1.6.7 Other drugs used in constipation

Lubiprostone
  • Capsules 24 micrograms (£53.48)

Indications

  • Chronic idiopathic constipation, adults

Dose

  • Adult over 18 years, 24 micrograms twice daily

Notes

  1. Lubiprostone may be considered for adults in whom treatment with at least 2 laxatives from different classes, at the highest tolerated recommended doses for at least 6 months, has failed to provide adequate relief and for whom invasive treatment for constipation is being considered.
  2. Local opinion is that lubiprostone may be initiated in primary care so long as previous courses of laxative treatments have been carefully reviewed.
  3. Initial duration of treatment with lubiprostone should be 2 weeks. If treatment with lubiprostone is not effective after 2 weeks the benefit of continuing treatment should be reconsidered.
  4. NICE TA318 Lubiprostone is recommended as an option for treating chronic idiopathic constipation (July 2014)
Prucalopride
  • Tablets 1mg, 2mg (£59.52 = 2mg daily)

Dose

  • Adult over 18 years, 2mg once daily
  • Elderly over 65 years, initially 1mg once daily, increased if necessary to 2mg once daily

Notes

  1. NICE TA211 Constipation (women) – prucalopride (December 2010).
  2. Prucalopride should be initiated in secondary care where the patient will be overseen for 4 weeks to assess the benefit of the treatment. If treatment with prucalopride is effective, then prescribing can be continued in primary care.
  3. If treatment with prucalopride is not effective after 4 weeks the women should be re-examined and the benefit of continuing treatment reconsidered.
Linaclotide

Not routinely commissioned for use in NEW Devon CCG and South Devon and Torbay CCG, following consideration by the clinical policy committee. Click here for more information. The policy indicates that in exceptional circumstances the Trust-Managed Individual Patient Treatments process can be used for this indication.

 

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