossing the blood-brain barrier, meaning it relieves constipation without interfering with the pain relief provided by opioids. This targeted mechanism makes Symproic effective at restoring normal bowel function while maintaining opioid analgesia.
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0.2 mg oral tablet — tablet
the only available dose. Taken once daily by mouth, with or without food.
Symproic scores a 45 out of 100 on our findability scale. While there is no active FDA shortage, Symproic is a brand-only, niche medication used specifically for opioid-induced constipation (OIC). Its limited patient population and lack of a generic version mean many pharmacies do not routinely stock it. You may need to call ahead or have your pharmacy order it, which can take 1–2 business days. Specialty pharmacies and larger chain pharmacies are more likely to have it on hand.
Symproic is most commonly prescribed by pain management specialists, gastroenterologists, and palliative care physicians. Primary care doctors and internists who manage patients on chronic opioid therapy also prescribe it. Since Symproic treats a side effect of opioid use, any licensed prescriber managing a patient's opioid therapy can prescribe it. Telehealth consultations are also available for obtaining a Symproic prescription.
No. Symproic is not a controlled substance. When it was first approved by the FDA in March 2017, it was temporarily placed in Schedule II. However, the DEA removed Naldemedine from all controlled substance schedules in September 2017 after determining it has no abuse potential. You do not need a special prescription to obtain Symproic.
Serious side effects can include gastrointestinal perforation (especially in patients with GI tract conditions like diverticulitis or Crohn's disease) and opioid withdrawal symptoms such as sweating, chills, tremors, and agitation. Contact your doctor immediately if you experience severe abdominal pain or signs of withdrawal.
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Movantik (Naloxegol)
Another PAMORA for OIC in chronic non-cancer pain, taken as a 25 mg oral tablet once daily.
Relistor (Methylnaltrexone)
A PAMORA available as a subcutaneous injection (12 mg) or oral tablet (450 mg) for OIC.
Amitiza (Lubiprostone)
A chloride channel activator approved for OIC, taken as a 24 mcg capsule twice daily.
Linzess (Linaclotide)
A guanylate cyclase-C agonist sometimes used off-label for OIC, primarily approved for IBS-C and chronic idiopathic constipation.
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Strong CYP3A4 inducers
moderate(Rifampin, Carbamazepine, Phenytoin, St. John's Wort) — avoid coadministration as they significantly decrease Naldemedine levels.
Other opioid antagonists
moderate(Naltrexone, Naloxone) — avoid coadministration due to increased risk of opioid withdrawal.
Strong CYP3A4 inhibitors
moderate(Itraconazole, Ketoconazole, Clarithromycin, Ritonavir) — monitor for adverse reactions.
P-glycoprotein inhibitors
moderate(Cyclosporine) — monitor for adverse reactions.
Grapefruit juice
moderatemay increase Naldemedine levels; use caution.
Symproic is an effective option for adults dealing with opioid-induced constipation from chronic non-cancer pain. As a brand-only medication with a niche indication, it can be harder to find in stock and carries a higher cash price ($484–$746 per month). However, the manufacturer's savings program can reduce costs to as little as $0 for commercially insured patients. If your pharmacy doesn't have Symproic in stock, ask them to order it or try a larger chain or specialty pharmacy. Use Medfinder to check local availability and compare prices before filling your prescription.
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