Types of Medications for Irritable Bowel Syndrome

The medical treatment of Irritable bowel Syndrome (IBS) has three main goals:

  • Achieving remission (the absence of symptoms)
  • Maintaining remission (ease of symptoms or life impacting flare-ups)
  • Improving your quality of life

To accomplish these goals, treatment is aimed at controlling the ongoing IBS symptoms. There is no standard approach to managing all people with IBS. The symptoms, severity of disease, and how the disease might impact vary considerably.

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Your healthcare provider will work with you to help decide the right treatment for you. It may take some time for medications to take effect, or sometimes a medication may stop working. The management of IBS involves dedication to taking your medications as prescribed, and maintaining open communication with your healthcare team so you can work together towards achieving a better quality of life.

There are many medications available to help control your disease symptoms. IBS medications generally fall into the following categories. View the categories below to learn more about your treatment options.

Be sure to talk to your doctor about the potential risks and side effects of these medications and weigh them against the potential benefits. We are not able to offer medical, pharmaceutical or nutritional advice. Please consult a healthcare professional.

Source:

National Institutes of Health (NIH)
PubMed – NCBI
Verywell.com
FDA.gov

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Medications for IBS

These prescription medications have been FDA approved for marketing for the indication of IBS and/or constipation.

Brand Name Generic name IBS type Type Comments
Amitiza® lubiprostone IBS-C Prescription indicated for IBS-C or chronic idiopathic constipation Link
Dicetel® pinaverium bromide All IBS types Prescription For the treatment and relief of symptoms associated with irritable bowel syndrome (IBS): abdominal pain, bowel disturbances and intestinal discomfort. Link
Linzess® / Constella® linaclotide IBS-C Prescription To treat irritable bowel syndrome with constipation (IBS‑C) and chronic idiopathic constipation (CIC). Link
Lotronex® alosetron IBS-D Prescription For some women with severe irritable bowel syndrome (IBS) whose main problem is diarrhea; whose IBS symptoms have lasted 6 months or longer and have not been helped enough by other treatments. Link
Resotran® / Motegrity® prucalopride IBS-C Prescription Prokinetic agent that works by targeting the serotonin (5-HT4) receptors in the intestines. Used for the treatment of chronic idiopathic constipation in women for whom laxative treatment has failed to provide relief by stimulating the muscle movement. Resotran™ and Motegrity™ are only approved in the Canada and the US respectively for chronic idiopathic constipation (CIC). Link
Trulance® / Plecanatide® guanylate cyclase-C agonist IBS-C Prescription Stimulate digestive fluid movement and support regular bowel function. Trulance (plecanatide) is approved for the treatment of IBS-C and Chronic Idiopathic Constipation (CIC) in adult patients in the United States. Link
Viberzi® / Truberzi® eluxadoline IBS-D Prescription Used to treat men and women adults who have irritable bowel syndrome with diarrhea (IBS-D). Truberzi® was recently approved for use in the European Union. Link
Xifaxan® / Zaxine® / Xifaxnta® / Xifapil® / Ciboz® rifaximin IBS-D Prescription Antibiotic indicated for the treatment of irritable bowel syndrome with diarrhea (IBS-D) in adults. Link


Antidepressants

Physicians may prescribe an antidepressant, also known as a central neuromodulator, to an IBS patient as an "off-label" use, as no antidepressant has received FDA approval as an IBS treatment. There is research which supports two classes of antidepressants TCAs and SSRIs, in treating symptoms associated with IBS. Antidepressants have been found to have a positive effect on gut motility and visceral hypersensitivity.

