Chronic idiopathic constipation 24 mcg twice daily until 28 days. Moderate hepatic impairment (Child-Pugh Class B) 16 mcg twice daily. Severe hepatic impairment (Child-Pugh Class C) 8 mcg twice daily. Irritable bowel syndrome w/ constipation 8 mcg twice daily until 12 wk. Severe hepatic impairment (Child-Pugh Class C) 8 mcg once daily.
Nausea. Discontinue use if severe diarrhea occurs. Risk of syncope & hypotension during treatment. Concomitant use of BP-lowering medication; diarrhea or vomiting may increase risk of syncope & hypotension. Dyspnea. Perform thorough evaluation to confirm absence of obstruction prior to initiating therapy in patients w/ symptoms of mechanical GI obstruction. Not to be taken by patients w/ rare hereditary problems of fructose intolerance. Patients w/ moderate (Child-Pugh Class B) & severe hepatic impairment (Child-Pugh Class C). Pregnancy. Monitor infants of nursing mothers for diarrhea. Childn <6 yr.