What is a good substitute for Movantik? Exploring Alternatives for OIC

October 9, 2025 •

4 min read

According to studies, many patients may not respond to Movantik (naloxegol) or may experience undesirable side effects. When questioning what is a good substitute for Movantik?, there are a range of effective options for treating opioid-induced constipation (OIC), including alternative prescription drugs, over-the-counter laxatives, and natural remedies.

Quick Summary

Alternatives to Movantik for opioid-induced constipation range from other peripherally acting opioid antagonists like Relistor and Symproic to different drug classes such as Amitiza, Linzess, and Trulance. Over-the-counter laxatives and lifestyle adjustments also offer relief for mild to moderate cases, with the best choice depending on individual patient needs.

Key Points

Variety of Alternatives: Movantik alternatives for OIC include other prescription medications, such as PAMORAs (Relistor, Symproic) and different drug classes (Amitiza, Linzess).
Different Mechanisms of Action: Unlike Movantik's targeted action on gut opioid receptors, alternatives like Amitiza increase intestinal fluid, while Linzess and Trulance boost fluid and motility through a different pathway.
OTC and Natural Remedies: For mild to moderate constipation, over-the-counter options like MiraLAX (PEG), stool softeners, or natural methods including a high-fiber diet and exercise can provide relief.
Consult a Doctor for Switches: It is crucial to consult a healthcare provider before switching from Movantik, especially to another prescription medication, to ensure safety and account for your medical history.
Insurance and Cost Considerations: Factors such as insurance coverage and cost often influence the choice of alternative, as Movantik and its prescription counterparts are brand-name and potentially expensive.
Administration Options: Relistor offers both oral and injectable forms, providing flexibility for patients who may have difficulty with oral tablets.

Understanding Opioid-Induced Constipation (OIC)

Opioid medications, while effective for pain management, bind to specific opioid receptors not only in the central nervous system but also in the gastrointestinal (GI) tract. This binding slows down bowel movements, increases water absorption, and decreases fluid secretion in the gut, leading to the condition known as opioid-induced constipation (OIC). Movantik (naloxegol) is a peripherally acting mu-opioid receptor antagonist (PAMORA) designed to block these peripheral opioid receptors in the GI tract without affecting the pain relief provided by opioids centrally. However, patients may need alternatives due to side effects, lack of efficacy, or insurance coverage issues.

Prescription Alternatives to Movantik

For those who require a prescription-strength solution for OIC, several other medications offer alternative mechanisms or administration methods.

Other Peripheral Opioid Antagonists (PAMORAs)

Like Movantik, these medications target the same peripheral mu-opioid receptors in the gut to reverse the constipating effects of opioids.

Relistor (methylnaltrexone): This is a direct competitor to Movantik and is also indicated for OIC. A key difference is its availability in both oral tablet and subcutaneous injection forms, providing an option for those who cannot take oral medications. The injectable version can work faster than the oral tablets.
Symproic (naldemedine): Also a PAMORA, Symproic is an oral tablet taken once daily. Studies have shown it to be effective in treating OIC and well-tolerated by patients.

Non-PAMORA Prescription Medications

These drugs use different pharmacological pathways to stimulate bowel movements and can also be effective for OIC, though some are primarily indicated for other types of chronic constipation.

Amitiza (lubiprostone): A chloride channel activator, Amitiza increases fluid secretion in the intestines, which softens the stool and promotes motility. It is indicated for OIC, chronic idiopathic constipation (CIC), and IBS-C.
Linzess (linaclotide): This medication works by activating guanylate cyclase-C, which increases intestinal fluid and accelerates stool transit. While indicated for CIC and IBS-C, it is sometimes used for chronic constipation resulting from opioid use.
Trulance (plecanatide): Similar to Linzess, Trulance also acts as a guanylate cyclase-C agonist to increase intestinal fluid and motility. It is indicated for CIC and IBS-C.

Over-the-Counter (OTC) and Natural Remedies

For less severe cases or as an initial approach, patients may find relief with non-prescription options. These are often tried before escalating to a prescription PAMORA.

OTC Laxatives

Several types of laxatives are available over the counter, each with a different mechanism.

