HealthDay News — Conventional non-pharmacologic and pharmacologic options for the management of opioid-induced constipation (OIC) in pregnancy are often ineffective or cause potentially troublesome adverse effects, according to a study published in the issue of the Journal of Clinical Pharmacy and Therapeutics.
Z. Li, PharmD, from Temple University in Philadelphia, and colleagues conducted a literature review of the non-pharmacologic (dietary modifications, laxatives, and peripherally acting mu-opioid receptor antagonists [PAMORAs]) and pharmacologic treatment options for the management of OIC during pregnancy.
The researchers found that while generally safe, non-pharmacologic approaches are usually insufficient when used alone to control OIC in pregnancy. Bulking, osmotic, and stimulant laxatives can be effective, but have potential adverse effects (electrolyte disturbances, dehydration, abdominal pain, and pulmonary edema or hypermagnesemia in the extreme) that might be particularly troublesome during pregnancy. Only minimal side effects have been seen with PAMORAs, which lessen OIC without affecting opioid-induced analgesia.
“The PAMORA strategy appears to provide a safe and effective new option superior to conventional therapies for the management of OIC during pregnancy,” the authors write.
Li Z, Pergolizzi J, Huttner R, Zampogna G, Breve F, Raffa R. Management of opioid-induced constipation in pregnancy: a concise review with emphasis on the PAMORAs. J Clin Pharm Ther. 2015. doi:10.1111/jcpt.12331.