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Opioid constipation prevention — GPhC CRA MCQ

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ModerateCNS TherapeuticsOpioid constipation preventionGPhC CRA

A 67-year-old man starts morphine modified-release 10mg twice daily for cancer pain with immediate-release morphine for breakthrough pain. He asks whether constipation usually settles after a few days. He has no bowel obstruction and takes no laxatives. What would you advise the patient?

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Correct answer: B — Start regular laxative treatment and maintain fluid intake if appropriate

Opioid-induced constipation is common and tolerance does not reliably develop. A regular stimulant laxative, often with an osmotic laxative depending on stools and local practice, is commonly needed. Loperamide would worsen constipation. Counselling should include hydration and when to seek help for bowel obstruction symptoms.

Reference: BNF; NICE CKS Palliative care