Types of Medication for Constipation

Constipation is difficulty passing stools due to poor diet and lack of exercise. It involves the inability to pass stools for more than three days, leading to dry and hard stools. Generally, everyone experiences bouts of constipation, which resolve on their own with dietary changes and time. Constipation is usually not serious and only causes a little discomfort. 

It is not a disease and may be a symptom of some underlying conditions.

Over-the-counter (OTC) and prescription medicines are indicated to treat constipation. These drugs aim to soften the stool for an easier bowel movement. Some of the OTC drugs include:

1. Fiber supplements: They add bulk to your stool, making it easier to pass. Examples include:
   • Psyllium
   • Calcium polycarbophil
   • Methylcellulose
2. Stimulants: They cause the intestine to contract for easier passage of stools. Examples include:
   • Bisacodyl
   • Sennosides
3. Osmotic diuretics: These drugs increase fluid secretion from the intestines and help stimulate bowel movements. Examples include:
   • Oral magnesium hydroxide
   • Magnesium citrate
   • Polyethylene glycol
4. Lubricants: Mineral oil aids the passage of stool through the colon.
5. Stool softeners: Drugs such as docusate sodium and docusate calcium moisten the stool by drawing water from the intestine.

Prescription medicines include:

1. Medications that draw water into the intestine: These drugs work by drawing water into the intestine and speeding up stool movement. Examples include:
   • Lubiprostone
   • Linaclotide
   • Plecanatide
2. Serotonin 5-hydroxytryptamine 4 receptors: Prucalopride aids the passage of stools through the colon.
3. Peripherally acting mu-opioid receptor antagonists: These drugs reverse constipation caused by opioid drugs. Examples include:
   • Naloxegol
   • Methylnaltrexone

Over-the-counter medications such as polyethylene glycol, bisacodyl, or senna are better choices than prescription medicines. These are most commonly used for the treatment of constipation because they

• Are more effective.
• Have more evidence for safety.
• Are much cheaper.

Common side effects of fiber supplements include:

• Bloating
• Abdominal pain
• Blocking of the intestine

Common side effects of stimulants include:

• Overuse

Common side effects of osmotic include:

• Cramping
• Diarrhea
• Nausea

Common side effects of stool softeners include:

• A sudden decrease in the effectiveness after long-term use

Common side effects of medicines that draw water into the intestine include:

• Gas
• Diarrhea
• Upset stomach
• Stomach cramps
• Headache
• Nausea
• Vomiting

Common side effects of serotonin 5-hydroxytryptamine 4 receptors include:

• Headache
• Abdominal pain
• Nausea
• Diarrhea
• Vomiting
• Dizziness
• Fatigue

This is not a complete list of side effects and other serious side effects or health problems that may occur because of the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to FDA at 1-800-FDA-1088.

These over-the-counter medicines are considered safe for treating constipation during pregnancy when taken as directed:

• Colace (docusate sodium)
• Fibercon (calcium polycarbophil)
• Metamucil (psyllium)
• Milk of Magnesia (magnesium hydroxide)
• Miralax (polyethylene glycol)

However, check with your doctor before taking any medicine during your pregnancy.

Laxatives can interfere with alcohol as both are metabolized in the liver. Avoid mixing alcohol and laxatives to prevent the following side effects:

• Dehydration
• Dizziness
• Sluggishness/drowsiness
• Itching/hives
• Bloating
• Constipation
• Diarrhea
• Reduced motor reflexes
• Nausea and/or vomiting