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Laxative choice in opioid therapy — GPhC CRA MCQ

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ModerateGastro-intestinal TherapeuticsLaxative choice in opioid therapyGPhC CRA

A palliative care patient taking oxycodone has hard stools despite senna. There is no bowel obstruction and fluid intake is adequate. The nurse asks for an additional laxative option. What is the most appropriate alternative?

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Correct answer: C — Macrogol oral powder

Opioid constipation often needs a combination of stimulant and osmotic laxatives. Macrogol is an osmotic laxative and is a reasonable additional option when stools remain hard. Loperamide would reduce bowel motility further. Kaolin and morphine would add opioid effect and is unsuitable.

Reference: BNF; NICE CKS