Amitiza (lubiprostone) is a brand-name prescription medication. It’s used to treat three types of constipation in adults:

  • chronic idiopathic constipation (CIC)
  • irritable bowel syndrome with constipation (IBS-C) in females
  • opioid-induced constipation (OIC) in people taking opioid drugs for long-lasting pain that’s not related to cancer

Amitiza is a type of drug called a chloride channel activator. It’s not a stool softener, a type of fiber, or a traditional laxative. However, it does bring on the same effects that these other treatments cause. It increases fluid in your intestines, which helps pass stool.

Amitiza comes as an oral capsule you take with food and water. It’s typically taken twice a day. You should take it for as long as your doctor recommends.

Effectiveness

For information about the effectiveness of Amitiza, see the “Amitiza uses” section below.

Amitiza is only available as a brand-name medication. It contains the drug lubiprostone, which is not currently available in generic form.

Amitiza can cause mild or serious side effects. The following list contains some of the key side effects that may occur while taking Amitiza. This list doesn’t include all possible side effects.

For more information on the possible side effects of Amitiza or tips on how to deal with a troubling side effect, talk with your doctor or pharmacist.

More common side effects

The more common side effects of Amitiza can include:

  • headache
  • stomach pain
  • diarrhea
  • gas and bloating
  • nausea
  • dizziness
  • trouble breathing (generally goes away after a few hours)

Most of these side effects may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious side effects

Serious side effects from Amitiza aren’t common, but they can occur. Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency.

Serious side effects and their symptoms can include the following:

  • Allergic reaction. Symptoms can include:
    • itching or hives
    • swelling in your face or hands
    • swelling or tingling in your mouth or throat
    • chest tightness
    • trouble breathing
  • Severe gastrointestinal upset. Symptoms can include:
    • diarrhea
    • pain or swelling in your belly
    • nausea or vomiting
  • Low blood pressure. Symptoms can include:
    • dizziness
    • fainting
    • trouble concentrating

Side effect details

You may wonder how often certain side effects occur with this drug. Here’s some detail on certain side effects this drug may cause.

Weight loss or weight gain

You’re unlikely to have weight changes when using Amitiza. Weight gain did occur in studies of Amitiza use, but it was rare. To find out how often this side effect occurred in clinical studies, see the drug’s prescribing information. If you have questions or concerns about this potential side effect, talk with your doctor or pharmacist.

Amitiza may make you feel dizzy or lightheaded. If you have these symptoms, be sure to move slowly when you stand or sit up. Feeling dizzy or lightheaded is more likely to occur when you first begin to use Amitiza, or if you become dehydrated while taking it.

The Amitiza dosage your doctor prescribes will depend on several factors. These include:

  • the type and severity of the condition you’re using Amitiza to treat
  • other medical conditions you may have
  • your age

Typically, your doctor will start you on a low dosage and adjust it over time to reach the dosage that’s right for you. They’ll ultimately prescribe the smallest dosage that provides the desired effect.

The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to suit your needs.

Drug forms and strengths

Amitiza comes as a capsule you take by mouth. It’s available in two strengths: 8 mcg and 24 mcg. The maximum recommended dosage is 48 mcg per day.

Dosage for chronic idiopathic constipation (CIC) and opioid-induced constipation (OIC)

The typical dosage recommended for adults is 24 mcg twice daily. Don’t take more than what is instructed by your doctor.

If you have liver damage, your doctor may prescribe a reduced dosage of 16 mcg twice daily or 8 mcg twice daily.

Dosage for irritable bowel syndrome with constipation (IBS-C)

The recommended adult dosage is 8 mcg twice daily.

If you have severe liver damage, your doctor may prescribe 8 mcg once daily.

What if I miss a dose?

If you miss a dose, take it as soon as you remember.

But if it’s almost time for your next dose, skip the missed dose and go back to your normal time. Don’t take extra medication to make up for a dose you missed.

As with all medications, the cost of Amitiza can vary.

The actual price you’ll pay will depend on your insurance coverage, your location, and the pharmacy you use.

Financial assistance

If you need financial support to pay for Amitiza, help is available.

Takeda Pharmaceuticals U.S.A., Inc, the manufacturer of Amitiza, offers an Amitiza Savings Card. This card offers savings for eligible people with commercial insurance. For more information and to find out if you’re eligible for the card, visit the program website.

Takeda also offers a financial assistance program called Help at Hand. For information, visit the program website or call 800-830-9159.

The Food and Drug Administration (FDA) approves drugs such as Amitiza for certain purposes.

Amitiza is approved to treat three types of constipation.

Amitiza for chronic idiopathic constipation

Amitiza is approved to treat chronic idiopathic constipation (CIC) in adults. “Idiopathic” means that the exact reason you are constipated isn’t known.

Effectiveness for treating CIC

In clinical studies of Amitiza, the medication was found to provide rapid relief from CIC.

