Possible Drugs for A Dominant Symptom in IBS
Symptom | Drug | Dose |
---|---|---|
Diarrhea | Loperamide | 2-4 mg when necessary/maximum 12 g/d |
Cholestyramine resin | 4 g with meals | |
Alosetrona | 0.5-1 mg bid (for severe IBS, women) | |
Constipation | Psyllium husk | 3-4 g bid with meals, then adjust |
Methylcellulose | 2 g bid with meals, then adjust | |
Calcium polycarbophil | 1 g qd to qid | |
Lactulose syrup | 10-20 g bid | |
70% sorbitol | 15 mL bid | |
Polyethylene glycol 3350 | 17 g in 250 mL water qd | |
Lubiprostone (Amitiza) | 24 mg bid | |
Magnesium hydroxide | 30-60 mL qd | |
Abdominal pain | Smooth-muscle relaxant | qd to qid ac |
Tricyclic antidepressants | Start 25-50 mg hs, then adjust | |
Selective serotonin reuptake inhibitors | Begin small dose, increase as needed |
aAvailable only in the United States.
Abbreviation: IBS, irritable bowel syndrome.
Source: Adapted from Longstreth GF et al: Functional bowel disorders. Gastroenterology 130:1480, 2006.