Brand Name Generic name IBS typeType Comments
Celexa® citalopram IBS-C Prescription Selective Serotonin Reuptake Inhibitor (SSRI). May alleviate the abdominal pain and associated symptoms of IBS. Side effect of diarrhea may be helpful for IBS-C. Link
Cymbalta® duloxetine IBS-A Prescription Serotonin-Norepinephrine Reuptake Inhibitor (SNRI). Helpful for managing pain and maybe for constipation or diarrhea. Effective in treating pain like the TCA's but without the side effects of TCA's. Link
Desyrel® trazodone IBS-D Prescription Serotonin antagonist and reuptake inhibitor (SARI). Link
Effexor® venlafaxine IBS-A Prescription Serotonin-Norepinephrine Reuptake Inhibitor (SNRI). Helpful for managing pain and maybe for constipation or diarrhea. Effective in treating pain like the TCA's but without the side effects of TCA's. Link
Elavil® amitriptyline IBS-D Prescription Tricyclic antidepressant (TCA). Usually recommended when antispasmodic medicines have not been able to control the symptoms of pain and cramping. Common side-effect of constipation can be helpful for IBS-D. Link
Lexapro® escitalopram IBS-C Prescription Selective Serotonin Reuptake Inhibitor (SSRI). May alleviate the abdominal pain and associated symptoms of IBS. Side effect of diarrhea may be helpful for IBS-C. Link
Norpramin® / Pertofrane® desipramine IBS-D Prescription Tricyclic antidepressant (TCA). Usually recommended when antispasmodic medicines have not been able to control the symptoms of pain and cramping. Common side-effect of constipation can be helpful for IBS-D. Less unwanted side-effects than Elavil®. Link
Pamelor® / Aventyl® nortriptyline IBS-D Prescription Tricyclic antidepressant (TCA). Usually recommended when antispasmodic medicines have not been able to control the symptoms of pain and cramping. Common side-effect of constipation can be helpful for IBS-D. Less unwanted side-effects than Elavil®. Link
Paxil® paroxetine IBS-C Prescription Selective Serotonin Reuptake Inhibitor (SSRI). May alleviate the abdominal pain and associated symptoms of IBS. Side effect of diarrhea may be helpful for IBS-C. Link
Pristiq® desvenlafaxine IBS-A Prescription Serotonin-Norepinephrine Reuptake Inhibitor (SNRI). Helpful for managing pain and maybe for constipation or diarrhea. Effective in treating pain like the TCA's but without the side effects of TCA's. Link
Prozac® fluoxetine IBS-C Prescription Selective Serotonin Reuptake Inhibitor (SSRI). May alleviate the abdominal pain and associated symptoms of IBS. Side effect of diarrhea may be helpful for IBS-C. Link
Remeron® mirtazapine IBS-D Prescription Noradrenergic and specific serotonergic antidepressant (NaSSA). Can also be classified as a tetracyclic antidepressant (TeCA). Link
Savella® milnacipram IBS-A Prescription Serotonin-Norepinephrine Reuptake Inhibitor (SNRI). Helpful for managing pain and maybe for constipation or diarrhea. Effective in treating pain like the TCA's but without the side effects of TCA's. Link
Tofranil® imipramine IBS-D Prescription Tricyclic antidepressant (TCA). Usually recommended when antispasmodic medicines have not been able to control the symptoms of pain and cramping. Common side-effect of constipation can be helpful for IBS-D. Link
Wellbutrin® / Zyban® bupropion IBS-D Prescription Norepinephrine-dopamine reuptake inhibitor (NDRI). Link
Zoloft® sertraline IBS-C Prescription Selective Serotonin Reuptake Inhibitor (SSRI). May alleviate the abdominal pain and associated symptoms of IBS. Side effect of diarrhea may be helpful for IBS-C. Link


Probiotics and Antibiotics

Probiotics are good bacteria that are thought to provide a health benefit including healthy digestion. Probiotics are increasingly being used and evaluated in the management of digestive health. Some antibiotics may make probiotics less effective. Antibiotics are a new class of prescription treatment for IBS. It is thought to work by its anti-inflammatory and antibacterial properties and additionally, it is a nonabsorbable antibiotic that acts locally in the gut, and considered to have less side effects to the whole body.

