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What is opioid-induced constipation?

Opioid-induced constipation (OIC), or constipation due to opioid therapy, is a common and unpleasant effect of opioid treatment.

What is opioid-induced constipation?

Opioid-induced constipation (OIC), or constipation due to opioid therapy, a common and unpleasant effect of opioid treatment.

How common is opioid constipation?

Line of people impacted by OIC icon

About 40%-50% of patients receiving opioid therapy for chronic non-cancer pain report developing OIC.

What is the difference between OIC and other kinds of constipation?

Some common forms of constipation may occur as a result of

  • Certain foods
  • Certain activities
  • A lack of fiber in your diet
  • Stress
  • Other medications

OIC is different. OIC, or opioid-induced constipation, is a term used to describe constipation that is the result of opioid therapy. Opioid constipation may last as long as you are on your opioid therapy.*


*Discontinue SYMPROIC® if treatment with opioid pain medication is discontinued.

How do opioids cause constipation?

Icon showing side effects of opioids that send signal to brain to reduce pain but also impact digestive tract receptors and cause constipationIcon showing side effects of opioids that send signal to brain to reduce pain but also impact digestive tract receptors and cause constipation

What are the most common symptoms of OIC?

OIC can cause a range of symptoms, including

  • Going less often
  • Pushing harder (straining more)
  • Not going all the way
  • Passing harder stools

Constipation can be extremely uncomfortable and debilitating, and you shouldn’t suffer in silence.


Access helpful resources to learn more about OIC.


Find Resources
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Laxatives may not be enough

Different types of OTC laxatives may help temporarily relieve constipation in some people. They work by coating your intestines to support movement, stimulating your bowel to move things along, or pulling water into your bowels. However, OTC laxatives may not be enough to treat opioid constipation, especially long term.

How long does opioid constipation last?

OIC can last as long as you take an opioid. Because many patients taking opioid therapy notice some level of constipation, it's important to have an open and honest conversation about OIC treatment options as soon as you begin your opioid therapy for chronic pain. Watch the below video to learn more about what causes OIC.

What causes opioid-induced constipation?

Opioids can be used to treat a wide variety of pain conditions, including chronic pain. However, opioids can have side effects, including nausea, vomiting, and constipation.

Common side effects with opioids

  • Nausea
  • Vomiting
  • Constipation

You have pain receptors throughout your body. In your spinal cord, these receptors relay pain signals to your central nervous system and on to your brain.

Most opioids relieve pain by binding to specific receptors—like the mu-opioid receptor—within your central nervous system and brain. The mu-opioid receptor is the most common opioid receptor. When an opioid binds to the mu-opioid receptor, it results in pain relief.

However, mu-opioid receptors are also found in your digestive system. When opioids bind to these receptors, they slow the activity of the digestive system and reduce the secretions needed to digest your food. This can result in opioid-induced constipation, or OIC.

OIC is different from other types of constipation and may last as long as you are taking opioids.

If you have OIC, you have probably noticed a difference in your bowel movements, such as:

  • Going less often
  • Straining when you go
  • Feeling like you’re not going completely, or you still have to go

Several products are available to treat opioid constipation, including over-the-counter laxatives, and prescription medications from your healthcare provider.

One type of prescription medication, called a PAMORA, specifically acts on the mu-opioid receptors in your digestive system, treating the underlying cause of OIC.

Don’t wait to talk to your doctor about opioid constipation

Opioid constipation can leave you feeling uncomfortable and frustrated, especially when discussing your condition with your doctor. As awkward as these conversations may seem, they are extremely important. Your doctor can only help you feel better if he or she understands what you’re going through.

Symproic Doctor Discussion Guide
Use this Doctor Discussion Guide to help you begin an open and honest conversation with your doctor.

Learn More
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SYMPROIC works by addressing the underlying cause of OIC—so you aren’t suffering from yet another kind of pain

MEDICATION GUIDE

What is the most important information I should know about SYMPROIC®?

SYMPROIC may cause serious side effects, including:

  • Tear in your stomach or intestinal wall (perforation). Stomach pain that is severe can be a sign of a serious medical condition. If you get stomach pain that does not go away, stop taking SYMPROIC and get emergency medical help right away.
  • Opioid withdrawal. You may have symptoms of opioid withdrawal during treatment with SYMPROIC including sweating, chills, tearing, warm or hot feeling to your face (flush), sneezing, fever, feeling cold, abdominal pain, diarrhea, nausea, and vomiting. Tell your healthcare provider if you have any of these symptoms.

