Key to symbols
The medicine should be initiated by, or on the advice of a specialist, but is suitable for continuation by a GP
The medicine should only be used and prescribed by a specialist
Indicates the preferred choice within a class or group of medicines
1. Gastro-intestinal system
1.6. Laxatives
Laxatives should generally be avoided, except when straining will exacerbate a medical condition, or increase the risk of bleeding, as in haemorrhoids or following abdominal surgery. They are important for prophylaxis of opioid-induced constipation.1.6.1. Bulk-forming laxatives
Bulk-forming laxatives are not the most appropriate choice for opioid-induced constipation.
Preferred List
1.6.2. Stimulant laxatives
Preferred List
Total Formulary
1.6.3. Faecal softeners
Total Formulary
1.6.4. Osmotic laxatives
Preferred List
MACROGOL
Prescribing Notes:
Laxido Orange is considered the preferred brand of macrogol oral powder in NHSGGC Acute Services.
Total Formulary
LACTULOSE (SOLUTION)
1.6.5. Bowel cleansing preparations
Preferred List
Total Formulary
FLEET PHOSPHO-SODA
Restrictions:
Restricted to specialist initiation and use as alternative to Picolax® and Moviprep® when they are unavailable.
1.6.6. Peripheral opioid-receptor antagonists
Total Formulary
NALDEMEDINE (RIZMOIC) (tablets)
Restrictions:
Use for the treatment of opioid induced constipation in adults is restricted to patients who have failed to respond to at least two classes of laxative (given at an adequate dose for a sufficient duration).
NALOXEGOL (tablets)
Restrictions:
Restricted to use in patients who have failed to respond to at least two classes of laxative (given at an adequate dose for a sufficient duration).