Drug Detail:Lubiprostone (Lubiprostone [ loo-bee-pros-tone ])
Drug Class: Chloride channel activators
Usual Adult Dose for Constipation - Chronic
24 mcg orally 2 times a day
Comments: The effectiveness of this drug in the treatment of opioid-induced constipation in patients taking diphenylheptane opioids (e.g., methadone) has not been established.
Use: Treatment of chronic idiopathic constipation and of opioid-induced constipation in adults with chronic non-cancer pain.
Usual Adult Dose for Irritable Bowel Syndrome
8 mcg orally 2 times a day
Use: Treatment of irritable bowel syndrome with constipation (IBS-C) in women age 18 years and older.
Renal Dose Adjustments
No adjustment recommended.
Liver Dose Adjustments
Patients with Chronic Idiopathic Constipation or Opioid-Induced Constipation:
Initial Dose:
- Mild Liver Dysfunction (Child-Pugh A): Dose adjustment not required.
- Moderate Liver Dysfunction (Child-Pugh B): 16 mcg orally 2 times a day
- Severe Liver Dysfunction (Child-Pugh C): 8 mcg orally 2 times a day
Patients with IBS-C:
- Mild (Child-Pugh A) and Moderate (Child-Pugh B) Liver Dysfunction: Dose adjustment not required.
- Severe Liver Dysfunction (Child-Pugh C): 8 mcg orally once a day
Maintenance Dose: If the initial dose is tolerated and an adequate response has not been obtained after an appropriate interval, escalate dose to full dosing with appropriate monitoring of patient response.
Precautions
Safety and efficacy have not been established in patients younger than 18 years.
Consult WARNINGS section for additional precautions.
Dialysis
No adjustment recommended.
Other Comments
Administration Advice:
- Take doses with food and water.
- Swallow drug capsules whole; do not break apart or chew them.
Storage Requirements:
- Store at 25 degrees Celsius (77 degrees Fahrenheit); excursions permitted to 15 to 30 degrees Celsius (59 to 86 degrees Fahrenheit).
- Store in the original container to protect from light and moisture.
- Use drug within 4 weeks after opening the original container.
General:
- Following 4 weeks of twice-daily treatment, withdrawal of this drug did not result in a rebound effect.
Monitoring:
- Assessment of need for continued therapy (periodically)
Patient Advice:
- Contact your healthcare provider immediately if you experience severe nausea, diarrhea, or dyspnea during treatment.
Frequently asked questions
- Which drugs cause opioid-induced constipation?