MEDICATION GUIDE

What is the most important information I should know about SYMPROIC®?

SYMPROIC may cause serious side effects, including:

  • Tear in your stomach or intestinal wall (perforation). Stomach pain that is severe can be a sign of a serious medical condition. If you get stomach pain that does not go away, stop taking SYMPROIC and get emergency medical help right away.
  • Opioid withdrawal. You may have symptoms of opioid withdrawal during treatment with SYMPROIC including sweating, chills, tearing, warm or hot feeling to your face (flush), sneezing, fever, feeling cold, abdominal pain, diarrhea, nausea, and vomiting. Tell your healthcare provider if you have any of these symptoms.

What is SYMPROIC?

SYMPROIC is a prescription medicine used to treat constipation that is caused by prescription pain medicines called opioids, in adults with long-lasting (chronic) pain that is not caused by active cancer.

It is not known if SYMPROIC is safe and effective in children.

Do not take SYMPROIC if you:

  • have a bowel blockage (intestinal obstruction) or have a history of bowel blockage.
  • are allergic to SYMPROIC or any of the ingredients in SYMPROIC. See the end of this Medication Guide for a complete list of ingredients in SYMPROIC. Tell your healthcare provider or pharmacist before you start or stop any medicines during treatment with SYMPROIC.

Before you take SYMPROIC, tell your healthcare provider about all of your medical conditions, including if you:

  • have any stomach or bowel (intestines) problems, including stomach ulcer, Crohn’s disease, diverticulitis, cancer of the stomach or bowel, or Ogilvie’s syndrome.
  • have liver problems.
  • are pregnant or plan to become pregnant. Taking SYMPROIC during pregnancy may cause opioid withdrawal symptoms in your unborn baby. Tell your healthcare provider right away if you become pregnant during treatment with SYMPROIC.
  • are breastfeeding or plan to breastfeed. It is not known if SYMPROIC passes into your breast milk. You should not breastfeed during treatment with SYMPROIC and for 3 days after your last dose. Taking SYMPROIC while you are breastfeeding may cause opioid withdrawal symptoms in your baby. You and your healthcare provider should decide if you will take SYMPROIC or breastfeed. You should not do both.

Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. Other medicines may affect the way SYMPROIC works.

How should I take SYMPROIC?
  • Take SYMPROIC exactly as your healthcare provider tells you to take it.
  • Take your prescribed dose of SYMPROIC 1 time each day.
  • SYMPROIC can be taken with or without food.
  • SYMPROIC has been shown to be effective in people who have taken opioid pain medicines for at least 4 weeks.
  • Tell your healthcare provider if you stop taking your opioid pain medicine. If you stop taking your opioid pain medicine, you should also stop taking SYMPROIC.

What are the possible side effects of SYMPROIC?

See “What is the most important information I should know about SYMPROIC?”

The most common side effects of SYMPROIC include stomach (abdomen) pain, diarrhea, nausea and vomiting (gastroenteritis).

Tell your healthcare provider if you have any side effect that bothers you or that does not go away. These are not all the possible side effects of SYMPROIC. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

How should I store SYMPROIC?

  • Store SYMPROIC at room temperature between 68°F to 77°F (20°C to 25°C).
  • Keep SYMPROIC in the bottle that it comes in.

Keep SYMPROIC and all medicines out of the reach of children.

General information about the safe and effective use of SYMPROIC.

Medicines are sometimes prescribed for purposes other than those in a Medication Guide. Do not take SYMPROIC for a condition for which it was not prescribed. Do not give SYMPROIC to other people, even if they have the same symptoms that you have. It may harm them. You can ask your pharmacist or healthcare provider for information about SYMPROIC that is written for health professionals.

What are the ingredients in SYMPROIC?

Active Ingredient: naldemedine tosylate

Inactive ingredients: D-mannitol, croscarmellose sodium, magnesium stearate, hypromellose, talc, and yellow ferric oxide.

Manufactured for: BioDelivery Sciences International, Inc. Raleigh, NC 27612

Please see full Prescribing Information and Medication Guide for SYMPROIC.

To report SUSPECTED ADVERSE REACTIONS, contact BioDelivery Sciences International, Inc. at 1-800-469-0261 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.

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