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Opioids Has anyone tried Naloxegol for constipation?

evo4ever

Bluelighter
Joined
Jun 14, 2016
Messages
1,398
Location
UK
Hello all.

I've been suffering with chronic constipation for almost a decade thanks to my Oxycodone prescription. I've tried all of the conventional laxatives with little success. I've been doing some research into "Peripherally Acting Opioid Antagonists" like Naloxegol and they look promising! Has anyone tried any of these drugs? Thanks in advance.
 
Hello all.

I've been suffering with chronic constipation for almost a decade thanks to my Oxycodone prescription. I've tried all of the conventional laxatives with little success. I've been doing some research into "Peripherally Acting Opioid Antagonists" like Naloxegol and they look promising! Has anyone tried any of these drugs? Thanks in advance.

I'd like to know this too as I was given a load of this stuff by a friend.

After reading there's a small percentage (Something like 1%) risk of induced withdrawal I never risked it cause I don't have extremely bad constipation that often.

The best tips I can give you as a long-term opioid user are as follows :

1. Walk about and/or exercise. Walking causes certain muscles and/or bones to massage the bowels, which helps constipation.

2. Add fibre and seeds to your diet.
I bought some ispaghol/psyllium husk/Plantago Ovato husk (Basixally a powder.) from an Asian ship and add it to yogurts, soups, cereals and other stuff.
It was far, far cheaper to buy it this way than buy it prepackaged as a fibre supplement or constipation aid in capsules.
I also use flaxseed/linseed, either whole or ground.
Ground is good in that it makes the nutrients far easier to absorb as the whole seeds can pass through you undigested.
They contain a lot of protein and Omega 3 fatty acids but with the ground seeds you don't know how fresh they are and the fats could have spoiled.
So try and buy from a decent company if you buy the ground type and make sure you try and find out how old they are.

3. Make sure you get plenty of fluid.
I tend to drink more so tea and cocoa cause they're not only healthier but with the caffeine, theobromine and theophylline in them they help make you wanna go for a #2, similar to how people say nicotine does too.
Fruit juices and smoothies are a good option too, just don't have smoothies all the time cause cause they're apparently chock full of sugar that normally wouldn't all be available as it'd be locked away in cells wrapped in fibre or at least released a lot slowly.

4. Magnesium supplements :
Magnesium helps draw moisture into the intestines and bowels, the opposite action of opioids.
Not all forms of magnesium are created equal.
Some like magnesium oxide are a waste of time to buy, it's only any good as a pill/capsule filler and for constipation as only 5% is bioavailabe but I'd not even use it for that.

Since the 1950's magnesium levels in soils around the world and in our food has plummeted by a massive amount.
Grains only contain about 10% of what they did back then and obviously we don't absorb all of that.

Magnesium is very good for depression, anxiety (It can be as effective as prescription drugs for them.), pain, sleep, muscle relaxation, PMS, migraines and many other conditions. It's used in over 100 different reactions/enzymes in our cells and also works on the NMDA receptor as an antagonist like ketamine and PCP does, it's assumed this is one way it helps anxiety, depression and pain.
It's also an electrolyte.

Magnesium Threonate has been found so far to be the best form for getting magnesium into the brain but unfortunately it is expensive compared to other forms.
So I use a 2/3's magnesium bisglycinate and 1/3 magnesium threonate.

If you have a choice between magnesium glycinate and magnesium bisglycinate go for the latter as the Mg is bound to two glycinate amino acid molecules and glycinate also like magnesium helps to relax and calm a person down.
The glycinate and bisglycinate forms have good bioavailability and help constipation too.

I've seen Magnesium citrate recommended for constipation too but as far as I'm aware the bioavailability isn't as good as the (bis)glycinate and obviously the threonate form.
I know magnesium hydroxide is used for constipation and I think upset stomachs as Milk of Magnesia but the bioavailability isn't that great if you're wanting it to help other stuff.
Epson salts, which is magnesium sulphate is another form especially used in baths ans foot baths for aching muscles and feet and for constipation but I don't think that it has a great bioavailability either.

As the majority of people are deficient in magnesium I'd definitely go for one with a good bioavailability.

5. Another route is ultra-low dose naltrexone. Similar to the Naloxegol but other than ordering the naltrexone online or getting a very understanding doctor to prescribed it to you I'm not sure how you'd get it but when I tried it via volume metric dosing it seems to be a bit more effective than double dosing magnesium and having a glass of fluid with it.
 
