Clinical pharmacology of lubiprostone, a chloride channel activator in defecation disorders

Background: Lubiprostone, a prostaglandin E₁ derivative, was approved in January 2006 for the treatment of chronic idiopathic constipation (CIC) in adults and in April 2008 for the treatment of irritable bowel syndrome with constipation (IBS-C) in adult women. Objective: To review the pharmacology, efficacy and safety of lubiprostone and recommend its place in therapy for CIC and IBS-C. Methods: We conducted a literature search using PubMed/Medline (1966 - April 2008) using the keywords lubiprostone, chronic constipation, and irritable bowel syndrome. Data provided by the manufacturer and the FDA were also reviewed. Conculsion: Available literature for lubiprostone is mostly available in abstract data making it difficult to evaluate the clinical evidence. Although this medication shows promise, more information is needed to determine its place in therapy.