The invention relates to a pharmaceutical composition to reduce
back pain comprising two compounds: an
opioid antagonist and a direct-acting alpha 2 adrenegic
agonist. The
Opioid antagonist is selected from the group consisting of alvimopan,
nalmefene, naloxone,
naltrexone,
methylnaltrexone, nalorphine, and pharmaceutically acceptable salt. The direct-acting alpha 2 adrenegic
agonist is selected from a group consisting of Apraclonidine,
Brimonidine,
Clonidine, Detomidine,
Dexmedetomidine, Guanabenz, Guanfacine, Lofexidine,
Medetomidine, Romifidine, Tizanidine, Tolonidine, Xylazine and Fadolmidine. In one embodiment, the composition may include
naltrexone (or its pharmaceutically acceptable salt) as the
opioid antagonist and
clonidine hydrochloride (or its pharmaceutically acceptable salt) as the direct-acting alpha 2 adrenegic
agonist. It is preferred
naltrexone be administered with a second agent such as an antitussive,
expectorant,
decongestant, or
antihistamine. The dosage of naltrexone may range between 0.25 mg to 15 mg, while the dosage of
clonidine hydrochloride ranges between 0.0125 mg and 0.3 mg.