Lubiprostone

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[edit] BRAND NAMES

[edit] STRUCTURE

Lubiprostone.jpg

[edit] MECHANISM OF ACTION

  • Lubiprostone is a prostaglandin E1 derivative. It increases chloride ion transport into the intestinal lumen, enhances fluid secretion into the bowels, and improves fecal transit.

[edit] INDICATIONS

  • Treatment of chronic idiopathic constipation in adults
  • Treatment of opioid-induced constipation in adults with chronic, non-cancer pain. Limitations of Use: Effectiveness of Amitiza in the treatment of opioid-induced constipation in patients taking diphenylheptane opioids (e.g., methadone) has not been established
  • Treatment of irritable bowel syndrome with constipation in women ≥ 18 years old

[edit] DOSAGE

  • Chronic Idiopathic Constipation and Opioid-induced Constipation: 24 mcg taken twice daily orally with food and water
  • Irritable Bowel Syndrome with Constipation: 8 mcg taken twice daily orally with food and water.

[edit] DOSAGE FORMS AND STRENGTHS

  • Capsules: 8 mcg and 24 mcg

[edit] CONTRAINDICATIONS

  • Patients with known or suspected mechanical gastrointestinal obstruction.

[edit] WARNINGS AND PRECAUTIONS

  • Patients may experience nausea; concomitant administration of food may reduce this symptom
  • Do not prescribe for patients that have severe diarrhea
  • Patients taking Lubiprostone may experience dyspnea within an hour of first dose. This symptom generally resolves within 3 hours, but may recur with repeat dosing.
  • Evaluate patients with symptoms suggestive of mechanical gastrointestinal obstruction prior to initiating treatment with Lubiprostone

[edit] INTERACTIONS

Concomitant use of diphenylheptane opioids (e.g., methadone) may interfere with the efficacy of Lubiprostone

[edit] PREGNANCY AND LACTATION

  • Pregnancy Category C (US): Based on animal data, Lubiprostone may cause fetal harm and should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.
  • Nursing Mothers: Caution should be exercised when administering to a nursing woman

[edit] SIDE EFFECTS

Most common adverse reactions (incidence > 4%) are nausea, diarrhea, abdominal pain, abdominal distension, flatulence

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[edit] BIBLIOGRAPHY

[edit] REFERENCES