Opioid Constipation

[Brynmr]

Not a fun topic but rather than derailing further Bearpaws' thread with an off-topic query, I thought I'd start my own.

Opioid constipation is a thing and I'm dealing with it now. I'm taking 20mg oxycodone daily and having trouble moving. The laxatives I'm taking, Miralax and dulcalax, don't do much so every 3 or 5 days I reach for Fleet. That works fine. But it's not ideal healthy-wise I imagine. Any advice? My Oncologist says to drink more water.

[ViewsAskew]

Water definitely helps. Fiber in the diet also very much helps. Magnesium can help some people (really does me, but only one variety, which is odd). Exercise can help. I am sensitive to several foods that cause diarrhea when I am not taking opioids, but make things just right when I am taking opioids - that is beets and dairy.

[Lissa496]

I would suggest taking magnesium citrate starting with 250 mgs. I took it every other day, until it stopped working, then every day, and I upped the dosage to 500 mgs when I noticed it was not working as well, which was the recommended dosage. I am not sure if you can raise the dosage from 500 mgs but it seems to work well at this dose so I have not changed it. I have been taking this for about 2 years and it seems to do the trick.

This is the active ingredient in milk of magnesium!

[Brynmr]

Thank you Lissa. I will look into it. All these treatments are supposed to be short term but we have a long term issue.

[ViewsAskew]

Oddly, magnesium citrate doesn't work for me when I buy it alone. But, there is a triple magnesium product (by Swanson in the US) that always works immediately for me. And doesn't work at all for my husband. Go figure.

[Brynmr]

Oddly, magnesium citrate doesn't work for me when I buy it alone. But, there is a triple magnesium product (by Swanson in the US) that always works immediately for me. And doesn't work at all for my husband. Go figure.

I'm reading it helps you get a better night's sleep.

[Frunobulax]

Not a fun topic but rather than derailing further Bearpaws' thread with an off-topic query, I thought I'd start my own.

Opioid constipation is a thing and I'm dealing with it now. I'm taking 20mg oxycodone daily and having trouble moving. The laxatives I'm taking, Miralax and dulcalax, don't do much so every 3 or 5 days I reach for Fleet. That works fine. But it's not ideal healthy-wise I imagine. Any advice? My Oncologist says to drink more water.

I can only repeat what I wrote in the other thread... Can't say more water helped me in any way though.

I'm ultra sensitive to side effects, and constipation is/was a massive problem for me, being on Oxycodone 20-30mg over the years. What works best for me is magnesium citrate, I take a teaspoon every evening dissolved in water, before going to bed. Allows me to "go" the next day without issues. Takes a bit time to get the dosage right, too much and you'll know it the next day, not enough and constipation is back. But I've been doing this for many years now and it's fine. It is sold as a supplement (I get mine from Amazon, pure powder in bulk containers), not as a laxative, but the effect is there.

If I want something more, um, faster acting, then I take magnesium peroxide. (Which I get as non-prescription from a pharmacy, but I'm not sure about the US brand names.) This works for me within 1-6 hours, depending on the dose. It is sold as a designated laxative.

I tried a lot of other things, but nothing was satisfactory, Lactulose worked but was hard to dose and caused flatulence. I also didn't like the taste. Other stuff, especially fiber like flea seeds, chia and whatever is the treatment of the day, did nothing at all for me.

[Frunobulax]

Oddly, magnesium citrate doesn't work for me when I buy it alone. But, there is a triple magnesium product (by Swanson in the US) that always works immediately for me. And doesn't work at all for my husband. Go figure.

Magnesium citrate has only a small amount of magnesium (ballpark of 15% I believe), so you need fairly large doses to see an effect. I need 3-4 grams a day for relief. Other magnesium products have a higher rate of elemental magnesium so they may work at much lower doses.

[Frunobulax]

I am not sure if you can raise the dosage from 500 mgs but it seems to work well at this dose so I have not changed it.

From what I've heard, magnesium only causes diarrhea unless you go really high (like 5 grams of elemental magnesium per day). Magnesium citrate has roughly 15% elemental magnesium, so you'd have to go over 30 grams per day for a while. I dare say you'll see the desired laxative effects at much lower doses than that, but you may need more than 500mg which is just 75mg magnesium (which IMO doesn't move the needle).

But as always, check with your doctor, especially if you have some kind of kidney disease.