lubiprostone
Pharmacologic class: Chloride channel activator
Therapeutic class: GI motility enhancer
Pregnancy risk category C
Action
Enhances chloride-rich intestinal fluid secretion without altering sodium and potassium serum concentrations; increases intestinal fluid secretion and intestinal motility, which promotes stool passage and relieves symptoms of chronic idiopathic constipation
Availability
Soft gelatin capsules: 8 mcg, 24 mcg
Indications and dosages
➣ Chronic idiopathic constipation
Adults: 24 mcg P.O. twice daily
➣ Treatment of irritable bowel syndrome with constipation in women
Adults ages 18 and older: 8 mcg P.O. b.i.d.
Dosage adjustment
• Moderate to severe hepatic impairment
Contraindications
• Hypersensitivity to drug or its components
• History of mechanical GI obstruction
Precautions
Use cautiously in:
• severe diarrhea, hepatic or renal dysfunction
• pregnant or breastfeeding patients.
Administration
• Administer with food and water.
Adverse reactions
CNS: headache, dizziness, hypoesthesia, fatigue, depression, anxiety, insomnia
CV: chest discomfort or pain, hypertension
EENT: sinusitis, nasopharyngitis, pharyngolaryngeal pain
GI: nausea, vomiting, diarrhea, constipation, abdominal distention, abdominal pain or discomfort, flatulence, dyspepsia, gastroesophageal reflux disease, gastroenteritis, dry mouth
GU: urinary tract infection
Musculoskeletal: arthralgia, back pain, extremity pain, muscle cramp
Respiratory: upper respiratory tract infection, influenza, bronchitis, dyspnea, cough
Other: weight gain, peripheral edema, fever, viral infection
Interactions
None
Patient monitoring
• Evaluate patient for signs and symptoms of mechanical obstruction before therapy begins.
• Assess patient periodically for continuing need for therapy.
Patient teaching
• Instruct patient not to break or chew capsule.
• Instruct patient not to take drug during episodes of severe diarrhea.
• Advise patient to report side effects, such as severe nausea, diarrhea, and dyspnea, to prescriber.
• Caution female patient with child-bearing potential that drug may pose hazard to fetus.
• Advise breastfeeding patient that she should decide whether to discontinue breastfeeding or stop taking drug.
• As appropriate, review all other significant adverse reactions.