Family, Internal Medicine, General Medical Questions/Opiate-related constipation


Hi there,

I am a 54 year old female with chronic pain from spinal stenosis and discs.  I take Hydrocodone-APAP 10-325 mg, 1.5 to 2 pills per day.  Constipation was not a side effect for me until I started improving my diet: way less fat, lots more fruit and raw vegs.  Now it's a real problem.

I used Docusate sodium 100mg stool softener but was taking twice the recommended dosage without satisfactory result.  I'm concerned about the sodium because I want to limit my salt intake.

The next thing I tried was Miralax (Polyetheline Glycol) laxative and this works better.  The instructions say not to use for more than 7 days, and I'm on pain meds for the long term.

I'm drinking plenty of water and get a lot of fiber in my diet.  I don't get much exercise due to my back problems.

What are your thoughts?  What do you recommend?

Thank you

Dear Mary,

Miralax is a safe medication to help you to stay regular while taking opiates. There is no time constraint on how long you can use it. It is not a stimulant laxative, so it therefore does not have the cramping side effects or the increase in stimuli to the intestinal tract. The reason for the 7 day warning, is to be sure you are not overlooking a serious medical condition, namely colon cancer. Hope this helps.  

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Dr. Pamela M. Cipriano, DNP, APRN


My name is Dr. Cipriano. I have a private practice specializing in adult health and wellness. I can answer questions associated with thyroid disease, cardiac disease, pulmonary disease, high blood pressure, muscular aches and pains, cholesterol levels, male/female sexual questions or questions on the sexual organs, gastrointestinal problems, healthy ways to lose weight and maintain a healthy lifestyle, and nearly anything else that pertains to medicine.


I am on the Medical Staff at a local hospital where I work as a medical/surgical hospitalist as well as in the emergency department. I am certified in critical care and advanced cardiac life support. Prior to becoming a Nurse Practitioner, I was a certified critical care nurse (CCRN).

Society of Hospital Medicine American Association of Critical Care Nurses American Association of Nurse Practitioners Connecticut Advance Nurse Practitioner Society

Maryville University 2014-2016 Doctor of Nursing Practice University of Connecticut 2007-2011 MSN, Acute Care Track Nurse Practitioner. Board Certified September 2011 Critical Care Certified 2014 Central Connecticut State University 2002-2006 BA Psychology St. Mary's Hospital School of Nursing 1991-1993 Diploma Nursing Registered Nurse

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