Initiate a Bowel Protocol When Scheduled Opioids Are Started

The approval of naloxegol (Movantik, mo-VAN-tick) will mean more options for treating opioid-induced constipation.

Work with your institution to have one standardized bowel protocol. Be proactive and initiate a bowel regimen when a scheduled opioid is started...or if a patient has a lot of PRN use.

Start with an osmotic laxative such as polyethylene glycol (Miralax, etc), and schedule it at least daily. These are well tolerated...inexpensive...cause less cramping than stimulants...and are safe to use long-term for patients on chronic opioids.