title: Pharmacokinetic and pharmacodynamic considerations for the current chronic constipation treatments.
abstract: BACKGROUND
  Chronic constipation is a frequent condition often treated pharmacologically. The laxatives available belong to very different pharmacologic groups.
  
  
  METHODS
  This is a short but comprehensive review of the pharmacology, efficacy and safety of currently available laxatives for chronic constipation. Pertinent publications were retrieved from reference lists of publications and by literature searches via PubMed, lastly performed in November 2012.
  
  
  CONCLUSIONS
  The most relevant laxative groups are the older representatives osmotic salts, sugars and sugar alcohols, macrogol, anthraquinones, diphenolic laxatives or diphenyl methanes (bisacodyl and sodium picosulfate) and the newer compounds prucalopride, lubiprostone and linaclotide. For all of these laxatives efficacy has been shown in controlled trials. Electrolyte losses do not occur when laxatives are given in therapeutic doses (rare exceptions with phosphate salts and salinic laxatives). The older laxatives are also safe regarding teratogenicity, abortion and lactation. For the newer compounds no respective data are available as yet. It is questionable whether the newer compounds offer advantages over the older ones. Unfortunately, comparative trials are lacking.
authors: Park-Klinik Weissensee, Schönstrasse 80, 13086 Berlin, Germany. mueli@park-klinik.com
authors: Stefan
authors: S
authors: Müller-Lissner
mesh_terms: D000527:Alprostadil / Q000031:analogs & derivatives / Q000493:pharmacokinetics / Q000627:therapeutic use; D000880:Anthraquinones / Q000493:pharmacokinetics / Q000627:therapeutic use; D001572:Benzofurans / Q000493:pharmacokinetics / Q000627:therapeutic use; D001726:Bisacodyl / Q000493:pharmacokinetics / Q000627:therapeutic use; D002908:Chronic Disease; D003248:Constipation / Q000188:drug therapy*; D004305:Dose-Response Relationship, Drug; D006801:Humans; D054368:Laxatives / Q000493:pharmacokinetics* / Q000627:therapeutic use*; D000068238:Lubiprostone; D010455:Peptides / Q000493:pharmacokinetics / Q000627:therapeutic use; D011092:Polyethylene Glycols / Q000493:pharmacokinetics / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
chemical_list: D000880:Anthraquinones; D001572:Benzofurans; D054368:Laxatives; D010455:Peptides; C406662:prucalopride; D001726:Bisacodyl; D011092:Polyethylene Glycols; D000068238:Lubiprostone; D000527:Alprostadil; C523483:linaclotide