Lubiprostone (Amitiza®)


How it works: Activates a channel on intestinal cells that causes secretion of electrolytes and water which softens the stool and helps it to pass through the intestines and colon.

Which symptoms does it help: Overall IBS-C symptoms, constipation, belly pain, bloating.

How long it takes to see a benefit: Within 1-2 weeks.

FDA approved: Adult women with IBS-C, adults with chronic constipation, adults with opioid induced constipation

Dosage: 8 and 24 mcg twice daily. The recommended dose is 8 mcg twice daily in patients with IBS-C, and 24 mcg twice daily for patients with chronic idiopathic constipation and opioid induced constipation.

Special considerations or risks: Patients with liver disease are at increased risk for adverse reactions and dose adjustment for patients with moderate or severe liver disease may be required. Pregnancy: There is insufficient data on Lubiprostone use in pregnancy. Animal studies did not show an increase in structural malformations.

Most common side effects: Nausea, diarrhea, and abdominal pain.

Recommendation: ACG recommends lubiprostone for overall symptom improvement in IBS-C patients. (Recommendation: strong; Quality of evidence: moderate)