From the Guidelines
To manage constipation induced by Ozempic (semaglutide), the most effective approach is to use polyethylene glycol (PEG) 3350 without electrolytes at a dose of 17g daily, as it has been shown to increase complete spontaneous bowel movements (CSBMs) and spontaneous bowel movements (SBMs) compared to placebo 1. This recommendation is based on the latest clinical practice guideline from the American Gastroenterological Association and American College of Gastroenterology, which suggests that PEG is a viable option for the management of chronic idiopathic constipation, despite being approved for occasional constipation by the FDA 1. Some key points to consider when using PEG 3350 include:
- It acts as an osmotic laxative, drawing water into the bowel to soften stool and stimulate bowel movements
- The dose of 17g daily is approved by the FDA for the treatment of occasional constipation, but it has been shown to be efficacious in individuals with chronic idiopathic constipation for up to 6 months 1
- Potential side effects include bloating, flatulence, and diarrhea, but these are typically mild or moderate and consistent with laxative therapy 1 In addition to PEG 3350, other measures can help manage constipation, such as:
- Increasing fluid intake to at least 8-10 glasses of water daily
- Adding more fiber to the diet through fruits, vegetables, and whole grains, aiming for 25-30 grams of fiber per day
- Engaging in regular physical activity, even just a 15-30 minute daily walk, to help stimulate bowel movements
- Maintaining a consistent bathroom routine and responding promptly to the urge to defecate If constipation persists despite these measures for more than two weeks, becomes severe, or is accompanied by abdominal pain or blood in stool, it is essential to consult a healthcare provider as medication adjustments or prescription treatments may be necessary.
From the FDA Drug Label
Uses for relief of occasional constipation (irregularity). This product generally produces bowel movement in 12 to 72 hours. To manage constipation induced by Ozempic (semaglutide), consider using psyllium (PO), as it is used for relief of occasional constipation (irregularity) and can produce a bowel movement in 12 to 72 hours 2.
- The management of Ozempic induced constipation may involve the use of a fiber supplement like psyllium.
- It is essential to follow the recommended dosage and administration instructions for psyllium (PO) to effectively manage constipation.
From the Research
Management of Ozempic Induced Constipation
- Ozempic (semaglutide) is a glucagon-like peptide-1 (GLP-1) receptor agonist used to treat type 2 diabetes, and it can cause constipation as a side effect 3, 4.
- There is no direct evidence on the management of Ozempic-induced constipation, but studies on chronic constipation can provide some insights.
- Increasing fiber intake may improve symptoms of constipation, with psyllium and pectin having significant effects 5.
- A higher response to treatment was apparent in fiber groups compared to control groups, particularly with higher fiber doses (>10 g/d) and treatment durations of at least 4 weeks 5.
- Over-the-counter therapies such as polyethylene glycol (PEG), senna, and psyllium may also be effective in managing constipation 6.
- It is essential to note that the safety profile of semaglutide is similar to that of other GLP-1RAs, with mostly mild-to-moderate and transient gastrointestinal disturbances 4.
Treatment Options
- Fiber supplementation: psyllium, pectin, and other types of fiber may help improve constipation symptoms 5, 6.
- Over-the-counter laxatives: polyethylene glycol (PEG), senna, and other stimulant laxatives may be effective in managing constipation 6.
- Dietary changes: increasing fluid intake, eating a balanced diet, and avoiding foods that can exacerbate constipation may also help 5, 6.