Methadone and Miralax

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mudslide
Posts: 40
Joined: Sun Jun 08, 2014 7:23 am

Methadone and Miralax

Post by mudslide »

Methadone has worked very well for me at a dosage of 7.5 mg. I've been using Miralax daily to deal with the constipation. These days, if I don't take just precisely the right amount, I either get seriously constipated or experience bowel incontinence without any sensation that it's happening. We're talking poopy panties here. Obviously I'm being very careful about measuring the dose accurately, but still, I'm starting to wonder if there's another way to manage the problem other than trying to find an alternative to the opioid. I know this is a luxury problem, comparatively speaking, but if anyone's got an idea, I'd love to hear it.

Frunobulax
Posts: 430
Joined: Mon Jun 02, 2014 7:41 pm

Re: Methadone and Miralax

Post by Frunobulax »

Taking laxatives like Miralax long term is not a good idea.

Surprisingly, reducing fiber can help a lot both for constipation and diarrhea. Common wisdom is that fiber helps, but it appears there is zero research to back this up. This guy knows what he's talking about: https://www.youtube.com/watch?v=DEx9foeADnc

There are so many things that we may be sensitive to and that affect our digestion: Lectins, oxalates, fodmaps, isoflavones, salicylates, histamines, nickel. Avoiding all of them for a while (=carnivor diet for a couple of months) can do wonders, especially if you are not sure what to avoid. After that you can reintroduce other food one by one and check which ones give you trouble.

Alternatives are a lectin free, low fodmap diet, as lectins and fodmaps are the usual suspects to mess up digestion. But carnivore is better :)

QyX

Re: Methadone and Miralax

Post by QyX »

Check this out: https://www.movantik.com/ (Naloxegol is the active substance in it)

This relatively new drug would be the best option to treat opioid induced constipation when the more conventional treatments don't work properly.

In your case, it might be worth a try and it is quite likely that you don't even need to take the drug daily and might require lower doses than advertised.

Also: you can check if changes in your diet might improve your constipation issues. Normally 7,5 mg of Methadone is a relatively low dose where constipation issues rarely happen. However it seems like you are rather sensitive in that area, so using a drug like naloxegol might be perfect in your situation.

Keep in mind that using a drug like Naloxegol might require a slight increase of your methadone dose, maybe from 7,5 to 10 mg per day.

If Movantik works for you, your bowel should work (almost) completely normal.

mudslide
Posts: 40
Joined: Sun Jun 08, 2014 7:23 am

Re: Methadone and Miralax

Post by mudslide »

Thank you so much for the info about Movantik, QyX. I had not heard of it; will run it by my sleep doc, who is well versed in RLS, and see what she thinks.
Frunobulax, I appreciate your response -- however, I haven't eaten red meat for decades and don't want to start now. I'll have to look up "fodmap," "lectin," etc. Completely new vocabulary for me!

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