Written by Nicole E. Cieri-Hutcherson, PharmD, BCPS, NCMP | Reviewed by Stacia Woodcock, PharmD
Key takeaways:
- There are many constipation-causing medications. Recognizing which ones have a higher risk can help you take steps to prevent this side effect.
- Lifestyle changes that can relieve constipation from medications include increasing your water and fiber intake. Starting a regular exercise routine may also help.
- If lifestyle methods haven’t worked, ask your healthcare provider or pharmacist about over-the-counter medications for constipation. If these don’t help or you can’t take them, it’s time to see your provider.
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Constipation is when you’re having fewer bowel movements than usual, or your stool becomes hard to pass. While most people experience this from time to time, it can be frustrating and uncomfortable. And finding relief may be a priority.
Constipation is also a common side effect of many medications. Some medications that are notorious for this side effect include opioid pain relievers, iron supplements, and antihistamines. Certain blood pressure medications, tricyclic antidepressants, and medications for overactive bladder can also cause constipation.
Knowing your medication can cause constipation can help you take steps to help prevent it. But what’s the best way to relieve constipation from medication? Let’s discuss five tips to help get things moving.
Add fiber
Adding fiber to your diet can improve constipation and promote regular bowel movements. There are two types of fiber: soluble and insoluble fiber. Soluble fiber helps your body absorb water, which makes stool softer. Insoluble fiber helps bulk up stool. Bulkier stools are easier to pass. Adding either or both types of fiber to your diet can help with constipation from medications.
Experts recommend adding fiber as a first-choice option for relieving constipation. And this doesn’t necessarily mean taking fiber supplements (although that’s an option). Certain foods are naturally high in fiber, such as:
- Fruits, such as apples, pears, and berries (be sure to eat the skin too for best results)
- Vegetables, such as broccoli, cauliflower, and spinach
- Legumes, such as beans and peanuts
- Nuts and seeds, such as almonds and pumpkin seeds
- Whole grains, such as brown rice and oats
Drink more water
Drinking more water can also help with constipation from medication. Along with adding fiber, increasing your fluid intake is a first-choice way of treating constipation. Drinking enough water each day increases the water content of your stool. This makes them pass more easily through the intestines.
It’s hard to determine exactly how much water you should drink each day. Some sources suggest drinking 1.5 to 2 liters (about 50 to 68 fluid oz) of water per day in addition to adding fiber may help relieve constipation. This amount, though, is influenced by many factors, such as your body weight, where you live, and how much you exercise. If you’re unsure how much water you should drink, it’s best to contact your healthcare provider.
Exercise
Regular exercise is another way that’s been reported to help manage constipation from medication. Some experts recommend exercise in combination with increased fluids and more fiber. But research isn’t clear on whether starting an exercise program without other lifestyle changes improves constipation.
A review of nine studies involving almost 700 participants found that exercise was an effective management strategy for constipation. Exercises in the study included walking and qigong (exercises similar to tai chi). Unfortunately, many of the studies were of low quality and had flaws. This makes it difficult to draw strong conclusions about the research.
But for many people, there’s little risk in adding some amount of exercise to your routine. Just make sure to ask your healthcare provider first about which exercises are safest for you to start.
Consider OTC laxatives for constipation
There are many over-the-counter (OTC) constipation medications to consider if lifestyle changes haven’t worked.
OTC laxatives for constipation include:
- Bulk forming laxatives: calcium polycarbophil (FiberCon), psyllium (Metamucil), and methylcellulose (Citrucel)
- Osmotic laxatives: polyethylene glycol (Miralax) and glycerin (Fleet suppositories)
- Stimulant laxatives: bisacodyl (Dulcolax) and senna (Senokot, Ex-Lax)
- Saline laxatives: magnesium hydroxide (Milk of Magnesia), magnesium citrate (Citroma), and magnesium oxide (Phillips’ Laxative Caplets)
- Lubricant laxative: mineral oil (Fleet Mineral Oil Enema)
- Stool softeners (emollient laxatives): docusate sodium (Colace, DocQlace)
These products work in different ways. You may prefer one over the other depending on the side effects, how it’s administered, or how soon it works.
Choosing an OTC laxative may also be dependent on which medication is causing constipation. For example, with opioid-induced constipation (OIC), healthcare providers often recommend a stimulant laxative with or without a stool softener. Osmotic laxatives, such as Miralax, are also commonly recommended for OIC. But bulk-forming laxatives should be avoided, as they might cause a bowel obstruction (blockage) in this case.
It’s best to ask your healthcare provider or pharmacist which OTC constipation medication would be best in your situation. Providing them with a medication list can also help them make a recommendation that’s both safe and effective. Sharing this list can help them identify which medication may be causing your constipation, as well as help you avoid interactions when selecting an OTC remedy.
Know when to contact your healthcare provider
Sometimes lifestyle changes and OTC medications don’t work well enough. If these options haven’t worked, it’s time to talk to your healthcare provider about other treatments.
Most OTC options are meant to be temporary, short-term fixes for occasional constipation. If your constipation is caused by medication that you take regularly, you may need to consider a longer-term solution with your provider. This could include prescription constipation medications. For example, Movantik (naloxegol) is a prescription-only treatment for OIC.
If you notice symptoms of severe constipation — such as persistent stomach pain, vomiting, or blood in your stool — seek medical care.
Should I stop taking my medication if it causes constipation?
Maybe, but not without your healthcare provider’s OK. It’s important to always speak to your provider before stopping or switching medications.
In some cases, adjusting the constipation-causing medication can help limit this side effect. This could mean lowering your dose or changing to an alternative that’s less likely to cause constipation. For example, chronic use of the antihistamine diphenhydramine (Benadryl) can be constipating. But newer antihistamines, such as loratadine (Claritin), may be less likely to cause this issue. So a healthcare provider may suggest switching antihistamines to help get things moving again.
The bottom line
There are many constipation-causing medications. Recognizing which ones have a higher risk is important. Increasing your fiber and water intake, as well as regularly exercising, may help head off constipation from medications. If lifestyle changes aren’t working, then it may be time to try OTC medications for constipation. If you’re still having trouble going, or your symptoms seem severe, it’s best to contact your healthcare provider.
References
Bayer Livewell. (2021). Phillips’ laxative caplets.
C.B. Fleet Company, Inc. (2020). Fleet- glycerin suppository [package insert]. DailyMed.
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