Recommendation 7: In adults with CIC who do not respond to OTC agents, the panel suggests the use of lubiprostone over management without lubiprostone (conditional recommendation, low certainty of evidence).

Implementation considerations Can be used as a replacement or as an adjunct to OTC agents. Duration of treatment in trials was 4 weeks, but the drug label does not provide a limit. Nausea may occur; however, the risk of nausea is dose-dependent and seems to be lower when taken with food and water.