Guidelines published in the American Journal of Managed Care for treating CIC recommend lubiprostone (Amitiza) as an option for treating symptoms of CIC.

Amitiza for IBS-C

Amitiza is also approved to treat irritable bowel syndrome with constipation (IBS-C). This condition is a form of irritable bowel syndrome (IBS) in which pain in your belly is associated with constipation.

Effectiveness for treating IBS-C

In two different clinical studies, Amitiza improved overall symptoms of IBS-C, such as abdominal pain and discomfort.

Guidelines from the American College of Gastroenterology recommend lubiprostone (the active drug in Amitiza) for improving symptoms in people with IBS-C.

Amitiza for OIC

Amitiza is also approved to treat opioid-induced constipation (OIC). This type of constipation is caused when people take opioids, which are medications prescribed to help treat pain. Amitiza is only approved for people who are taking opioids for long-lasting pain that’s not related to cancer.

Effectiveness for treating OIC

In three clinical studies that looked at Amitiza use in people with OIC, some had increased bowel movements.

Guidelines from the American Gastroenterological Association on OIC currently don’t make a recommendation for or against lubiprostone (the active drug in Amitiza), citing the need for more evidence.

Amitiza for children

Amitiza isn’t approved for use in children. This is because it hasn’t been found to be either safe or effective for treating constipation in children.

In a clinical study of children ages 6 to 17 years, Amitiza wasn’t found to be effective in treating constipation.

If your child shows signs of constipation, talk with their doctor about medications or other treatments that could help relieve it.

Amitiza isn’t classified as a fiber or a traditional laxative. However, it does cause the same effects that these other treatments cause. It increases fluid levels in your intestines, which helps to pass stool.

Amitiza is a type of drug called a chloride channel activator. Chloride channels are found in most cells throughout your body. They’re proteins that transport certain molecules across cell membranes.

In your gastrointestinal tract, these channels play an important role in transporting fluid. Amitiza activates these channels, which increases the amount of fluid in your intestines. The increased fluid helps your body to pass stool.

Other drugs are available that can treat different types of constipation. Some may be better suited for you than others. If you’d like to find an alternative to Amitiza, talk with your doctor to learn more about other medications that may work well for you.

Note: Some of the drugs listed here are used off-label to treat constipation.

Alternatives for opioid-induced constipation (OIC)

Other drugs that can be used to treat OIC fall into five main groups.

Stool softeners

These drugs allow water and fats to enter the stool, which makes it easier to pass. Examples of stool softeners include:

  • docusate (Colace, Col-Rite, Doc-Q-Lace, Docusoft-S, Phillips Liqui-Gels, Silace, Surfak, others)

Stimulant laxatives

These drugs help stimulate constriction (tightening) and relaxation of the muscles of your intestines. This action helps move stool through the intestines.

Examples of stimulant laxatives include:

  • bisacodyl (Ducodyl, Dulcolax, Fleet Bisacodyl, GoodSense Bisacodyl EC)
  • senna (Ex-Lax, Geri-kot, GoodSense Laxative Pills, Senekot, SennaCon, Senna Lax)

Osmotic laxatives

These drugs work by drawing more water into your intestines. This helps to soften the stool and make it easier to pass.

Examples of osmotic laxatives include:

  • polyethylene glycol (GlycoLax, MiraLAX)
  • lactulose (Constulose, Enulose, Generlac, Kristalose)
  • sorbitol
  • magnesium sulfate
  • magnesium citrate
  • glycerin

Lubricants

These drugs work by keeping water inside the intestines and the stool. This makes the stool softer so it’s easier to pass.

Examples of lubricants include:

  • mineral oil (Fleet Oil, GoodSense Mineral Oil)

Peripherally acting mu-opioid receptor agonists (PAMORAs)

Opioids slow down your gastrointestinal tract and reduce fluid in your bowels. These effects can cause constipation. PAMORAs work by blocking the effects of opioids in certain parts of the body, including the gastrointestinal tract. This decreases constipation that’s caused by opioid use, without affecting pain relief.

Examples of PAMORAs include:

  • methylnaltrexone (Relistor)
  • naloxegol (Movantik)
  • naldemidine (Symproic)

Alternatives for chronic idiopathic constipation (CIC)

Other drugs that can be used to treat CIC belong to four main groups.

Selective serotonin-4 (5-HT4) receptor agonists

Normally, your intestines move food through them by constricting (tightening) and relaxing the muscles in the walls of the intestines. When this activity slows down, constipation can occur.

Selective serotonin-4 (5-HT4) receptor agonists work by stimulating this action in your intestines. An example of this drug is:

  • prucalopride (Motegrity)

Guanylate cyclase-C agonists

These medications work by increasing the amount of water in your intestines. This softens the stool, which helps it move through your intestines. These drugs work similarly to Amitiza, but they act on a different kind of protein.

