Potential Utility of Peripherally Applied Loperamide in Oral Chronic Graft-versus-host Disease Related Pain

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Japanese Journal of Clinical Oncology Advance Access originally published online

on October 24, 2008

Japanese Journal of Clinical Oncology 2008 38(12):857-860;

doi:10.1093/jjco/hyn110

Potential Utility of Peripherally Applied Loperamide in Oral Chronic

Graft-versus-host Disease Related Pain

Natsuko Nozaki-Taguchi1, Mariko Shutoh2 and Naohito Shimoyama2

1 Department of Anesthesiology and Palliative medicine, Chiba University

Graduate School of Medicine, Chiba

2 Department of Anesthesiology and Palliative medicine, National Cancer Center

Hospital, Tokyo, Japan

For reprints and all correspondence: Natsuko Nozaki-Taguchi, Department of

Anesthesiology and Palliative medicine, Chiba University Graduate School of

Medicine, 1-8-1 Inohana, Chuo, Chiba 260-8677, Japan. E-mail:

nnoztag@...

Received June 18, 2008; accepted September 16, 2008

Four patients with oral chronic graft-versus-host disease pain were treated with

loperamide oral-rinse solution. Two-week continued use of the drug solution

improved not only the pain scores but also the pain-causing disabilities

associated with eating, drinking and sleeping, with no noticeable side effects.

Current results suggest that the mu-opioid agonist, loperamide, has a potential

analgesic effect that could be clinically used as a peripheral analgesic agent

for stomatits pain. However, these observations will need to be further

confirmed in a randomized-controlled trial.