TOLERANCE AND EFFICACY OF POLYETHYLENE-GLYCOL-3350 ELECTROLYTE SOLUTION VERSUS LACTULOSE IN RELIEVING OPIATE INDUCED CONSTIPATION - A DOUBLE-BLINDED PLACEBO-CONTROLLED TRIAL

Chronicity and high therapeutic cost prompted this study to determine a cost-effective and efficacious regimen in treating narcotic-induced constipation. The efficacy of lactulose was compared with polyethylene glycol 3350/electrolyte solution for relief of methadone-induced cons tipation. This was a randomized, triple cross-over after control run-i n (no treatment) study conducted at a methadone maintenance program in Baltimore, Maryland in 57 patients who are affected by opiate-induced constipation. The study was measured by self-reported frequencies, co nsistency, and ease of defecation during a 1 week run-in control perio d, followed by 3 treatment phases of 2 weeks each. Polyethylene glycol 3350/electrolyte solution and lactulose produced more ''nonhard'' sto ols than the placebo (P<0.01) and control (P<0.003). Polyethylene glyc ol 3350/electrolyte solution produced the loosest stool (P<0.0001) com pared with the control, whereas lactulose had the most adverse effects . There were no significant differences in reducing hard stool formati on in either experimental group, but both were better than having noth ing or just the placebo. Polyethylene glycol/electrolyte solution resu lted in the loosest (diarrheal) stool. It is also likely that polyethy lene glycol/electrolyte solution is the most cost effective.