Background: A case of severe constipation is described in a 75-year- old cancer patient receiving methadone for pain. Her constipation was refractory to the current treatment and she suffered severe discomfort and cognitive impairment. Due to the severity of the clinical situation and after excluding mechanical obstruction, low doses of subcutaneous neostigmine were administered, having bowel movements with evacuation of stools in a few hours after its administration.
Discussion: The results suggest that subcutaneous neostigmine could be an alternative choice in a group of selected patients with advanced cancer and opioid-induced constipation.
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