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Opioid constipation prophylaxis — GPhC CRA MCQ

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EasyCNS TherapeuticsOpioid constipation prophylaxisGPhC CRA

A 74-year-old patient is started on morphine sulfate modified-release tablets for cancer pain. His prescription also includes oral morphine solution for breakthrough pain but no laxative. What is the most appropriate action?

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Correct answer: D — Contact the prescriber to add a regular stimulant laxative unless contraindicated

Opioids commonly cause constipation and tolerance to this effect does not reliably develop. A regular laxative is usually required when starting ongoing opioid therapy. Bulk-forming laxatives may worsen symptoms if fluid intake is poor and are not the usual first choice for opioid-induced constipation. Breakthrough analgesia should not be omitted without clinical review.

Reference: BNF; NICE CKS