Examples of guanylate cyclase-C agonists include:

  • plecanatide (Trulance)
  • linaclotide (Linzess)

Osmotic laxatives

These drugs work by drawing more water into your intestines. This helps to soften stool and make it easier to pass.

Examples of osmotic agents include:

  • polyethylene glycol (GlycoLax, MiraLAX)
  • lactulose (Constulose, Enulose, Generlac, Kristalose)

Stimulant laxatives

Like selective serotonin-4 (5-HT4) receptor agonists (above), stimulant laxatives work by stimulating the muscles in your intestines. The laxatives cause the muscles to constrict and relax, which moves stool through your intestines.

Examples of stimulant laxatives include:

  • bisacodyl (Ducodyl, Dulcolax, Fleet Bisacodyl, GoodSense Bisacodyl EC)
  • sodium picosulfate
  • senna (Ex-Lax, Geri-kot, GoodSense Laxative Pills, Senekot, SennaCon, Senna Lax)

Alternatives for irritable bowel syndrome with constipation (IBS-C)

Other drugs that can be used to treat IBS-C fall into five main groups.

Bulking agents

These drugs work by absorbing water in your intestines and then swelling up. This increases the amount of stool, which stimulates your bowels to move. Examples of bulking agents include:

  • psyllium (Metamucil, Laxmar, Genfiber, Fiberall)
  • methylcellulose (Citrucel, GoodSense Fiber)
  • calcium polycarbophil (FiberCon)

Stool softeners

These drugs allow water and fats to enter the stool, which makes it easier to pass. Examples of surfactants include:

  • docusate (Colace, Col-Rite, Doc-Q-Lace, Docusoft-S, Phillips Liqui-Gels, Silace)

Osmotic laxatives

These drugs work by increasing the amount of water in your intestines. This helps to soften the stool and make it easier to pass. Examples of osmotic agents include:

  • milk of magnesia (Pedia-Lax, Phillips)
  • magnesium citrate
  • magnesium sulfate
  • sodium picosulfate/magnesium citrate (PicoPrep)
  • lactulose/lactitol
  • sorbitol

Stimulant laxatives

Stimulant laxatives work by stimulating the muscles in your intestines. The laxatives cause the muscles to constrict and relax, which moves stool through your intestines.

Examples of stimulant laxatives include:

  • bisacodyl (Ducodyl, Dulcolax, Fleet Bisacodyl, GoodSense Bisacodyl EC)
  • sodium picosulfate
  • senna (Ex-Lax, Geri-kot, GoodSense Laxative Pills, Senekot, SennaCon, Senna Lax)

Guanylate cyclase-C agonists

These medications work by increasing the amount of water in your intestines. This softens the stool, which helps it move through your intestines. These drugs work similarly to Amitiza, but they act on a different kind of protein.

Examples of guanylate cyclase-C agonists include:

  • plecanatide (Trulance)
  • linaclotide (Linzess)

You should take Amitiza according to your doctor or healthcare provider’s instructions.

How to take

Swallow the Amitiza capsule whole. Don’t chew or break apart the capsule.

When to take

Amitiza is typically taken either once in the morning and once in the evening, or once daily. Your doctor will tell you how often you should take it and when.

Taking Amitiza with food

Take Amitiza with food and a full glass of water. Taking Amitiza with a small meal can help lessen the risk of nausea, which can be a common side effect.

Can Amitiza be crushed?

Amitiza capsules shouldn’t be crushed, broken, or chewed. Be sure to swallow the capsule whole.

There are no known interactions between alcohol and Amitiza. However, taking Amitiza can make you feel dizzy or lightheaded. Drinking alcohol can also cause these effects, so taking them together could make these effects worse.

If dizziness is a problem for you while taking Amitiza, it may be best to avoid alcohol. If you have trouble avoiding alcohol and it causes you to feel dizzy or lightheaded, talk with your doctor.

Most drugs can interact with other medications. Different interactions can cause different effects. For instance, some can interfere with how well a drug works, while others can cause increased side effects.

Amitiza and other medications

Before taking Amitiza, be sure to tell your doctor and pharmacist about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Drugs that can interact with Amitiza

Below are examples of medications that can interact with Amitiza. This list doesn’t contain all drugs that may interact with Amitiza.

  • High blood pressure medications. Taking Amitiza with drugs to treat high blood pressure could raise your risk of fainting or low blood pressure.
  • Anti-diarrheal medications. Taking Amitiza with drugs used to treat diarrhea can make Amitiza less effective. Examples of anti-diarrheal drugs include:
  • Methadone. In lab tests, methadone (an opioid pain medication) has been shown to decrease the actions of chloride channels. Chloride channels are proteins that transport certain molecules across cell membranes. This effect may prevent Amitiza from working well.

