Frequently asked questions

Key things you need to know

faq
faq question
Opioid-induced constipation (OIC)

Opioid-induced constipation, or opioid-induced constipation, is a type of constipation you may develop as a result of taking opioid medication prescribed by your doctor to relieve pain.

Opioid pain medication can help relieve your pain but may have an undesired effect in the gut that causes constipation. This constipation, called opioid-induced constipation, happens when opioids attach to mu-opioid receptors in your bowel. This is the underlying cause of opioid-induced constipation and can make it difficult for you to have bowel movements. opioid-induced constipation can last the entire time you're taking opioid pain medication.

Opioid-induced constipation is different from other types of constipation that you might treat with OTC laxatives. OTC laxatives are typically used for the treatment of occasional constipation, and do not treat the underlying cause of opioid-induced constipation.

You should talk to your doctor if you’re taking opioid pain medication for long-lasting (chronic) pain and experiencing any of these symptoms:

  • Not having bowel movements regularly (less than 3 per week)
  • Bloating or pain in your stomach area
  • Needing to push harder during a bowel movement
  • Dry, hard stools
  • Sense of incomplete emptying of your bowels
Download the Healthcare Provider Discussion Guide Learn more about Relistor

Pay as
little as
$0 with
RELISTOR
co-pay card

Terms and conditions apply

Relistor

Relistor (methylnaltrexone bromide) is a prescription medicine used to treat for constipation in adults that is caused by prescription pain medicines called opioids:

  • Relistor (methylnaltrexone bromide) tablets and Relistor (methylnaltrexone bromide) injection are used to treat constipation caused by opioids in adults with long-lasting (chronic) pain that is not caused by active cancer
  • Relistor (methylnaltrexone bromide) injection is used to treat constipation caused by opioids in adults with advanced illness or pain caused by active cancer and who need increases in their opioid dose for comfort care.

It is not known if Relistor (methylnaltrexone bromide) is safe and effective in children.

Relistor (methylnaltrexone bromide) helps to keep opioids from attaching to mu-opioid receptors in the gut. Relistor (methylnaltrexone bromide) works differently from over-the-counter (OTC) laxatives—it is specifically designed to target the effect opioids have in the gut without impacting opioid pain relief in the central nervous system.

Tell your doctor if you experience any changes in your pain relief.

If you are taking Relistor (methylnaltrexone bromide) tablets for OIC:

Relistor (methylnaltrexone bromide) tablets should be taken daily, as directed by your healthcare provider. Even if you do not feel constipated, do not make changes to your medication schedule without talking to your healthcare provider.

  • For adults with long-lasting (chronic) non-cancer pain, take 3 tablets, one time each day, with water, in the morning on an empty stomach
    • Take Relistor (methylnaltrexone bromide) at least 30 minutes before eating your first meal of the day
    • Stop taking laxatives before you start taking Relistor (methylnaltrexone bromide) tablets. You may use laxatives if Relistor (methylnaltrexone bromide) does not work after 3 days of treatment
  • Your healthcare provider may change your dose if you have kidney or liver problems

If you are taking Relistor (methylnaltrexone bromide) injection for OIC:

Relistor (methylnaltrexone bromide) injection should be taken as directed by your healthcare provider. Relistor (methylnaltrexone bromide) injection is injected under the skin of the upper arm, stomach-area (abdomen), or thigh. Do not inject at the same spot each time (rotate injection sites).

  • For adult patients with long-lasting (chronic) non-cancer pain, inject 1 dose of Relistor (methylnaltrexone bromide) each day
    • Stop taking other laxatives before you start treatment with Relistor (methylnaltrexone bromide). Laxatives can be used as needed if Relistor does not work after 3 days of treatment
  • For adults with advanced illness, inject 1 dose of Relistor (methylnaltrexone bromide) every other day as needed. You should not inject more than 1 dose of Relistor in a 24-hour period

Stop taking Relistor (methylnaltrexone bromide) if you stop taking your prescription opioid pain medication. Tell your healthcare provider if your pain medication changes.

Relistor (methylnaltrexone bromide) can work quickly. After taking a dose of Relistor (methylnaltrexone bromide) tablets or injection, you may have a bowel movement within 4 hours. *†‡

In a clinical study of adult patients with advanced illness taking Relistor (methylnaltrexone bromide) injection, some patients had a bowel movement within 30 minutes.‡

Individual results may vary.

