PAMORAS drugs for opioid-induced constipation (OIC)

Hi, @neigenfindk - I wanted to let you know I moved your post to start its own discussion, as I thought the topic of opioid-induced constipation (OIC) and peripherally acting μ-opioid receptor antagonists (PAMORAS) would be useful for the Mayo Clinic Connect community as well as for you.

A relative of mine recently had an orthopedic surgery where she had to take opioids, while disliking it, to dull the terrible pain. However, she then went back and forth into terrible constipation with pain and bloating, and counteracted it with foods and medication and ended up with diarrhea.

I think this is a common journey.

Have you had constipation due to taking opioids a doctor prescribed for you? If so, will you share more about what happened?

I have been taking opioid pain medication for over 10 years prescribed by my pain doctor for a very bad back ( very serious spinal spinosis). I have had occasional constipation problems over the years but recently they have become very bad. Even taking every kind of laxatives from over the counter, none of them seem to work. I only have a bowel movement maybe 2 times a week if I am lucky. My next doctor appointment is not for about 6 weeks and I have been researching alternatives and just read about some new medication that is suppose to be specifically for opioid induced constipation called Pamoras drugs. I plan on talking to my pain doctor when I have my appointment in 6 weeks but was interested if anyone on this site has any input.
Thank-You and I hope this helps me and others that have this problem

Tagging a few members from different support groups around Mayo Clinic Connect who have mentioned opioids/ constipation. Thinking they may be interested in this discussion on PAMORAS, medications for oxycodone-induced constipation: @shh418 @baker23 @jcaesar @ddsack @markymarkfl @surftohealth88 @diverdown1 @missjb @archie2 @diverdown1 @missjb.

Have you or a loved one had opioid-induced constipation (OIC)? Have you heard of or have you or your loved one taken peripherally acting μ-opioid receptor antagonists (PAMORAS)? If so, was it helpful?

This is very good to know for people that need the opioid painkillers for longer term use. Or maybe there are people who for some reason can't take laxatives?
I was only on Tramadol/Oxycodone for the one day hospital stay, plus maybe a day or two at home before I felt my degree of pain did not warrant the side effects of dizziness and nausea. I brought the constipation on myself by not taking the provided laxatives after the first TKR because I normally am very "loose" and I mistakenly thought my gut would just tighten things up and I'd have firmer BM's. Big mistake! I was in more misery from constipation for a couple of days than I was from the surgery. Took my laxatives religiously after the next TKR and TSR and things were much better!
I don't know what the long term use of laxatives does to the gut, but it sounds like the PAMORAS would be a solution. Or maybe alternate between the two if they shouldn't be taken at the same time?