Prescription Medication for Chronic Constipation

Few prescription medications have specific indications for treating chronic constipation, and only one, Amtiza, is well known. Medications ranging from muscle relaxants to antidepressants can help people who have frequent trouble emptying their bowels, however. If you need relief from chronic constipation, your physician may prescribe one of these other drugs. Be aware, though, that you cannot take any of the medications described here to relieve constipation due to a blockage of your gastrointestinal tract.

Amtiza

Amtiza, a branded version of the antispasmodic drug lubiprostone marketed by Sucampo, has U.S. Food and Drug Administration approval for treating chronic constipation whether of unknown cause or from irritable bowel syndrome in women older than 18 years of age. The medication works by increasing the secretion of fluid by the walls of the intestines. Do not take Amtiza if you have diarrhea--a significant side effect--or are pregnant or planning to become pregnant. Be sure to take Amtiza capsules with food to minimize nausea.

Other Antispasmodics

Other antispasmodics that physicians prescribe to relieve chronic constipation include dicyclomine (e.g., Bentyl from Axcan) and hyoscyamine (e.g., Anaspaz from B.F Ascher). These medications can produce drowsiness and blurred vision and can put you at risk for heat exhaustion.

Muscle Relaxants

Your physician may prescribe a muscle relaxant in addition to an antispasmodic medication. A meta-analysis of clinical studies reported in the October 1994 issue of the journal Alimentary Pharmacology & Therapeutics determined that cimetropium bromide, pinaverium bromide (e.g., Dicetel from Solvay), trimebutine, octilium bromide and mebeverine provided the most benefits for patients with chronic constipation. Combining antispasmodics and muscle relaxants can cause significant drowsiness and dizziness.

Antidepressants

The tricyclic antidepressants amitriptyline and desipramine (e.g., Norpramin from sanofi aventis) can relieve the pain associated with chronic constipation. Constipation can occur with the use of antidepressants, however.

Metoclopramide

Indicated for up to 12 weeks of treatment for gastroesophageal reflux disease and for delayed gastric emptying in diabetics, metoclopramide is sometimes used to increase the muscle activity along the intestines in patients with chronic constipation. Available under the brand name Reglan in tablet form from Alaven Pharmaceuticals and in an injectable form from Baxter Healthcare, metoclopramide can rarely cause dangerous elevations of blood pressure or a tremor disorder called tardive dyskinesia. Watch for drowsiness, fatigue, and lack of energy when taking metoclopramide.

Tegasarod Warning

The antispasmodic medication tegaserod, once sold under the brand name Zelnorm by Novartis, does have a specific indication for treating chronic constipation in adults with irritable bowel syndrome. The medication was withdrawn from the market in March 2007, however, because use of tegaserod was associated with angina, heart attacks and stroke. The FDA may allow emergency use of tegaserod for women younger than 55 years of age who have no history of cardiovascular disease, smoking or mood disorders.

References

• Amtiza prescribing information
• Chronic constipation overview
• Tegasarod emergency use

Resources

• Constipation from the National Library of Medicine
• Irritable bowel syndrome from the National Institute of Diabetes and Digestive and Kidney Disorders