*Based on a clinical study of 401 adult patients with OIC and long-lasting (chronic) non-cancer pain treated with Relistor (methylnaltrexone bromide) tablets or placebo (sugar pill).

†Based on a clinical study of 312 adult patients with OIC and long-lasting (chronic) non-cancer pain treated with Relistor (methylnaltrexone bromide) injection or placebo injection.

‡Based on a clinical study of 133 adult patients with advanced illness and OIC treated with Relistor (methylnaltrexone bromide) injection or placebo injection.

In a clinical study, the most common side effects in adult patients with long-lasting (chronic) non-cancer pain taking Relistor (methylnaltrexone bromide) tablets included stomach-area (abdomen) pain (14%), diarrhea (5%), headache (4%), swelling or feeling of fullness or pressure in your stomach (abdomen) (4%), vomiting (3%), sweating (3%), anxiety (2%), muscle spasms (2%), runny nose (2%), and chills (2%).

In a clinical study, the most common side effects of Relistor (methylnaltrexone bromide) injection in adult patients with long-lasting (chronic) pain that is not caused by cancer included stomach-area (abdomen) pain (21%), nausea (9%), diarrhea (6%), sweating (6%), hot flush (3%), tremor (1%), and chills (1%).

In clinical studies, the most common side effects of Relistor (methylnaltrexone bromide) injection in adult patients receiving treatment for their advanced illness included stomach-area (abdomen) pain (29%), gas (13%), nausea (12%), dizziness (7%), and diarrhea (6%).

Relistor (methylnaltrexone bromide) injection is injected under the skin (subcutaneous injection) of the upper arm, stomach-area (abdomen), or thigh.

Do not inject at the same spot each time (rotate injection sites).

Download the Healthcare Provider Discussion Guide Learn more about Relistor

Pay as
little as
$0 with RELISTOR
co-pay card

Terms and conditions apply

Savings

You must activate this savings card before using it by visiting www.relistor.com, calling 1-855-202-3719, or texting SaveNow to 24109.

Message and data rates may apply. The full terms and conditions can be viewed at relistor.copaysavingsprogram.com/sms-terms.

Patients without commercial insurance are not eligible. The RELISTOR Savings Program is not valid for any person eligible for reimbursement of prescriptions, in whole or in part, by any federal, state, or other governmental programs, including, but not limited to, Medicare (including Medicare Advantage and Part A, B, and D plans), Medicaid, TRICARE, Veterans Administration or Department of Defense health coverage, CHAMPUS, the Puerto Rico Government Health Insurance Plan, or any other federal or state health care programs. The RELISTOR Savings Program is only good in the USA at participating retail pharmacies. The RELISTOR Savings Program cannot be redeemed at other locations, including government subsidized clinics or facilities. The RELISTOR Savings Program is not valid where otherwise prohibited, taxed, or otherwise restricted. The RELISTOR Savings Program cannot be combined with other offers. The savings card has no cash value. No other purchase is necessary. The savings card is nontransferable. No substitutions are permitted. The savings card is not health insurance. Maximum benefits apply.

Please call 1-855-202-3719 for more information.

The out-of-pocket cost of RELISTOR can vary based on your commercial insurance coverage and pharmacy. The RELISTOR Savings Program is available for patients with commercial insurance, including commercially insured patients without coverage for RELISTOR. For eligible patients, Salix Pharmaceuticals will be responsible to cover your co-pay out-of-pocket expense for each eligible prescription fill using this savings card, maximum benefits and other restrictions apply.

Please see terms and conditions.

Please call 1-855-202-3719 for more information.

Every insurance plan is different. Check with your insurance plan to find out if you have coverage for RELISTOR.

Download the Doctor Discussion Guide Learn more about Relistor

Indications

RELISTOR® is a prescription medicine used to treat constipation in adults that is caused by prescription pain medicines called opioids.

  • RELISTOR tablets and RELISTOR injection are used to treat constipation caused by opioids in adults with long-lasting (chronic) pain that is not caused by active cancer.
  • RELISTOR injection is also used to treat constipation caused by opioids in adults with advanced illness or pain caused by active cancer and who need increases in their opioid dose for comfort care.

It is not known if RELISTOR is safe and effective in children.