I'd like to know this too as I was given a load of this stuff by a friend.

After reading there's a small percentage (Something like 1%) risk of induced withdrawal I never risked it cause I don't have extremely bad constipation that often.

The best tips I can give you as a long-term opioid user are as follows :

1. Walk about and/or exercise. Walking causes certain muscles and/or bones to massage the bowels, which helps constipation.

2. Add fibre and seeds to your diet.
I bought some ispaghol/psyllium husk/Plantago Ovato husk (Basixally a powder.) from an Asian ship and add it to yogurts, soups, cereals and other stuff.
It was far, far cheaper to buy it this way than buy it prepackaged as a fibre supplement or constipation aid in capsules.
I also use flaxseed/linseed, either whole or ground.
Ground is good in that it makes the nutrients far easier to absorb as the whole seeds can pass through you undigested.
They contain a lot of protein and Omega 3 fatty acids but with the ground seeds you don't know how fresh they are and the fats could have spoiled.
So try and buy from a decent company if you buy the ground type and make sure you try and find out how old they are.

3. Make sure you get plenty of fluid.
I tend to drink more so tea and cocoa cause they're not only healthier but with the caffeine, theobromine and theophylline in them they help make you wanna go for a #2, similar to how people say nicotine does too.
Fruit juices and smoothies are a good option too, just don't have smoothies all the time cause cause they're apparently chock full of sugar that normally wouldn't all be available as it'd be locked away in cells wrapped in fibre or at least released a lot slowly.

4. Magnesium supplements :
Magnesium helps draw moisture into the intestines and bowels, the opposite action of opioids.
Not all forms of magnesium are created equal.
Some like magnesium oxide are a waste of time to buy, it's only any good as a pill/capsule filler and for constipation as only 5% is bioavailabe but I'd not even use it for that.

Since the 1950's magnesium levels in soils around the world and in our food has plummeted by a massive amount.
Grains only contain about 10% of what they did back then and obviously we don't absorb all of that.

Magnesium is very good for depression, anxiety (It can be as effective as prescription drugs for them.), pain, sleep, muscle relaxation, PMS, migraines and many other conditions. It's used in over 100 different reactions/enzymes in our cells and also works on the NMDA receptor as an antagonist like ketamine and PCP does, it's assumed this is one way it helps anxiety, depression and pain.
It's also an electrolyte.

Magnesium Threonate has been found so far to be the best form for getting magnesium into the brain but unfortunately it is expensive compared to other forms.
So I use a 2/3's magnesium bisglycinate and 1/3 magnesium threonate.

If you have a choice between magnesium glycinate and magnesium bisglycinate go for the latter as the Mg is bound to two glycinate amino acid molecules and glycinate also like magnesium helps to relax and calm a person down.
The glycinate and bisglycinate forms have good bioavailability and help constipation too.

I've seen Magnesium citrate recommended for constipation too but as far as I'm aware the bioavailability isn't as good as the (bis)glycinate and obviously the threonate form.
I know magnesium hydroxide is used for constipation and I think upset stomachs as Milk of Magnesia but the bioavailability isn't that great if you're wanting it to help other stuff.
Epson salts, which is magnesium sulphate is another form especially used in baths ans foot baths for aching muscles and feet and for constipation but I don't think that it has a great bioavailability either.

As the majority of people are deficient in magnesium I'd definitely go for one with a good bioavailability.

5. Another route is ultra-low dose naltrexone. Similar to the Naloxegol but other than ordering the naltrexone online or getting a very understanding doctor to prescribed it to you I'm not sure how you'd get it but when I tried it via volume metric dosing it seems to be a bit more effective than double dosing magnesium and having a glass of fluid with it.

Trust me I've literally tried everything over the years including Mg! Naloxegol is the only thing left to try. If Naloxegol definitely reverses the constipating effects of opioids then I bet that will have a positive impact on my cholesterol levels too! I'm gonna call my GP today and ask for it.
 
Trust me I've literally tried everything over the years including Mg! Naloxegol is the only thing left to try. If Naloxegol definitely reverses the constipating effects of opioids then I bet that will have a positive impact on my cholesterol levels too! I'm gonna call my GP today and ask for it.

