I'm on 50 miligrams of Fentanyl and 8 tabs of of Norco daily, and I need a good laxitive!
Hi Karen, I have been on opiates for 15 yrs. I have a fentanyl patch changed every 72 hrs and norco for breakthrough pain. I have tried many laxatives, stool softeners, suppositories, enemas but found them not only to be hard on me but hard on my system. Gas , bloating, sometimes bouts of loose stools and cramping and bleeding hemmorhoids. With the loose stools at times I have lost too much fluid. Just not a feeling of well being. I was given an Rx for MiraLax, took it every single day for 3 days and used a glycerine suppository just to help get me started and now I have regular soft formed stools.No bloating, gas abdominal pain, impactions or bleeding hemmorhoids, no problems. MiraLax is a daily medication for me. It is now over the counter and there is now a generic brand and my insurance covers it. Bonus! you mix it with any liquid and is virtually tasteless!!
I also eat prunes occassionally, drink as much water as I can rememer to do so, eat fruits and some veggies. I understand your situation and hope you feel better soon.
Time and a fiber-rich diet are the best course of action when dealing with opiate-induced constipation. Stimulant laxatives are only a short-term solution and a bad choice if you're going to be on the drugs for even a moderate period of time.
Nearly all short-term relief such as stimulant laxatives, suppositories and enemas cause some type of rebound effect, which can make the problem worse instead of better. MiraLax is a somewhat different approach that doesn't. It's very effective and leaves you feeling "normal" afterwards, but it's not fast. It generally takes 2-3 days to work and if you haven't anticipated needing it, you're going to be pretty miserable by thetime it finally does.
Another natural approach which works well, but again, isn't fast, is Activia brand yogurt. By itself, it's not a laxative but used in combination with MiraLax or even a stimulant laxative, will even out the function of your bowels to a more normal pattern.
But really, the best approach of all is to increase both the fiber in your diet (fresh fruit works faster and more effectively for me, and prunes are a miracle worker!) and to also increase your fluid intake. Ditto for exercise, although that may or may not be an option depending on why you're taking opiate meds. Inactivity and inadequate fluid intake can both aggravate poor bowel function.
It does require adjusting your diet and habits, but will be worth it for the overall effects on your health, which will be better by far.
I have been using Lactulose now for about four years. I take four taplespoons full every morning and usually I have my bowel movement within two hours. It works great and doesn't taste too bad. It is just very very sweet. I take fiber supplements twice a day also.
You might laugh but watermelon is the thing for
opiate constipation and it will work like you would not believe!!!
I have been in that situation!
Take Care and good luck
Use Miralax daily and it should help you
My preferences for laxatives are using both Lactulose and Peri-Colace, they were both recommended by my board certified pain management specialist as well as my gastroenterologist and they work extremely well.
Another good one that is recommended is Miralax, it works well too though I prefer the first two that I mentioned.
These are all very safe and are not harsh and do work for those of us that take opioid medications daily.
You might want to ask your physician what he/she recommends but I have personally found the ones that I have mentioned to be the "gold standards".
Of the medications that I just mentioned, only Lactulose requires a prescription.
I have the same problems because of the meds I'm on. I use Dulcolax stool softener and Dulcolax laxative. I take both at the same time and they work pretty well. Good luck. I hope you have a low pain day. Scooter
If you haven't used anything for constipation in the past, I would not start out with a laxative. I would try taking Colace (Docusate Sodium 250 mg) with plenty of fluids and see if that works. Check with your Pharmacist, but I have seen people take it twice a day in the beginning. It comes in 100mg & 2500mg, the 100mg generic is about $6.00 per 100. There is also, Peri-Colace which is Docusate Sodium with a laxative added. The biggest problem with laxatives is that your body can get used to it. This is cheapest way to go. I am on Kadian 80mg, Norco 10/325 5 times a day, Oxycodone 5mg 5 times a day, and understand the contstipation thing quite well! I have also worked as a Pharmacy Technician for the last 20 years, so I also see what the Dr.s do for it. If you are desperate, just to get some releif now, I would start with generic Peri-Colace. Then make sure you take at least 250mg of Dcousate. It will just make your stool soft, so you are able to have bowl movements on a steady basis. Miralax is a great mediicine, it comes RX and over the counter, some insurances are still paying for it, if the Dr. writes a prescription for it. It they don't cover it, it is about $17-$20 for the medium size. I have several patients that were on it, but they were having problems with loose stools. Latulose works good, you usually have to buy a large quantity depending on your dose. The cost on that will be your generic co-pay, if you have insurance, $13-20 plus for a months supply without. I like the Docusate because it designed to prevent hard, dry stools, your body doesn't get addicted to it and it's the cheapest. You can get 200 capsules for about $7.00 at Costco. If you don't have insurance, always call around for the best price. Costco/Sams are usually the cheapest and you do not have to be a member to use the pharmacy. Always make sure you are drinking lots and lots of fluids while on any narcotic, this will help tons!
Good Luck! Finding the one that suits you the best is key!
Ask your doctor about a prescription for Enulose ( also known as Lactulose). It can be administered orally (by mouth) or rectally. Fortunately, it DOES NOT taste bad. It is very sweet, kinda like pancake syrup. This medication causes the body to leave water in the stool so it doesn't get hard and plug your rectum. After 3 years of fighting the constipation and horrible effects of intestinal blockages, my doctor started me on this medicine. A 1 oz. dose each night, plenty of fluids and adequate fiber in your diet does wonders.
Other than that, my doctor said that dulcolax is a good laxative. It doesn't affect the spasms in the intestines that are slowed by narcotic medications. So you can take it as needed without becoming dependant on it.
I wish you good luck. I am on similar medications and don't see any change ahead. So I understand your situation.
I'm on pretty much the same meds and I suffered from serious constipation that almost landed me in the hospital and caused serious problems for a while. After a couple of sessions of colonic treatments (which really helped me, actually.) I began taking 1-2 ounces of Aloe Vera gel, mixed with 1 small capful of mineral oil, in a few ounces of pear or mangoe nectar or juice, daily. When things get really rough, for whatever reason, I add Amateeza to my regiment. It's a newer laxative, and although it wasn't originally intended for medication-related constipation, it works better than anything I've ever tried. It's prescription only, so I told my pain doctor about it, and now he recommends it to all his patients. I must say, once you begin to use the Aloe Vera concoction daily, you won't need much of a laxitive. It's really great. and it's one less pill you have to take a day! it doesn't cause any cramping, and it's good for you. The other thing that helps is the yogurt with probiotics in it, and drinking tons of liquids is really important when on these meds...Good luck!
I think the best laxitive is a natural one, I use a generic over the counter "vegetable laxitive", they are easy to regulate and very easy on the system. I also have ulcerative colitis so I have to really watch laxitives.