Important Safety Information

  • Do not take Relistor if you have a bowel blockage (called an intestinal obstruction) or have a history of bowel blockage.
  • Relistor can cause serious side effects such as a tear in your stomach or intestinal wall (perforation). Stomach pain that is severe can be a sign of a serious medical condition. If you get stomach pain that is severe, does not go away, or gets worse, stop taking Relistor and get emergency medical help right away.
  • Stop using Relistor and call your healthcare provider if you get diarrhea that is severe or that does not go away during treatment with Relistor.
  • You may have symptoms of opioid withdrawal during treatment with Relistor including sweating, chills, diarrhea, stomach pain, anxiety, and yawning. Tell your healthcare provider if you have any of these symptoms.
  • Tell your healthcare provider if you have kidney or liver problems.
  • Tell your healthcare provider if you have any stomach or bowel (intestines) problems, including stomach ulcer, Crohn’s disease, diverticulitis, cancer of the stomach or bowel, or Ogilvie’s syndrome.
  • Tell your healthcare provider if you are pregnant or plan to become pregnant. Taking Relistor during pregnancy may cause opioid withdrawal symptoms in your unborn baby. Tell your healthcare provider right away if you become pregnant during treatment with Relistor.
  • Taking Relistor while you are breastfeeding may cause opioid withdrawal in your baby. You should not breastfeed during treatment with Relistor. You and your healthcare provider should decide if you will take Relistor or breastfeed. You should not do both.
  • Also, tell your healthcare provider about all of the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.
  • In a clinical study, the most common side effects of Relistor tablets in people with long-lasting (chronic) pain that is not caused by cancer include: stomach-area (abdomen) pain, diarrhea, headache, swelling or a feeling of fullness or pressure in your abdomen, sweating, anxiety, muscle spasms, runny nose, and chills.
  • In a clinical study, the most common side effects of Relistor injection in people with long-lasting (chronic) pain that is not caused by cancer include: stomach-area (abdomen) pain, nausea, diarrhea, sweating, hot flush, tremor, and chills.
  • In clinical studies, the most common side effects of Relistor injection in people receiving treatment for their advanced illness include: stomach-area (abdomen) pain, gas, nausea, dizziness, and diarrhea.

You are encouraged to report side effects of prescription drugs to FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

For product information, adverse event reports, and product complaint reports, please contact:

Salix Product Information Call Center
Phone: 1-800-321-4576
Fax: 1-510-595-8183

Please click here for full Prescribing Information for RELISTOR tablets and RELISTOR injection, including medication guide.

plus icon

Indications - RELISTOR® is a prescription medicine used to treat constipation in adults that is caused by prescription pain medicines called opioids.

  • RELISTOR tablets and RELISTOR injection are used to treat constipation caused by opioids in adults with long-lasting (chronic) pain that is not caused by active cancer.
  • RELISTOR injection is also used to treat constipation caused by opioids in adults with advanced illness or pain caused by active cancer and who need increases in their opioid dose for comfort care.

It is not known if RELISTOR is safe and effective in children.

plus icon minus icon

Important Safety Information - Do not take Relistor if you have a bowel blockage (called an intestinal obstruction) or have a history of bowel blockage.

  • Relistor can cause serious side effects such as a tear in your stomach or intestinal wall (perforation). Stomach pain that is severe can be a sign of a serious medical condition. If you get stomach pain that is severe, does not go away, or gets worse, stop taking Relistor and get emergency medical help right away.
  • Stop using Relistor and call your healthcare provider if you get diarrhea that is severe or that does not go away during treatment with Relistor.
  • You may have symptoms of opioid withdrawal during treatment with Relistor including sweating, chills, diarrhea, stomach pain, anxiety, and yawning. Tell your healthcare provider if you have any of these symptoms.
  • Tell your healthcare provider if you have kidney or liver problems.
  • Tell your healthcare provider if you have any stomach or bowel (intestines) problems, including stomach ulcer, Crohn’s disease, diverticulitis, cancer of the stomach or bowel, or Ogilvie’s syndrome.
  • Tell your healthcare provider if you are pregnant or plan to become pregnant. Taking Relistor during pregnancy may cause opioid withdrawal symptoms in your unborn baby. Tell your healthcare provider right away if you become pregnant during treatment with Relistor.
  • Taking Relistor while you are breastfeeding may cause opioid withdrawal in your baby. You should not breastfeed during treatment with Relistor. You and your healthcare provider should decide if you will take Relistor or breastfeed. You should not do both.
  • Also, tell your healthcare provider about all of the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.
  • In a clinical study, the most common side effects of Relistor tablets in people with long-lasting (chronic) pain that is not caused by cancer include: stomach-area (abdomen) pain, diarrhea, headache, swelling or a feeling of fullness or pressure in your abdomen, sweating, anxiety, muscle spasms, runny nose, and chills.
  • In a clinical study, the most common side effects of Relistor injection in people with long-lasting (chronic) pain that is not caused by cancer include: stomach-area (abdomen) pain, nausea, diarrhea, sweating, hot flush, tremor, and chills.
  • In clinical studies, the most common side effects of Relistor injection in people receiving treatment for their advanced illness include: stomach-area (abdomen) pain, gas, nausea, dizziness, and diarrhea.

