Treatment of Opioid-induced Constipation: A Therapeutic Update

In 2013, an estimated 207 million opioid prescriptions were dispensed by retail pharmacies in the U.S. (https://www.drugabuse. gov/about-nida/legislative-activities/testimony-to-congress/2016/ americas-addiction-to-opioids-heroin-prescription-drug-abuse). While opioids are highly efficacious for the treatment of acute and chronic pain, they may cause a number of significant side effects. One of the most commonly reported side effects of opioid use is opioidinduced constipation (OIC). According to recent studies, 41-47% of patients using opioids for chronic pain experience significant OIC. In patients on chronic opioid therapy, the degree of OIC can be quite severe and even debilitating.

Treatment of Opioid
Treatment of Opioid

A number of therapeutic interventions are currently available to treat OIC with varying degrees of efficacy. Treatment for OIC may include over-the-counter (OTC) options such as stimulant laxatives, stool softeners and osmotic laxatives, as well as prescription drugs that antagonize peripheral μ-opioid receptors, and directly stimulate intestinal secretions and motility. The various treatment options will be discussed below with emphasis on their mechanism of action, efficacy, and potential side-effects.

 

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