From the Guidelines
Constipation associated with Zepbound can be effectively managed with polyethylene glycol (PEG) 17g daily, as it has been shown to increase spontaneous bowel movements (SBMs) and complete spontaneous bowel movements (CSBMs) compared to placebo 1. When experiencing constipation while taking Zepbound, it is essential to prioritize lifestyle modifications, including:
- Increasing water intake to at least 64 ounces daily
- Gradually adding more fiber to the diet, aiming for 25-30 grams daily from fruits, vegetables, and whole grains
- Engaging in regular physical activity, such as walking for 30 minutes daily, to stimulate bowel movements If lifestyle modifications are insufficient, over-the-counter options like PEG 17g mixed in water daily can be considered, as it has been demonstrated to be efficacious in individuals with chronic idiopathic constipation (CIC) for up to 6 months 1. Key points to consider when using PEG include:
- It is widely available without a prescription and relatively inexpensive
- It may cause side effects such as bloating, flatulence, and diarrhea, although these are typically mild or moderate
- It has been shown to have a similar or greater efficacy compared to other medications, such as tegaserod, prucalopride, and lactulose, in individuals with CIC 1 If constipation persists or becomes severe, it is crucial to contact a healthcare provider for further guidance and potential adjustment of medication or additional treatments.
From the Research
Constipation Treatment Options
- There are various treatment options available for constipation, including lifestyle changes, increased fiber and fluid intake, and medication 2.
- Polyethylene glycol, sodium picosulfate, bisacodyl, prucalopride, lubiprostone, and linaclotide have been shown to be effective in treating chronic idiopathic constipation 2.
- Osmotic laxatives, such as polyethylene glycol 3350 (PEG 3350) and lactulose, are considered safe and effective for both long and short term treatment of pediatric functional constipation 3.
Over-the-Counter Laxatives
- Over-the-counter laxatives, such as senna and bisacodyl, can be effective in treating constipation, but their use should be guided by evidence-based recommendations 4.
- Polyethylene glycol (PEG) and senna have good evidence supporting their use as first-line laxatives, while fiber supplements, fruits, stimulant laxatives, and magnesium-based products have moderate evidence supporting their use 4.
Specific Treatment Comparisons
- A study comparing polyethylene glycol versus vegetable oil based bisacodyl suppositories found that polyethylene glycol based suppositories reduced the time required for bowel care in persons with spinal cord injury 5.
- Another study compared 2-Litre polyethylene glycol-citrate-simethicone plus bisacodyl versus 4-litre polyethylene glycol as preparation for colonoscopy in chronic constipation, and found that the 2-L PEG-CS/bisacodyl regimen was more acceptable and had better compliance, but was not superior in terms of bowel cleansing 6.
Zepbound Specific Information
- There is no specific information available on the use of Zepbound for constipation in the provided studies.