Which medications are used in the treatment of constipation?

Updated: May 18, 2020
  • Author: Abimbola Farinde, PharmD, PhD; more...
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Constipation is a symptom with various etiologies and can be associated with many factors that contribute to its presentation. [1] Primary constipation may be characterized by normal [2] or slow intestinal transit or may be caused by an anatomical issue (eg, pelvic flow dysfunction). Secondary constipation is associated with endocrine or metabolic disorders (eg, hypercalcemia, hypothyroidism, pregnancy, diabetes mellitus), neurologic disorders (stroke, Parkinson disease, multiple sclerosis), connective tissue disorders (eg, scleroderma, amyloidosis), and eating disorders. [3, 4]

Commonly identified medications that may contribute to constipation include antidepressants, iron, bismuth, anticholinergics, opioids, antacids, calcium channel blockers, nonsteroidal anti-inflammatory drugs (NSAIDs), sympathomimetics, and antipsychotics (typical or atypical). Long-term use of cholestyramine or stimulant laxatives may lead to a dilated atonic laxative colon, resulting in constipation and the presumed need for more laxatives.

The choice of laxative for treatment or prevention of constipation depends on the etiology. Medications to treat constipation include bulk-forming agents, lubricant laxatives, stool softeners, stimulant laxatives, osmotic laxatives, saline laxatives, and prokinetic agents. [3, 5, 4]

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