When it comes to opioid-
induced constipation (OIC),
there’s no more time to wait
When it comes to opioid-induced constipation (OIC), there’s no more time to wait
- OIC often persists throughout patients’ opioid therapy and is not typically dependent on dose or duration of opioid use2
How long is too long?
of people in a survey of 322 patients taking oral opioid therapy daily and over-the-counter (OTC) laxatives reported still being constipated1
- OIC often persists throughout patients’ opioid therapy and is not typically dependent on dose or duration of opioid use2
Despite using OTC laxatives, some patients may still have fewer than 3 bowel movements per week and experience continued discomfort with OIC1,*
*Multinational internet-based survey designed to assess the prevalence, frequency, and severity of opioid-induced bowel dysfunction (OBD) symptoms, specifically constipation, in patients receiving opioid therapy for chronic pain who were taking laxatives; 322 patients taking daily oral opioids and laxatives completed the 45-item questionnaire.1
Patients with OIC often cycle through OTC options without adequate relief 3,4
Laxatives, including stimulants and osmotic laxatives, are typically used as initial treatments for OIC.5-7
Not intended to suggest a comparison of efficacy, safety, or comparability.
Studies have shown that, when combined with a healthy diet and exercise, CYCLOSET helped lower blood sugar levels after each meal throughout the day.
This may help achieve the goals you and your doctor want.
Bridging the communication gap with your patients is crucial
In surveys of physicians and patients:
Patients are suffering in silence
In a survey of patients with non-cancer pain and OIC (n=493)3:
of patients did not discuss their constipation-related symptoms with their HCPs3,†
Of those patients who did not discuss OIC:
0%reported being concerned about having their pain medication changed3,†
HCPs may be unaware
In the physician component of the same survey8:
of HCPs did not know that their patients were experiencing constipation8,†
of HCPs did not know if their patients were on laxatives or not8,†
†Prospective longitudinal survey conducted in the United States, Canada, Germany, and United Kingdom to assess the burden of OIC in patients with non-cancer pain using a combination of patient surveys, retrospective data abstraction from medical records, and physician surveys.3,8 In a study of 493 patient survey participants, baseline patient-reported outcomes were evaluated.3 In a study of 489 patient survey participants, evaluations of physician-completed surveys were conducted.8
OIC is caused by opioids binding to mu-opioid receptors in the gastrointestinal (GI) tract, which can slow GI motility2,11
effects that can contribute to OIC include
DECREASED PERISTALTIC MOTION12,13
INCREASED FLUID ABSORPTION FROM THE GUT12,13
DECREASED FLUID SECRETION INTO THE GUT12,13
REFERENCES: 1. Bell TJ, Panchal SJ, Miaskowski C, Bolge SC, Milanova T, Williamson R. The prevalence, severity, and impact of opioid-induced bowel dysfunction: results of a US and European patient survey (PROBE 1). Pain Med. 2009;10(1):35-42. 2. Pergolizzi JV Jr, Raffa RB, Pappagallo M, et al. Peripherally acting μ-opioid receptor antagonists as treatment options for constipation in noncancer pain patients on chronic opioid therapy. Patient Prefer Adherence. 2017;11:107-119. 3. Coyne KS, LoCasale RJ, Datto CJ, Sexton CC, Yeomans K, Tack J. Opioid-induced constipation in patients with chronic noncancer pain in the USA, Canada, Germany, and the UK: descriptive analysis of baseline patient-reported outcomes and retrospective chart review. Clinicoecon Outcomes Res. 2014;6:269-281. 4. Emmanuel A, Johnson M, McSkimming P, Dickerson S. Laxatives do not improve symptoms of opioid-induced constipation: results of a patient survey. Pain Med. 2017;18(10):1932-1940. 5. Crockett SD, Greer KB, Heidelbaugh JJ, Falck-Ytter Y, Hanson BJ, Sultan S; American Gastroenterological Association Institute Clinical Guidelines Committee. American Gastroenterological Association Institute guideline on the medical management of opioid-induced constipation. Gastroenterology. 2019;156(1):218-226. 6. Zhao Q, Chen YY, Xu DQ, et al. Action mode of gut motility, fluid and electrolyte transport in chronic constipation. Front Pharmacol. 2021;12:1-15. 7. Brock C, Olesen SS, Olesen AE, et al. Opioid-induced bowel dysfunction: pathophysiology and management. Drugs. 2012;72(14):1847-1865. 8. LoCasale RJ, Datto C, Margolis MK, Coyne KS. Satisfaction with therapy among patients with chronic noncancer pain with opioid-induced constipation. J Manag Care Spec Pharm. 2016;22(3):246-253. 9. Pappagallo M. Incidence, prevalence, and management of opioid bowel dysfunction. Am J Surg. 2001;182(5)(suppl):11S-18S. 10. Cook SF, Lanza L, Zhou X, et al. Gastrointestinal side effects in chronic opioid users: results from a population-based survey. Aliment Pharmacol Ther. 2008;27(12):1224-1232. 11. Galligan JJ, Sternini C. Insights into the role of opioid receptors in the GI tract: experimental evidence and therapeutic relevance. Handb Exp Pharmacol. 2017;239:363-378. 12. Streicher JM, Bilsky EJ. Peripherally acting μ-opioid receptor antagonists for the treatment of opioid-related side effects: mechanism of action and clinical implications. J Pharm Pract. 2018;31(6):658-669. 13. Bader S, Jaroslawski K, Blum HE, Becker G. Opioid-induced constipation in advanced illness: safety and efficacy of methylnaltrexone bromide. Clin Med Insights Oncol. 2011;5:201-211.