We administered methylnaltrexone, a peripheral opioid receptor antagon
ist, to guinea pigs previously injected with morphine sulfate to deter
mine whether the compound could block opioid-induced cough suppression
without blocking antinociception. The effects of methylnaltrexone (2.
0, 1.6, 0.8 mg/kg) and of naltrexone (0.32, 0.16, 0.02 and 0.01 mg/kg)
were compared in animals who had been injected with morphine sulfate
(8.1 mg/kg). At 2.0 mg/kg methylnaltrexone, number of coughs returned
to baseline value and nociception remained unaffected. At the two high
er doses of naltrexone (0.32 and 0.16 mg/kg), morphine-induced antitus
sive effect was blocked, but antinociception was reversed. Our results
suggested that methylnaltrexone possesses opioid antagonist activity
in receptors peripheral to the blood-brain barrier. Its peripheral act
ivity makes metylnaltrexone a clinically interesting agent for maintai
ning the cough reflex in those who must take opioids for analgesia.