I would like to see a comparison guide for common medications used for side-effect management, such as constipation, nausea, anxiety, etc. that includes a cost comparison—even if used a price range or one $ to four or five $ to reflect the cost. —Name withheld on request
Medications commonly used for managing each of these side effects are numerous. To make it easier to use this information, the editors are presenting each category of side-effect medication in separate charts.
This chart presents information on prescription, OTC, and consumer products for managing constipation. The list is not all-inclusive; medications indicated for opioid-induced constipation for noncancer-related pain are not included.
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Future installments of this chart will present information on other side-effect management medications.
| Product or generic (brand name) | Contraindications | Warnings/ Cautions |
Interactions | Adverse reactions | Price (OTC or Rx) |
| CONSTIPATION | |||||
| Benefiber | Children should not use caplet form | Powder: not recommended for carbonated beverages Kidney stones Calcium-restricted diet Pregnancy/Nursing mothers |
$ (OTC) | ||
| bisacodyl (Dulcolax) | Discontinue if rectal bleeding or no bowel movement occurs Do not use if abdominal pain, nausea, or vomting present |
Tablets: Do no take within at least 1 hour after antacids or milk | Abdominal discomfort Faintness Cramps Rectal burning (suppositories) |
$-$$ (OTC) | |
| docusate (Colace, Kaopectate, Phillips Milk of Magnesia) | Discontinue if rectal bleeding or no bowel movement occurs Pregnancy/Nursing mothers |
May increase systemic absorption of mineral oil | Glycerin sup. laxative: rectal discomfort, burning sensation | $ (OTC) | |
| docusate sodium (Peri-colace) | Discontinue if rectal bleeding or no bowel movement occurs Pregnancy/Nursing mothers |
Docusate may increase systemic absorption of mineral oil | $ (OTC) | ||
| Fibercon | Discontinue if rectal bleeding or no bowel movement occurs | $ (OTC) | |||
| Konsyl Psyllium | Signs/symptoms of appendicitis Intestinal obstruction Fecal impaction |
Rectal bleeding Diabetes (sugar containing forms) |
Tablets block tetracycline absorption (give at least 1 hr before or 2 hrs after tetracycline) | Esophageal, gastric, enteral, rectal obstruction | $ (OTC) |
| lactulose (Enulose, Generlac, Kristalose, generics) | Not recommended for children | Electrocautery in proctoscopy, colonoscopy Reduce dose or discontinue if diarrhea persists Monitor electrolytes if used >6 months in elderly or debilitated Diabetes Pregnancy (Category B)/Nursing mothers |
May be antagonized by nonabsorbable antacids | Flatulence Intestinal cramps Diarrhea Nausea Vomiting Electrolyte imbalances |
$$-$$$$ (Rx) |
| Metamucil | Signs/symptoms of appendicitis Intestinal obstruction Fecal impaction Dysphagia |
Rectal bleeding Esophageal narrowing Diabetes (sugar-containing forms) |
Separate dosing by a least 2 hours from other medications | Esophageal, gastric, enteral, rectal obstruction | $ (OTC) |
| polyethylene glycol 3350 (Glycolax, MiraLax, generic) | Bowel obstruction (known or suspected) | Nausea, vomiting, abdominal pain or distention: exclude bowel obstruction Elderly (increased incidence of diarrhea) Avoid prolonged, frequent, or excessive use Pregnancy (Category C) |
Nausea, abdominal bloating, cramping, flatulence, diarrhea | $ (Rx) $ (OTC) |
|
| senna (Ex-Lax, Senokot) | Discontinue if rectal bleeding or no bowel movement occurs Pregnancy/Nursing mothers |
$ (OTC) |
KEY: $, <$25; $$, $25-$49; $$$, $50-$74; $$$$, $75-$100; $$$$$ >$100; OTC, over-the-counter; Rx, prescription.
SOURCES: Prices were found via Internet search for the over-the-counter or consumer product. Prescription prices are from: Healthcare Bluebook. https://healthcarebluebook.com/page_Default.aspx. Accessed March 24, 2015.
Indications, contraindications, warnings/cautions, interactions, and adverse effects information is from MPR Drug Database, accessed via MPR app. Accessed December 1, 2014.
To access Part 2 of this series, Comparison of medications for managing nausea and vomiting, click here.
To access Part 3 of this series, Comparison of medications for managing anxiety, click here.
