Medication for constipation opioid induced – 9 over the counter options

If you are one of the millions of people who rely on opioids to manage chronic pain, you may have experienced opioid-induced constipation (OIC). OIC is a common side effect of opioid therapy that can significantly impact a patient’s quality of life. In our clinic, the incidence of OIC is about 70-80%. However, several medications can help alleviate OIC. In this article, we will explore the various options for medication for opioid constipation and help you understand which one may be right for you.

Understanding Opioid-Induced Constipation

What is Opioid-Induced Constipation?

Opioid-induced constipation is a type of constipation that occurs as a side effect of opioid use. Opioids bind to receptors in the digestive tract, which can slow down the movement of food through the intestines, leading to constipation.

Symptoms of OIC

The symptoms of opioid-induced constipation can include:

• Straining during bowel movements
• Hard or lumpy stools
• Feeling like you haven’t completely emptied your bowels
• Infrequent bowel movements (less than three times a week)

Medications for Opioid-Induced Constipation

Traditional Laxatives

Traditional laxatives, such as stool softeners, fiber supplements, and stimulant laxatives, are often the first-line treatment for OIC. They work by either softening the stool or stimulating the muscles in the intestines to push the stool through more quickly. While traditional laxatives can be effective for some patients, they may not work for everyone and can cause uncomfortable side effects, such as cramping and diarrhea.

Osmotic Laxatives

Osmotic laxatives work by drawing water into the intestines, making the stool softer and easier to pass. This type of laxative is often used for patients with severe constipation, as it can produce rapid results. However, osmotic laxatives can cause dehydration and electrolyte imbalances, which can be dangerous for some patients.

Prokinetic Agents

Prokinetic agents are medications that help stimulate the muscles in the intestines to move stool through more quickly. These medications can be effective for patients with OIC, but they are not commonly used due to their potential side effects, which can include nausea and vomiting.

Mu-Opioid Receptor Antagonists (MORAs)

Mu-opioid receptor antagonists, or MORAs, are medications that work by blocking the opioid receptors in the digestive tract, which can help relieve OIC. There are currently three MORAs approved by the FDA for use in the United States: naloxegol, methylnaltrexone, and naloxone. While MORAs can be effective for some patients, they can also be expensive and may not be covered by insurance.

Combination Therapies

Combination therapies, which involve using two or more medications to treat OIC, can be effective for patients who do not respond to traditional laxatives or MORAs. For example, a combination of a traditional laxative and a MORA may provide more relief than either medication alone.