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Can Oncol Nurs J. 2013 Autumn;23(4):236-46.

Efficacy and side-effect profiles of lactulose, docusate sodium, and sennosides compared to PEG in opioid-induced constipation: a systematic review.

[Article in English, French]

Author information

Royal Alexandra Hospital, Alberta Thoracic Oncology Program/Chest Medicine Clinic, Room 4505 Children's Centre, Royal Alexandra Hospital, 10240 Kingsway Ave., Edmonton, AB T5H 3V9.
Faculty of Medicine, Division of Geriatric Medicine, Faculty of Nursing Level 3, Edmonton Clinic Health Academy, 11405 87 Ave., University of Alberta, Edmonton, AB T6G C9.
Division of Gastroenterology, 2-30A Zeidler-Ledcor, 130 University Campus, University of Alberta, Edmonton, AB T6G 2X8.


Opioid-induced constipation (OIC) is a side effect of opioid therapy that can affect quality of life, adherence to treatment, and morbidity and possibly mortality.


To investigate whether docusate sodium, sennosides, and lactulose have equal efficacy and side effect profiles compared to PEG in the management of OIC in adults.


A systematic review was undertaken. Randomized controlled trials of adults taking opioids for cancer or non-cancer pain were considered if they met inclusion criteria.


Statistical pooling was not possible as no studies met inclusion criteria. Large, well-powered, randomized controlled trials are feasible. Standard definitions of OIC would assist with the execution of these studies and contribute to their internal and external validity. Further research is strongly encouraged.

[Indexed for MEDLINE]

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