Pharmacologic class: Chloride channel activator
Therapeutic class: GI motility enhancer
Pregnancy risk category C
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
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.
• Moderate to severe hepatic impairment
• Hypersensitivity to drug or its components
• History of mechanical GI obstruction
Use cautiously in:
• severe diarrhea, hepatic or renal dysfunction
• pregnant or breastfeeding patients.
• Administer with food and water.
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
• Evaluate patient for signs and symptoms of mechanical obstruction before therapy begins.
• Assess patient periodically for continuing need for therapy.
• 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.
Pharmacologic: chloride channel activators
Time/action profile (reduction in symptoms)
|PO||within 1 wk||1 wk||unknown|
Adverse Reactions/Side Effects
Central nervous system
- peripheral edema
- diarrhea (most frequent)
- nausea (most frequent)
- abdominal pain
- abdominal distention
- dry mouth
Drug-Drug interactionNone noted.
Chronic Idiopathic Constipation and Opioid-Induced Constipation
Hepatic ImpairmentOral (Adults) Moderate hepatic impairment (Child-Pugh Class B)-16 mcg twice daily; if patient tolerates, can titrate to 24 mcg twice daily, if needed; Severe hepatic impairment (Child-Pugh Class C)-8 mcg twice daily; if patient tolerates, can titrate to 24 mcg twice daily, if needed.
IBS with Constipation
Hepatic ImpairmentOral (Adults) Severe hepatic impairment (Child-Pugh Class C)-8 mcg once daily; if patient tolerates, can titrate to 8 mcg twice daily, if needed.
- Assess for abdominal distention, presence of bowel sounds, and usual bowel patterns prior to and periodically during therapy.
- Assess color, consistency, and amount of stool produced.
- Lab Test Considerations: Assess women of childbearing age for pregnancy. Begin therapy following a negative pregnancy test.
Potential Nursing DiagnosesConstipation (Indications)
Diarrhea (Adverse Reactions)
- Patients with symptoms suggestive of mechanical GI obstruction should be evaluated prior to initiating therapy.
- Oral: Administer with food and water to decrease nausea. Swallow capsules whole; do not crush, break or chew.
- Do not administer to patients severe diarrhea.
- Instruct patient to take lubiprostone as directed.
- Inform patient that dyspnea may occur within 1 hr of first dose; usually resolves within 3 hrs, but may return with repeat doses.
- Advise patients that lubiprostone may cause diarrhea. Advise patient to notify health care professional if diarrhea becomes severe.
- May cause dizziness. Caution patient to avoid driving or other activities requiring alertness until response to medication is known.
- Advise female patients that a negative pregnancy test should be determined prior to taking lubiprostone and to use effective contraception during therapy. Notify health care professional if pregnancy is planned or suspected or if breastfeeding.
- Decrease in symptoms of chronic constipation. Need for continued therapy should be assessed periodically.