Lubiprostone is an effective medication approved for the treatment of opiate induced constipation. Opiates bind delta, kappa and mu receptors. Although all three receptors are related to pain mitigation, these are all also linked to decreased gastrointestinal motility. Lubiprostone works independently of these receptors by binding chloride channels in the intestine which leads to increased intestinal fluid secretion and gastrointestinal motility.
MethylNaltrexone is an opiate antagonist does not cross the blood-brain barrier and can be used for opiate induced constipation.
Naloxegol (Movantik) – Peripheral Opioid Antagonists. Selectively antagonizes peripheral mu-opioid receptors, inhibiting opioid-induced GI hypomotility (peripheral mu-opioid antagonist).
Osmotic and stimulant agents are also used for opiate induced constipation.