Over the counter medications for opioid induced constipation (OIC)

 

Over-the-counter (OTC) constipation medications work through different mechanisms of action to provide relief from constipation. Bulk-forming laxatives, such as psyllium or methylcellulose, absorb water and expand in the intestines, increasing stool volume and stimulating bowel movements. Osmotic laxatives, like polyethylene glycol or magnesium salts, draw water into the intestines to soften the stool and ease its passage. Stimulant laxatives, such as senna or bisacodyl, increase intestinal contractions to facilitate stool evacuation. Lastly, stool softeners, like docusate, work by adding moisture to the stool, making it easier to pass. Each medication type addresses constipation differently, and the choice of which to use may depend on the specific situation or individual preferences.

Our recommendations

 

1 stimulant (Dulcolax) + stool softer (Colace)

OR

2. daily osmotic laxative – (MiraLax) Polyethylene glycol

The following are the 10 most common over the counter medications used for general constipation which can be used for opioid induced constipation (OIC).  

Product NameMechanism of ActionCommon Side Effects 
1. MiraLAXOsmotic laxativeBloating, gas, cramps 
2. DulcolaxStimulant laxativeCramps, diarrhea, nausea 
3. MetamucilBulk-forming fiber supplementGas, bloating, choking 
4. ColaceStool softenerGas, bloating, cramps 
5. Milk of MagnesiaSaline laxativeDiarrhea, nausea, cramps 
6. SennaHerbal stimulant laxativeDiarrhea, cramps, nausea 
7. BenefiberBulk-forming fiber supplementGas, bloating, choking 
8. Magnesium CitrateSaline laxativeDiarrhea, nausea, cramps 
9. Fleet EnemaRectal sodium phosphate enemaRectal irritation, cramps 
10. Suppository (Glycerin)Hyperosmotic laxative (rectal use)Rectal irritation

Studies have shown that either a combination of stimulant + a stool softener or daily use of an osmotic laxative yields the best results.  There are prescription requiring medications which we talked about in another article which you can find here.

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