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Ondansetron caused constipation woes

Has anyone got a reliable way of coping with the constipation caused by the anti-sickness drug ondansetron? It is really making my life a misery while I'm on chemotherapy. I'm taking stool softeners and senna tablets but they don't work well and I just feel so sluggish and yucky when I'm in the grips. The chemo is three weekly doses and then a week off and I just get back to normal before it all starts again.

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I was advised to start Movicol the day before chemo - eventually got it down to a fine art of how long to use it and how many sachets. It takes a bit of experimenting, but I think starting early is key. It's miserable, so hope you get it sorted.

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Movicol or equivalent is good, but even better is switching to Cyclazine ( Merazine in USA) for an anti-nausea medication and using Ondasetron sparingly.

I had really bad nausea during my first round and reacted badly to all alternatives except Cyclazine which you can use often with no ill effects. I take one along with an Omeprozole before each meal and before bedtime. If I still feel queasy, I take another.

If I still feel queasy, then I take the Ondansetron.

Hope this helps,

Laura

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It took me a while to realize that my bowels were more sluggish than normal. I needed more stool softener, and I needed to take it several days in advance of chemo. Same with colonoscopies. I need to start several days before "normal" instructions.

Good luck. This constipation is horrid. I was passing cement pebbles before I twigged in.

XXOO

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I hate it. When I realised it was responsible for the constipation I decided I'd rather have nausea than it and stopped taking it. I was fortunate in that nausea not a big issue for me, but you could try reducing the dose perhaps, rather than feeling you have to learn to live with it. x

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If you're nauseas, eating is hard to do but I find taking Mirilax nightly PLUS daily apple and "high fiber veggies will do the trick. Just hard to do that every day as no appetite during chemo. The apple seems to be the best supplement to Mirilax and if I do not have the apple--even while taking the Mirilax, my body won't cooperate! ox

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I found sennakot best for me. Got a lot of support from chemo nurses who first tried laxido and lactulose (both made nausea worse) used a glycerine suppository if it got bad, it helped.

There was a lot of kind support available when I phoned the 24 hour helpline.

Good luck xxx

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Hi Coalole, an awful problem! I remember sending my husband out for glycerine suppositories & not to come back without them! 😆 The Oncology nurses said to me that Ondansetron is notorious for this, so only use sparingly, as other ladies have said.

I agree apples are great 🍏 & have lots of vitamins etc, also prunes or any fruit, plus lots of water/warm drinks.

My favourite stool softener (!) is Docusate sodium (capsules). You can take up to 4 per day. Now (several months on from chemotherapy), I just take one at night if needed. Hope these posts help you. What funny (but important) subjects we talk about! Linda x 🌷

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I used movicol it was still slow but then my palliative care doc said you can double dose. That worked lol

I found fresh coffee and iced water was very good too plus it helped with sickness

Good luck

LA xx

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I use prune juice... seems to work! Love C xxxx

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As the other ladies said, use ondansetron sparingly. I used domperidone and cyclizine for nausea and sodium duccosate capsules for the constipation.

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And here I read 'DomPerignon' . Hook me up! :)

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Avoid! After getting completely bound up I asked not to be given it again. It felt like my entire digestive system had been paralysed, from the neck down (I recognised the symptoms from when I was in hospital). Domperidone did the job and would give me a blissful single cycle of REM sleep just after taking it - since I was badly sleep-deprived, it was magic! I insist on it being listed as allergy when I am in hospital so they don't give it to me.

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I get it! I was given sachets of Movicol butvit fid bit work for me and tastes revolting! I ended up using laxatives for a few days and that helped alot.

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When I was on weekly chemo, I was prescribed Domperidone as anti sickness. When I had Ondansetron for other chemo, sometimes I started taking senna the night before chemo. Di

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I had terrible sickness after my first dose of Carbo/Caelyx and this time they have given me a stronger anti sickness pill to be taken the day of and two days after chemo which seems to work fine, it is called Emend. They say it doesn’t cause constipation but I will find out! Ondansetron is notorious for it. Sodium docusate is good as other ladies have mentioned.

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I totally understand where you're coming from I found the constipation one of the hardest things to deal with. The doctor said its a brilliant anti sickness but unfortunately it paralyses the bowel. I found taking docusate and movicol a couple of days before chemo really helped. Good luck

Sue x

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Hi - I totally commiserate; after my first chemo infusion I was gummed up for 10 days and felt miserable. I wasn't sure how much Laxido (Macrogol 3350) to take and ended up making myself sick by taking too many sachets in one go as directed to relieve impaction. I agree with several other comments about taking laxatives a few days before your chemo. Everyone is different and you will find the right combination. A couple of days before chemo I took 4 x 5g tablets of Bisacodyl (Tesco Constipation Relief) which was recommended by my surgeon to use for bowel clearance ahead of my debulking op. This results in a rumbling tum and a couple of runs to the loo (pardon the pun) but then it's done. The day before chemo I took 2/3 sachets of Laxido and continue for a few days after. I find eating small meals, drinking lots of water and pinching my nose to down prune juice each am does deliver the required result. When I come out of the loo and shout "Thunderbirds are Go!" all is well with the world. I also believe that a bit of meditation - I listen to one on YouTube - helps calm the associated agitation and helps you relax which aids the process. I'm pleased we can discuss this issue on here with so much helpful advice because many people who aren't living with the disease minimise this debillitating side effect. I hope this helps xxx

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I couldn't take Ondansetron at all. It froze my bowels up completely. I also tried Gravisetron which was supposed to be better but it wasn't. Eventually settled on Emend and Domperidone which was much better but I still needed laxatives (Dulcolax, not Senokot-I have IBS and senna causes cramps)

Hope you get it sorted!

Lou xx

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Thanks everyone. I'm given five ondansetron pills to take after chemo (one every 12 hours) as well as the intravenous dose which is given as part of the chemo treatment. I have been given sodium docusate and senna pills by the consultant and I resorted to suppositories this week because nothing was moving. I'm seeing the consultant on Friday before the next cycle starts and I will ask about alternatives to ondansetron, also about maybe only taking four and then moving to metaclopramide if I'm sick. I have been sick but much less that when I first started treatment.

The treatment regime does seem to be very "set in stone" so I don't know if I'll get anywhere but I'll keep my fingers crossed.

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I'd second the recommendation for Domperidone. It's the only one which doesn't seem to have nasty side effects. My first chemo I was given both of them as well as steroids to take after for several days. It was a much nastier regime than any I've had for OC, so perhaps that was why. But it was that early experience that has made me so militant about this.

Whatever the consultant says, remember you're an adult who can make their own decisions, and,if you can manage without it, then you can choose to do so. I didn't tell them until after I'd done it. It won't affect the effectiveness of your actual treatment. x

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Yes I agree about Domperidone as it actually helps gastric motility. It was trial & error with Ondansetron and to be avoided in my future treatment .

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