Osmotic Laxatives: Products like MiraLAX (polyethylene glycol) work by drawing water into the colon to soften stools and increase bowel movements.
Stool Softeners: Docusate sodium (Colace) adds water and fats to the stool, making it easier to pass.
Stimulant Laxatives: Senna (Senokot) and bisacodyl (Dulcolax) stimulate the intestinal muscles to induce bowel movements. These should be used with caution and typically for short-term relief, as long-term use can lead to dependency.

Natural Options and Lifestyle Changes

Foundational treatments for constipation of any cause should always include lifestyle adjustments.

High-Fiber Diet: Increasing the intake of dietary fiber through foods like fruits, vegetables, beans, and whole grains can help bulk up and soften stool.
Hydration: Drinking plenty of water daily is essential to help soften stool and support regular bowel function.
Exercise: Regular physical activity, even moderate exercise like walking, can stimulate the digestive system and promote more frequent bowel movements.

Comparison of Movantik and Common Alternatives


Feature	Movantik (naloxegol)	Relistor (methylnaltrexone)	Amitiza (lubiprostone)	OTC Laxatives (e.g., MiraLAX)
Mechanism	PAMORA (peripheral opioid antagonist)	PAMORA (peripheral opioid antagonist)	Chloride channel activator	Osmotic (pulls water into colon)
Indication	OIC in adults	OIC in adults	OIC, CIC, IBS-C	Occasional/general constipation
Administration	Oral tablet, once daily	Oral tablet or injection, once daily	Oral capsule, twice daily	Oral powder, tablet, etc., as directed
Speed of Action	Within 24 hours	Injection can work in ~4 hours	Within 24 hours	1-3 days for MiraLAX
Availability	Prescription only	Prescription only	Prescription only	Over-the-counter
Cost	Brand-name only, potentially expensive	Brand-name only, potentially expensive	Brand-name (generic may be preferred)	Generally lower cost

How to Switch from Movantik to a Substitute

Deciding on an alternative for Movantik is a personal decision that must be made in consultation with a healthcare provider. The process should involve a thorough review of your medical history, current medications, side effects experienced with Movantik, and treatment goals. Switching between different types of prescription medications, especially from one opioid antagonist to another, should always be supervised by a doctor. Your healthcare provider can determine the most appropriate and safest option for you based on their medical expertise and knowledge of your specific condition.

Conclusion

While Movantik is an effective treatment for many with opioid-induced constipation, it is not the only option available. The best substitute depends on an individual's unique health profile, the severity of their constipation, and their response to different treatments. Prescription alternatives such as the PAMORAs Relistor and Symproic, or non-PAMORA drugs like Amitiza, offer targeted solutions for OIC. For less severe cases, or as a complementary approach, OTC laxatives and lifestyle adjustments can provide significant relief. Ultimately, patients should work closely with their doctor to explore these options and find the most suitable and safe long-term solution for their constipation. A comprehensive discussion with your healthcare team is the most important step in finding the right path forward.

Visit SingleCare for additional details on Movantik alternatives and how to switch your prescription safely.

Frequently Asked Questions

You should not switch directly or abruptly from Movantik to another prescription medication without consulting your healthcare provider. They will help determine the appropriate timing and process to ensure a safe transition and prevent complications.

Movantik is a peripheral opioid antagonist that blocks the effects of opioids in the gut. Amitiza increases intestinal fluid through a different mechanism (chloride channels), while Linzess and Trulance are guanylate cyclase-C agonists that boost fluid and motility.

Over-the-counter laxatives can be effective for milder cases of constipation and are often tried first. However, they work differently and may not be strong enough to counteract the effects of opioids for everyone, which is why a prescription PAMORA might be needed.

Both Movantik and Relistor are PAMORAs for OIC. The key differences are that Movantik is only available as an oral tablet, while Relistor can be taken orally or administered via injection, and its injection form works faster.

Natural remedies and lifestyle changes, such as increasing dietary fiber intake, ensuring adequate hydration, and exercising regularly, are foundational for constipation relief and can be used in addition to or, for milder cases, sometimes instead of Movantik.

If Movantik is not effective after several days of treatment, you should contact your healthcare provider. They can explore dose adjustments, alternative prescription medications like Relistor or Amitiza, or other strategies to manage your constipation.

Yes, insurance coverage can vary significantly for different prescription alternatives. Some plans, particularly Medicaid, may have a preferred drug list where certain Movantik alternatives like Amitiza and Linzess might be covered without prior authorization, whereas Movantik might require it.