Brand Name Generic name IBS typeType Comments
Alflorex® bifidobacterium infantis 35624 All IBS types Over-the-counter Probiotic that delivers "good" bacteria to your digestive system to relieve abdominal pain, bloating, urgency, constipation or diarrhea. Link
Align® bifidobacterium infantis 35624 All IBS types Over-the-counter Probiotic that delivers "good" bacteria to your digestive system to relieve abdominal pain, bloating, urgency, constipation or diarrhea. Link
Bimuno® galacto-oligosaccharides (B-GOS) All IBS types Supplement Bimuno® is a prebiotic supplement and is the result of an on-going research and development programme conducted in collaboration with the University of Reading’s Food Microbial Sciences Unit and other globally recognised research institutes. Bimuno® contains a mixture of unique, patented galacto-oligosaccharides (B-GOS). B-GOS belongs to a special group of nutrient fibres (oligosaccharides) also found in maternal milk that naturally feed and stimulate the growth of friendly bacteria in the gut. Link
Florastor® saccharomyces boulardii IBS-D Over-the-counter Probiotic derived from yeast. Normalizes intestinal flora and relieves diarrhea. Link
TuZen® lactobacillus plantarum 299v All IBS types Over-the-counter TuZen increases the population of "good" lactobacillus plantarum 299v (Lp229v) bacteria, increases the concentration of carboxylic acids, an important energy source for the cells of the intestinal mucosa, inhibits the adhesion of a "bad" bacteria (Enterobacteria) on the intestinal mucosa and inhibits the growth of potential pathogenic agents (antibacterial activity). Additional relief may also be a result of TuZen's proven effectiveness as an anti-inflammatory. Link
Visbiome® 8 strains of lactic acid bacteria All IBS types Over-the-counter Probiotic medical food is designated for the dietary management of IBS. It is a prescribable medicine and should not be confused with an over-the-counter probiotic. It must be used under medical supervision and may be dispensed by a pharmacist. Link
Xifaxan® / Zaxine® / Xifaxnta® / Xifapil® / Ciboz® rifaximin IBS-D Prescription Antibiotic indicated for the treatment of irritable bowel syndrome with diarrhea (IBS-D) in adults. Link


Antispasmodics

Antispasmodics relax abdominal muscle spasms where pain and cramps occur. They are usually taken before meals.

Brand NameGeneric nameIBS typeType Comments
Bentyl® / Bentylol® dicyclomine hydrochloride All IBS types Prescription antispasmodic which relieves smooth muscle spasm of the gastrointestinal tract (May be over the counter in some countries.) Link
Buscopan® / Buscapina® hyoscine butylbromide All IBS types Over-the-counter antispasmodic medication for relieving abdominal discomfort and pain due to cramps and spasms. (May require a physician's prescription in some countries.) Link
Colpermin® peppermint oil All IBS types Over-the-counter Relives abdominal cramp, spasms and bloating of IBS. Link
Donnatal® phenobarbital, hyoscyamine sulfate, atropine sulfate, scopolamine hydrobromide All IBS types Prescription Slows the natural movements of the gut by relaxing the muscles in the stomach and intestines and acts on the brain to produce a calming effect. Link
Librax® chlordiazepoxide, clidinium IBS-A Prescription A benzodiazepine which reduces stomach acid and decreases intestinal spasms. Link
Modulon® trimebutine maleate All IBS types Prescription Regulates abnormal intestinal activity. Link
Pamine® / Pamine Forte® methscopolamine bromide All IBS types Prescription Slows the natural movements of the gut and relaxes the muscles in the stomach/intestines. Link
Spasmonal® alverine citrate All IBS types Prescription An “anti-spasmodic” medicine. It relaxes the muscles in the intestine (gut). Link


Antidiarrheal Agents

Antidiarrheal agents work to help restore the digestive system to its normal pace. Some slow down the colon to allow for more liquid to be absorbed and/or slow down the contractions which move food materials. Some also work to bind to substances which might otherwise contribute to diarrhea.

Brand NameGeneric nameIBS typeType Comments
Colestid® colestipol IBS-D Prescription Bile acid sequestrant which binds bile in the gastrointestinal tract to prevent its reabsorption. Commonly used to treat diarrhea resulting from bile acid malabsorption. Link
Imodium® loperamide IBS-D Over-the-counter Slows down the movement of fluid through the intestines. Link
Lomotil® diphenoxylate, atropine sulfate IBS-D Prescription Decreases the motion of muscles in the intestines and prolonging the time it takes to move the contents through the body. May be habit forming. Link
Motofen® difenoxin hydrochloride, atropine sulfate IBS-D Prescription Slows intestinal motility. May be habit forming. Link
Questran® cholestyramine IBS-D Prescription Bile acid sequestrant which binds bile in the gastrointestinal tract to prevent its reabsorption. Commonly used to treat diarrhea resulting from bile acid malabsorption. Link


Laxatives

Laxatives are substances that loosen stools and increase bowel movements. They are used to treat and prevent constipation. Laxatives vary as to how they work and the side effects they may have. Certain stimulant, lubricant and saline laxatives are used to evacuate the colon for rectal and bowel examinations, and may be supplemented by enemas under certain circumstances. Sufficiently high doses of laxatives may cause diarrhea.

