Opioids Opioids induced constipation

I'm on a longterm painkiller rx, oxycodone at 120mg/d, and unsurprisingly, its causing way more of a problem with constipation than my old script, which was dihydrocodeine at the same dose.

I try to make sure as much as possible of who I eat is high in fiber, and regularly take a proprietary effervescent MgSO4 product, and just recently added a polyethylene glycol based product, just trying the latter out though.

I'm somewhat reluctant to use a laxative of the irritant kind due to their potential side effects and overall more violent nature than those acting on osmolality of the lower GI tract or those such as fibre supplements, but it seems intuitively like they may be more effective for dealing with opioid related constipation than the others, due to their actively stimulating peristalsis. Certainly not suitable for regular use of course.

Any advice from those with experience dealing with this particular issue?

One odd thing I noticed also, is that whilst I quite possibly came a few picometers from having a stroke whilst taking a shite earlier yesterday, after taking a second dose of oxy (and I dare say, a little larger than prescribed) some time later, dropped one without much trouble at all after that. Completely the opposite of what I would expect.

dried fruit
muesli
wholegrain bread
lots of water
- those are my methods. other people have their own preferences. there are certainly many ways to have a healthy, high-fibre diet without having to take laxatives. i'd just recommend eating lots of fruit - it's tasty, full of vitamins and it'll help you stay regular.

Stool softener and a high fiber diet should help. Personally, I don't like laxatives for opiate educed constipation, but some people do. I just found that if you have a blockage with solid stool, a laxative can cause a lot of pain due to building up pressure and gas behind this large, solid stool. It reminds me of this. Although that video clip is funny, I find it to be pretty accurate in describing opiate related constipation, and Wonka basically described opiate constipation at :55 and on.


This has been discussed before at length, so you will likely get more answers (and get them quicker) by searching through previous threads. Here;

Opiates/opioid constipation
Dealing with OPIATE RELATED CONSTIPATION Mega-Thread

For more results, just type in 'constipation' as the keyword in the search function, and change the drop-down menu from 'search entire posts' to 'search titles only.' This will yield better results.

Get some of that methylnaltrexone!

i am on sub and I have had horrific constipation the entire time I have been on it. This sucks even more because I was suffering from hemorrhoids before this...

Miralax seems to be the best for maintenance. Take one dose a day (in the morning) and maybe two if that does not work after a couple days. If you want to rotate something else I use bisacodyl suppositories. They work wayyyy better than the miralax and work in less than 30 minutes. As long as you don't have a problem with suppositories, they are the most effective.

dcraver877 said:

i am on sub and I have had horrific constipation the entire time I have been on it. This sucks even more because I was suffering from hemorrhoids before this...

Miralax seems to be the best for maintenance. Take one dose a day (in the morning) and maybe two if that does not work after a couple days. If you want to rotate something else I use bisacodyl suppositories. They work wayyyy better than the miralax and work in less than 30 minutes. As long as you don't have a problem with suppositories, they are the most effective.

Click to expand...

Ive had the same problems with Suboxone before especially when i was on 8mg. Try tapering down a bit more (comfortably) and youll notice a difference with constipation and itll be a lot easier as long as you continue with a high fiber diet. That was my experience, but if you are on a low dose already try more fiber and a stool softener since those aren't like laxatives that make you shit your brains out uncomfortably

I didn't become free of constipation until I dropped down to one milligram of suboxone a day. I can't stand that shit. Literally!

Yep, constipation can become pretty horrendous with long term use. Not uncommon to go over a week without passing anything, and the stools can become seriously impacted. Instead of using oral laxatives it's sometimes best to tackle the problem from the other end. Glycerin suppositories can be really useful. They draw water down from the bowel which will soften the stool, and provide a little lubrication which makes passing a large, impacted stool a little easier, hopefully avoiding too much straining and tearing.

Fleet brand glycerin suppositories work really well. they come in a green jar. I'm on methadone maintenance which causes really bad constipation; this was the only thing that actually worked. i was pooping within 10 minutes of using the product. Best of luck to you i know how "shitty" constipation can make one feel

My mom was in the hospital for a week in 2011 from the constipation she gets from methadone. She goes to a pain clinic, and they give her methadone for pain. She takes that, plus hydrocodone. These come with a prescription liquid that is supposed to keep her from getting constipated. She and I were on vacation last year for about a week, and come to find out, she had not brought the liquid with her. We were back at my parents home for 2 days, during which time my mom started experiencing severe abdominal pain.

She eventually let my dad and I take her to the emergency room and the hospital admitted her. I've never seen my mom so sick. I seriously thought she was dying. The doctors had to put her on an IV drip for pain and started doing enemas. I supposed my mom had 5 or 6 enemas over her hospital stay and when she finally had a movement it was explosive.

She is 73, and NOT wanting to experience severe, life-threatening constipation again, she is careful to remember her laxatives, both the prescription and OTC kind. She prefers Miralax.

She had gone for 11 or 12 days without a bowel movement before it got so bad and so painful that she could not help herself anymore and had to be in the hospital before she finally got better. If you are taking methadone for ANY reason, please be careful that you keep your bowels moving. My mom eats a very high fiber diet but that just is not sufficient to combat the effect methadone has on her ability to go poo.

^Damn, that's shitty


Going in to mild w/d has always helped me move bowels. Miralax is too expensive; Magnesium Citrate/Oxide work as laxatives, though.

Its improved, not really noticing a problem after increasing the amount of fiber in my diet significantly and using that movicol that was rx'ed to my (former) hell-bitch housemate.

Never used glycerin suppositories, but on occasion, when it comes to 'dire straits' constipation territory, cramping pains, etc, one thing I find to be completely reliable is to dissolve 5ml of glycerine in 10ml of warm water and plug it. Best be already sat on the shitter though as its effective within a couple of minutes.

When I was doing heroin I had difficulty going to the bathroom but I always ended up going eventually. Now the withdrawls that's a given, its going to happen no matter what. I just got on suboxone last Tuesday and I finally gave in and had to buy some ex lax today. I had not used the bathroom since monday. So I took the ex lax and 6 hours latee I was good to go. Hurt like a mother fucker to get it out.

Limpet_Chicken said:

Its improved, not really noticing a problem after increasing the amount of fiber in my diet significantly and using that movicol that was rx'ed to my (former) hell-bitch housemate.

Never used glycerin suppositories, but on occasion, when it comes to 'dire straits' constipation territory, cramping pains, etc, one thing I find to be completely reliable is to dissolve 5ml of glycerine in 10ml of warm water and plug it. Best be already sat on the shitter though as its effective within a couple of minutes.

Click to expand...

Glad to hear that it has improved.

I am suffering from this now, it has been 4 days now I am really starting to worry. I am using movicol, drinking water and eating prunes so I hope something happens soon.

Dulcalax, a stimulant, can get things started.

To keep it leveled out, use miralax.