If you're in the US it'd be far cheaper to get naltrexone either from ordering from India or a sympathetic doctor and making a ultra-low-dose solution.
 
If you're in the US it'd be far cheaper to get naltrexone either from ordering from India or a sympathetic doctor and making a ultra-low-dose solution.

I've managed to get my GP to prescribe it for me. I'll let you know how I get on.
 
Well I'm on day two of taking the Naloxegol and I've had three bowl movements, so far so good!

What dose did you get prescribed? Is there different doses?

What opioid(s) are you using and how much and how often?

How long does it take for the naloxegol to kick in after you've swallowed it?

Does it seem to cause any withdrawal symptoms at all?

Is it a regular bowel movement, still slightly constipated or slightly watery/borderline diarrhoea?

Good to hear your doc' was OK and helped you and that it's working.
 
What dose did you get prescribed? Is there different doses?

What opioid(s) are you using and how much and how often?

How long does it take for the naloxegol to kick in after you've swallowed it?

Does it seem to cause any withdrawal symptoms at all?

Is it a regular bowel movement, still slightly constipated or slightly watery/borderline diarrhoea?

Good to hear your doc' was OK and helped you and that it's working.

I got prescribed 25mg, I'm using Shortec (Oxycodone) 30mg 4x a day, I got a bowl movement about 2 hours after my first dose, the only thing I noticed when it comes to possible WD is occasional hot flashes but that's it, I've had 4 bowel movements since I started taking it which is alot more than 1 bowl movement a week without the Naloxegol. I highly recommend it to anyone whos on chronic opioid treament!
 
magnesium oxide
Magnesium Threonate
magnesium bisglycinate
magnesium glycinate
Magnesium citrate
magnesium hydroxide
magnesium sulphate

–Malate and –acetyl taurate were shown to have the highest bioavailabilities:

Timeline (Bioavailability) of Magnesium Compounds in Hours: Which Magnesium Compound Works Best?. Uysal, N., Kizildag, S., Yuce, Z., Guvendi, G., Kandis, S., Koc, B., Karakilic, A., Camsari, U. M., Ates, M. 2019. Biological trace element research, 187(1), 128–136. 10.1007/s12011-018-1351-9

… And the plot thickens …

❝If your Mg is not liposomal or sucrosomial you are likely peeing most of it out.❞ h‍ttps://x.com/chydorina/status/1997045207192498605

❝When taking magnesium citrate, only 6% of the magnesium is actually usable for the cells❞ Allgemeines zu Kolloiden. www.raum-bewusstsein.info.

❝ReMag® liquid magnesium is a pure, 60,000ppm magnesium supplement that has been proven effective in both the consumer and healthcare community. A placebo and cross over blinded control study was performed to prove the difference in our picometer liquid minerals, and their ability to be absorbed at higher rates by the body.❞ https://rnareset.com/pages/clinical-proof-of-picometer-size

Circulating Ionized Magnesium as a Measure of Supplement Bioavailability: Results from a Pilot Study for Randomized Clinical Trial. Zhan, J., Wallace, T. C., Butts, S. J., Cao, S., Ansu, V., Spence, L. A., Weaver, C. M., Gletsu-Miller, N. 2020. Nutrients, 12(5), 1245. 10.3390/nu12051245
 
I've read somewhere that Peripherally-Acting Mu-Opioid Receptor Antagonists like Naloxegol have been such a success that pharma companies are planning to compound their Opioids with PAMORAs which might see the end of constipation associated with long-term Opioid use.
 
Take this with a grain of salt but I've been getting monthly shots of Vivitrol (depot muscle injection naltrexone) and seen almost no constipation over that time. I'm not all that great at eating fiber, and have occasionally in the past had constipation issues prior to taking the naltrexone.

I'm sorry you're going through this.

My brother has constipation a lot (he's on fentanyl patches), but I'm not sure if he still does and if so how he handles it.
 
Take this with a grain of salt but I've been getting monthly shots of Vivitrol (depot muscle injection naltrexone) and seen almost no constipation over that time. I'm not all that great at eating fiber, and have occasionally in the past had constipation issues prior to taking the naltrexone.

I'm sorry you're going through this.

My brother has constipation a lot (he's on fentanyl patches), but I'm not sure if he still does and if so how he handles it.

You should tell him to look into PAMORAs.
 
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