Brand NameGeneric nameIBS typeType Comments
Metamucil® psyllium IBS-C Supplement Psyllium is a bulk-forming fiber laxative. Psyllium works by absorbing liquid and swelling in the intestines to create a softer, bulky stool that is easier to pass. Link
Miralax®, Glycolax® polyethylene glycol IBS-C Over-the-counter Polyethylene glycol is an osmotic laxative. Polyethylene glycol works by retaining water in the stool, resulting in softer stools and more frequent bowel movements. Link


Medical Foods

While medical foods do not need approval in the same way as prescription medications, they do have the FDA designation as a Medical Food. A medical food is specially formulated to be consumed or administered enterally (orally) under the supervision of a physician. Medical foods are intended for specific dietary management of a disease or condition for which distinctive nutritional requirements, based on recognized scientific principles, are established by medical evaluation.

Brand NameGeneric nameIBS typeType Comments
Atrantil® peppermint, quebracho, and horse chestnut extract All IBS types Over-the-counter Patented combination of natural polyphenols which reduces bloating and supports digestive health. Active ingredients are peppermint, quebracho, and horse chestnut extract. Link
EnteraGam® serum-derived bovine immunoglobulin/protein isolate IBS-D Prescription Medical food for chronic loose or frequent stools (IBS-D). Link
IBgard® Ultramen®, an ultra-purified peppermint oil All IBS types Over-the-counter Targeted technology to deliver peppermint oil directly to the small intestine Link


Investigational Medications

There remains a significant unmet need for effective treatments particularly for the pain component of IBS and other functional gastrointestinal disorders (FGIDs). There is a promising pipeline of investigational medications for the future treatment of IBS and related FGIDs. These medications are being researched and may be available in clinical trials.

Brand Name Generic nameIBS type Type Comments
Bekinda® ondansetron IBS-D A patent-protected, extended-release (24 hours) oral pill formulation of ondansetron. Ondansetron is a 5-HT3 antagonist. Link
Blautix All IBS types Single-strain bacteria that consumes gases which are known to cause bloating, abdominal pain and changes in bowel frequency. Link
Ibodutant® tachykinin NK2 IBS-D Tachykinin NK2 receptor antagonist. Proposed as a potential novel drug for the therapy of gastrointestinal diseases characterized by motility alterations, visceral pain, and/or inflammation, such as IBS. Link
IBset® / Nasea® / Nozia® / Irribow® ramosetron IBS-D Improves abnormal bowel movement associated with the acceleration of intestinal transit by inhibiting 5-HT3 receptor selectively. It also improves visceral hypersensitivity by suppressing the transmission of intestinal nociception. Link
ORP-101® buprenorphine IBS-D A buprenorphine dimer therapeutic, is a peripherally active partial mu opioid receptor agonist and K opioid receptor antagonist designed to ease colonic hypersensitivity stemming from intestinal hyperalgesia and motility dysfunction in IBS-D. Link
SYN-010® lovastatin lactone IBS-C A proprietary, modified-release formulation of lovastatin lactone that is designed to reduce methane production in the intestine, curbing IBS-C. Link
Tenapanor® NHE3 IBS-C Non-systemic small molecule inhibitor of NHE3, a sodium transporter present on the epithelia surface of the GI tract. Reduces the absorption of dietary sodium and phosphorus thereby relieving IBS-C. Link
Vibegron® IBS-A Studied in women with abdominal pain due to IBS with predominant diarrhea (IBS-D) or mixed episodes of diarrhea and constipation (IBS-M). Vibegron is an investigational oral beta-3 adrenergic receptor agonist currently being assessed for the treatment of overactive bladder. Link

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