title: Lubiprostone for Opioid-Induced Constipation Does Not Interfere with Opioid Analgesia in Patients with Chronic Noncancer Pain.
abstract: To determine whether lubiprostone 24 μg twice daily (BID), administered to relieve opioid-induced constipation (OIC), affects opioid analgesia in patients with chronic noncancer pain.
  
  
  
  Data were pooled from 3 randomized, double-blind, placebo-controlled trials of lubiprostone in adults with chronic noncancer pain receiving stable opioid analgesia and who had documented OIC. In each study, lubiprostone 24 μg BID or placebo was administered for 12 weeks for relief of OIC using a common protocol. The Brief Pain Inventory short form (BPI-SF) was administered, and opioid use (expressed as morphine-equivalent daily dose [MEDD]) was recorded at baseline and months 1, 2, and 3. The BPI-SF provided patient scores for pain severity, the worst pain experienced in the past 24 hours, and pain interference with daily life.
  
  
  
  The pooled patient population (N = 1300) was predominately female (62.5%) and white (82.1%), with a mean age of 50.5 years. The MEDD was 97.5 mg (range, 5 to 3656 mg) in patients receiving placebo and 112.5 mg (range, 4 to 7605 mg) in patients treated with lubiprostone. Lubiprostone 24 μg BID treatment did not appear to affect opioid use or pain scores; changes from baseline were not significantly different with placebo vs. lubiprostone 24 μg BID at months 1, 2, and 3 for MEDD (P ≥ 0.435) and for BPI-SF scores for pain interference, pain severity, and worst pain (P ≥ 0.402).
  
  
  
  Lubiprostone 24 μg BID administered for relief of OIC in patients with chronic noncancer pain does not interfere with opioid analgesia.
authors.affiliation: Headache & Face Pain Program, Tufts Medical Center, and Craniofacial Pain Center, Tufts University School of Dental Medicine, Boston, Massachusetts, U.S.A.
authors.forename: Egilius L H
authors.initials: EL
authors.lastname: Spierings
authors.affiliation: Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina, U.S.A.
authors.forename: Randall P
authors.initials: RP
authors.lastname: Brewer
authors.affiliation: Carolinas Pain Institute, Winston-Salem, North Carolina, U.S.A.
authors.forename: Richard L
authors.initials: RL
authors.lastname: Rauck
authors.affiliation: Sucampo Pharma Americas, LLC, Bethesda, Maryland, U.S.A.
authors.forename: Taryn
authors.initials: T
authors.lastname: Losch-Beridon
authors.affiliation: Sucampo Pharma Americas, LLC, Bethesda, Maryland, U.S.A.
authors.forename: Shadreck M
authors.initials: SM
authors.lastname: Mareya
mesh_terms: D000328:Adult; D000698:Analgesia / Q000379:methods; D000701:Analgesics, Opioid / Q000009:adverse effects* / Q000494:pharmacology; D065101:Chloride Channel Agonists / Q000494:pharmacology / Q000627:therapeutic use; D059350:Chronic Pain / Q000175:diagnosis / Q000188:drug therapy*; D003248:Constipation / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy*; D004311:Double-Blind Method; D004347:Drug Interactions; D005260:Female; D006801:Humans; D000068238:Lubiprostone / Q000494:pharmacology / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement / Q000187:drug effects* / Q000379:methods
chemical_list: D000701:Analgesics, Opioid; D065101:Chloride Channel Agonists; D000068238:Lubiprostone
keywords: 
  OIC
  ; bowel dysfunction; constipation; lubiprostone; opioid; opioid-induced constipation; pain