Opioid-induced constipation (OIC)
- Start bowel regimen when opioid starts
- Osmotic ± stimulant laxative first
- Persistent OIC → PAMORA
- naldemedine/naloxegol/methylnaltrexone
- Lubiprostone is another option
- Avoid bulk fiber if severe hypomotility
- Rule out obstruction before aggressive therapy
Use at a glance
- Start bowel regimen when opioid starts
Treatment options
- Rule out obstruction before aggressive therapy
Practical pearls
- Osmotic ± stimulant laxative first
- Persistent OIC → PAMORA
- naldemedine/naloxegol/methylnaltrexone
- Lubiprostone is another option
Safety / pitfalls
- Avoid bulk fiber if severe hypomotility
Self-check
- What should be started in Opioid-induced constipation (OIC)?
bowel regimen when opioid starts.
- What should generally be avoided in Opioid-induced constipation (OIC)?
bulk fiber if severe hypomotility.
Drugs used for this (4)
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