Medical Management of Opioid-Induced Constipation

Publication Date: January 1, 2019
Last Updated: December 15, 2022

Treatment

Summary of Recommendations of AGA Clinical Guidelines for the Medical Management of OIC

Traditional laxatives

In patients with OIC, AGA recommends use of laxatives as first-line agents. ( Moderate , Strong )
612

Peripherally-acting µ-opioid receptor antagonists

In patients with laxative refractory OIC, AGA recommends naldemedine over no treatment. ( High , Strong )
612
In patients with laxative refractory OIC, AGA recommends naloxegol over no treatment. ( Moderate , Strong )
612
In patients with laxative refractory OIC, AGA suggests methylnaltrexone over no treatment. ( Low , Conditional (weak) )
612

Intestinal secretagogues

In patients with OIC, AGA makes no recommendation for the use of lubiprostone. ( Evidence Gap , No recommendation )
612

Selective 5-HT agonists

In patients with OIC, AGA makes no recommendation for the use of prucalopride. ( Evidence Gap , No recommendation )
612

Recommendation Grading

Overview

Title

Medical Management of Opioid-Induced Constipation

Authoring Organization

American Gastroenterological Association

Publication Month/Year

January 1, 2019

Last Updated Month/Year

October 3, 2024

Document Type

Guideline

External Publication Status

Published

Country of Publication

US

Document Objectives

This document presents the official recommendations of the American Gastroenterological Association (AGA) on the medical management of opioid-induced constipation. 

Target Patient Population

Adults with opioid-induced constipation

Inclusion Criteria

Male, Female, Adult, Older adult

Health Care Settings

Ambulatory, Hospital, Outpatient

Intended Users

Nurse, nurse practitioner, physician, physician assistant

Scope

Treatment, Management

Diseases/Conditions (MeSH)

D000079689 - Opioid-Induced Constipation

Keywords

opioids, constipation, OIC, Opioid Induced Constipation

Supplemental Methodology Resources

Technical Review