If you have questions about potential interactions with Amitiza, talk with your doctor or pharmacist.

Amitiza belongs to a class of drugs called chloride channel activators. Chloride channels are found throughout your body in nearly every type of cell. They’re proteins that transport certain molecules across cell membranes.

Amitiza activates (increases the activity of) these chloride channels in your intestine. This action increases the amount of fluid that flows into your intestine. This increased fluid allows stool to pass more easily through your system, helping to relieve constipation.

How long does it take to work?

Amitiza begins to work quickly. For instance, a clinical study looked at use of Amitiza in adults with chronic idiopathic constipation (CIC). About 57 percent of the people studied had a bowel movement within 24 hours of taking the medication. In the group who received a placebo (no medication), that effect was found in only 37 percent of people.

Within 48 hours of treatment, 80 percent of the people who had taken Amitiza had a bowel movement. Only 61 percent of people in the placebo group had the same result.

Not enough research has been done to know if Amitiza is safe for use during pregnancy. In animal studies, Amitiza was shown to harm the fetus. However, animal studies don’t always predict what would happen in humans.

If you’re pregnant or become pregnant while being treated with Amitiza, talk with your doctor. Together you can evaluate the benefits and risks of using Amitiza during your pregnancy.

It isn’t known if Amitiza passes into breast milk, or what its effects might be on your body’s milk production. In animal studies, Amitiza was not found in the milk of lactating animals. But animal studies don’t always reflect the effects that could occur in humans.

Talk with your doctor about whether Amitiza use is a good idea for you while you breastfeed. And if you decide to breastfeed your child while taking Amitiza, watch for signs of diarrhea. Amitiza could cause diarrhea in a child who is breastfed. If your child develops diarrhea, stop breastfeeding and call your doctor.

Here are answers to some frequently asked questions about Amitiza.

Can Amitiza be used for males?

Amitiza is approved for treating three types of constipation in adults. For two of these types, it can be used in males. These types are chronic idiopathic constipation (CIC) and constipation caused by opioid medication in people with chronic pain that’s not caused by active cancer.

However, the third type of constipation that Amitiza is approved to treat can’t be used in males. This type is irritable bowel syndrome with constipation (IBS-C).

The reason for this difference is that there hasn’t been enough research done on Amitiza use in males with IBS-C. In clinical studies, only 8 percent of the people with IBS-C who were studied were male. Because the male population in the studies was so low, there’s not enough evidence to determine whether men with IBS-C respond differently to Amitiza than women do.

Will I have withdrawal symptoms when I stop taking Amitiza?

No, you likely won’t have withdrawal symptoms when stopping Amitiza. No such symptoms were seen in a clinical study in which people stopped their treatment with the drug.

Is Amitiza a controlled substance?

No, Amitiza isn’t a controlled substance. A controlled substance is a drug that’s regulated by the government due to its potential to be misused.

However, Amitiza is a medication that requires a prescription from your doctor.

Before taking Amitiza, talk with your doctor about your health history. Amitiza may not be right for you if you have certain medical conditions. These include:

  • Bowel blockage. If you have a bowel obstruction, you shouldn’t use Amitiza. If you’re not sure if you have one, ask your doctor to examine you before you start treatment with Amitiza.
  • Severe diarrhea. Taking Amitiza can make severe diarrhea worse. If you have severe diarrhea, you should avoid taking this drug.
  • History of allergy to Amitiza or any of its ingredients. If you’re allergic to Amitiza or have had a reaction in the past, you shouldn’t use Amitiza. If you have such an allergy, talk with your doctor about other treatment options for your constipation.

Taking too much Amitiza can increase your risk of severe side effects.

Overdose symptoms

Symptoms of an overdose can include:

  • nausea
  • diarrhea
  • vomiting
  • dizziness
  • headache
  • stomach ache
  • flushing (warmth and redness in your face or neck)
  • dry heaves (retching)
  • trouble breathing
  • chest tightness
  • fainting

What to do in case of overdose

If you think you’ve taken too much of this drug, call your doctor or seek guidance from the American Association of Poison Control Centers at 800-222-1222 or through their online tool. But if your symptoms are severe, call 911 or go to the nearest emergency room right away.

When Amitiza is dispensed from the pharmacy, the pharmacist will add an expiration date to the label on the bottle. This date is typically one year from the date the medication was dispensed.

The purpose of such expiration dates is to guarantee the effectiveness of the medication during this time. The current stance of the Food and Drug Administration (FDA) is to avoid using expired medications.

How long a medication remains good can depend on many factors, including how and where the medication is stored. Amitiza capsules should be stored at room temperature at around 77°F (25°C). Store them in a dry location in a tightly sealed and light-resistant container. Don’t store medications in your bathroom.

If you have unused medication that has gone past its expiration date, talk to your pharmacist about whether you might still be able to use it.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.