You are encouraged to report side effects of prescription drugs to FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

For product information, adverse event reports, and product complaint reports, please contact:

Salix Product Information Call Center
Phone: 1-800-321-4576
Fax: 1-510-595-8183

Please click here for full Prescribing Information for RELISTOR tablets and RELISTOR injection, including medication guide.

plus icon

Indications

RELISTOR® is a prescription medicine used to treat constipation in adults that is caused by prescription pain medicines called opioids.

  • RELISTOR tablets and RELISTOR injection are used to treat constipation caused by opioids in adults with long-lasting (chronic) pain that is not caused by active cancer.
  • RELISTOR injection is also used to treat constipation caused by opioids in adults with advanced illness or pain caused by active cancer and who need increases in their opioid dose for comfort care.

It is not known if RELISTOR is safe and effective in children.

Important Safety Information

Do not take Relistor if you have a bowel blockage (called an intestinal obstruction) or have a history of bowel blockage.

  • Relistor can cause serious side effects such as a tear in your stomach or intestinal wall (perforation). Stomach pain that is severe can be a sign of a serious medical condition. If you get stomach pain that is severe, does not go away, or gets worse, stop taking Relistor and get emergency medical help right away.
  • Stop using Relistor and call your healthcare provider if you get diarrhea that is severe or that does not go away during treatment with Relistor.
  • You may have symptoms of opioid withdrawal during treatment with Relistor including sweating, chills, diarrhea, stomach pain, anxiety, and yawning. Tell your healthcare provider if you have any of these symptoms.
  • Tell your healthcare provider if you have kidney or liver problems.
  • Tell your healthcare provider if you have any stomach or bowel (intestines) problems, including stomach ulcer, Crohn’s disease, diverticulitis, cancer of the stomach or bowel, or Ogilvie’s syndrome.
  • Tell your healthcare provider if you are pregnant or plan to become pregnant. Taking Relistor during pregnancy may cause opioid withdrawal symptoms in your unborn baby. Tell your healthcare provider right away if you become pregnant during treatment with Relistor.
  • Taking Relistor while you are breastfeeding may cause opioid withdrawal in your baby. You should not breastfeed during treatment with Relistor. You and your healthcare provider should decide if you will take Relistor or breastfeed. You should not do both.
  • Also, tell your healthcare provider about all of the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.
  • In a clinical study, the most common side effects of Relistor tablets in people with long-lasting (chronic) pain that is not caused by cancer include: stomach-area (abdomen) pain, diarrhea, headache, swelling or a feeling of fullness or pressure in your abdomen, sweating, anxiety, muscle spasms, runny nose, and chills.
  • In a clinical study, the most common side effects of Relistor injection in people with long-lasting (chronic) pain that is not caused by cancer include: stomach-area (abdomen) pain, nausea, diarrhea, sweating, hot flush, tremor, and chills.
  • In clinical studies, the most common side effects of Relistor injection in people receiving treatment for their advanced illness include: stomach-area (abdomen) pain, gas, nausea, dizziness, and diarrhea.

You are encouraged to report side effects of prescription drugs to FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

For product information, adverse event reports, and product complaint reports, please contact:

Salix Product Information Call Center
Phone: 1-800-321-4576
Fax: 1-510-595-8183

Please click here for full Prescribing Information for RELISTOR tablets and RELISTOR injection, including medication guide.