The FDA has approved use of lubiprostone (Amitiza) for treatment of opioid-induced constipation in adults with chronic non-cancer pain. The drug was previously approved for chronic idiopathic constipation and irritable bowel syndrome with constipation.1,2

OPIOID-INDUCED CONSTIPATION — Patients develop tolerance to the analgesic and CNS-depressant effects of opioids, but not to constipation, which can be dose-limiting or cause discontinuation of therapy. It is usually treated with laxatives and stool softeners, which have limited efficacy.3 Methylnaltrexone (Relistor), a mu-opioid receptor antagonist that must be given subcutaneously, is FDA-approved for treatment of opioid-induced constipation in patients with advanced illness receiving palliative care; it apparently does not cross the blood-brain barrier and therefore does ... more      

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