II. Indications
III. Contraindications
IV. Mechanism
- Bicyclic Fatty Acid derived from Prostaglandin E1 derivative
- Chloride channel activator (Secretagogue)
- Lubiprostone binds and activates type 2 chloride channels (CIC2) in the gastrointestinal epithelium
- Results in chloride release into the gastrointestinal lumen, with water following
V. Dosing
-
General
- Capsules should be swallowed whole
- Decrease dose with moderate to severe liver dysfunction
-
Constipation Dominant Irritable Bowel Syndrome (women age >18 years)
- Take 8 mcg orally twice daily
-
Chronic Idiopathic Constipation (men and women)
- Take 24 mcg orally twice daily with food and water
-
Opioid Induced Constipation (non-cancer related, in men and women)
- Take 24 mcg orally twice daily with food and water
VI. Adverse Effects
-
Nausea (esp. with 24 mcg dose)
- Decreased when taken with food
-
Diarrhea (esp. with 24 mcg dose)
- Hold Lubiprostone for severe Diarrhea
- Abdominal Pain
-
Chest Pain or Dyspnea
- Follows dose within 1 hour
- Resolves within 3 hours
VII. Safety
- Pregnancy Category C
- Unknown safety in Lactation
VIII. Efficacy
- Low efficacy in Irritable Bowel Syndrome with Constipation (only 14% respond)
IX. Drug Interactions
-
Methadone
- Decreases Lubiprostone efficacy
X. Resources
- Lubiprostone (DailyMed)
XI. References
- Chang (2006) Curr Treat Options Gastroenterol 9(4):314-23 [PubMed]
- (2021) Irritable Bowel Syndrome Drug Comparison, Presc Lett, #370305
- (2020) Med Lett Drugs Ther 62(1594): 41-58
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Related Studies
| lubiprostone (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| LUBIPROSTONE 24 MCG CAPSULE | Generic | $4.32 each |
| LUBIPROSTONE 8 MCG CAPSULE | Generic | $4.13 each |
| amitiza (on 2/23/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| AMITIZA 24 MCG CAPSULES | Generic | $4.32 each |
| AMITIZA 8 MCG CAPSULE | Generic | $4.13 each |