Opioid Constipation Risk: Which Painkillers Cause It?
- MANCHESTER, England — Certain opioid painkillers, including morphine, oxycodone, and fentanyl, carry a significantly higher risk of severe constipation compared to codeine, according to a recent study published...
- Tramadol, conversely, was associated with the lowest risk of constipation among the opioids examined.
- The study, which analyzed electronic health records of 80,475 patients in Northwest England from 2009 to 2020, also found that patients receiving more than 50 morphine milligram equivalents...
Certain opioid painkillers elevate constipation risk, a critical finding from a new study. Morphine, oxycodone, and fentanyl pose a greater danger. Meanwhile, codeine exhibits a comparatively lower risk, while tramadol presents the lowest.This research, published in BMC medicine, analyzed health records to uncover the connection between opioid use and severe adverse effects. Patients on more than 50 morphine milligram equivalents (MME) daily are at the highest risk. Opioid-induced constipation impacts quality of life, perhaps leading to longer hospital stays and increased emergency room visits.Healthcare professionals are urged to consider these findings when managing pain relief. Learn how this impacts treatment choices and dosing strategies. For more details, visit News Directory 3. Discover what’s next in pain management.
Opioid Painkillers: Study Links Morphine, Oxycodone to Higher Constipation Risk
MANCHESTER, England — Certain opioid painkillers, including morphine, oxycodone, and fentanyl, carry a significantly higher risk of severe constipation compared to codeine, according to a recent study published in BMC medicine.

Tramadol, conversely, was associated with the lowest risk of constipation among the opioids examined.
The study, which analyzed electronic health records of 80,475 patients in Northwest England from 2009 to 2020, also found that patients receiving more than 50 morphine milligram equivalents (MME) daily faced the greatest risk. Fifty MME is roughly equivalent to 50mg of morphine or 33mg of oxycodone per day.
Dr. Meghna Jani, NIHR Advanced Fellow and Senior Clinical Lecturer at The University of Manchester, emphasized the impact of opioid-induced constipation on patients’ lives. “Constipation is a frequent adverse event associated with opioid medications that can have a considerable impact on patients’ quality of life,” Jani said.She added that it is also linked to longer hospital stays, higher costs, and increased emergency room visits.
The UK Faculty of Pain Medicine of the Royal College of Anesthetists’ Opioids Aware site suggests that the risks of opioid use may outweigh the benefits above 120 MME per day, though this guidance is under review.
Researchers measured opioid exposure using hospital records and defined severe constipation as the administration of an enema or suppository.
Jani noted that the study will help clinicians and patients make informed decisions about pain relief, balancing the benefits against the risk of constipation. She urged prescribers to use caution with opioid dosing, aiming for the lowest effective dose.
The study authors also noted that electronic health records likely underrepresent the true prevalence of constipation, as patients may not report it or healthcare providers may not code it consistently.
