A laxative for chronic constipation that works on bile acids
Elobixibat
A laxative for chronic constipation that works by increasing bile acids in the bowel to draw in water and get things moving.
What is Elobixibat?
Elobixibat is a laxative used for chronic (long-term) constipation. It belongs to a newer group called IBAT inhibitors, which work by stopping bile acids being reabsorbed so that more of them reach the large bowel, where they draw in water and stimulate movement. It is taken before food. The most common side effects are tummy pain and diarrhoea, especially early on, as the bowel adjusts. It is used when other laxatives have not worked well enough.
Education and reference only. This is a plain-language guide to Elobixibat — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Elobixibat is a laxative used to treat chronic constipation, the kind that goes on for a long time and is not relieved well enough by simpler measures or older laxatives. It works in a different way from many laxatives: it acts on bile acids, the substances the body uses to digest fat. It is taken by mouth as a tablet, before food, so that it is in place to act when bile is released at mealtimes. It is generally used as one of the later options when other laxatives have not given enough relief.
How it works
Normally, most bile acids released into the gut to help digest food are reabsorbed near the end of the small bowel and recycled. Elobixibat blocks the transporter (called IBAT) that does this reabsorption, so more bile acids carry on into the large bowel. There, the bile acids draw water into the bowel and stimulate its natural movement, which softens the stool and helps it pass. Because it works on bile released at mealtimes, it is taken before food so that it is ready to act.
Company & origin
Originated / developed by: Specialist manufacturers.
A laxative used for long-term constipation, working by increasing the amount of bile acids that reach the bowel.
Practical use
How to take Elobixibat
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- Take it before food, usually before the first meal of the day, as it works on the bile released when you eat.
- Swallow the tablet whole with water as prescribed.
- Expect that it may take a little time to find a regular pattern; let your team know if it is not helping.
- Report troublesome or persistent diarrhoea or tummy pain, especially if it does not settle.
- Keep up plenty of fluids and, where suitable, fibre and activity to support healthy bowel habits.
Weighing it up
Advantages & disadvantages of Elobixibat
Advantages
- Effective for long-term constipation, including when other laxatives have not worked well enough.
- Works in a different way from most laxatives, by acting on bile acids in the bowel.
- Taken once a day by mouth before food.
Disadvantages
- Commonly causes tummy pain and diarrhoea, especially when first started.
- Needs to be taken before food, which takes a little planning.
- Generally kept for when simpler laxatives have not given enough relief.
Practical use
Good to know
The most useful practical point with elobixibat is that it is taken before food, usually before the first meal of the day, because it works on the bile acids released when you eat. The most common side effects are tummy pain and diarrhoea, particularly in the first days or weeks as the bowel gets used to it; these often settle, but troublesome or persistent diarrhoea should be reported. It works in a different way from most other laxatives, which is why it can help when those have not, but it is generally kept for when simpler options have not worked well enough. As with any change in bowel habit, it is worth mentioning any new or unexplained symptoms, such as bleeding or weight loss, to your doctor.
Who should not take it / use with caution
- People who have had a serious allergic reaction to elobixibat should not take it.
- It is not suitable for people with a blocked or suspected blocked bowel.
- It is used with care in people with certain bowel or gallbladder conditions, under medical guidance.
Monitoring
- Reviewing how well constipation is relieved and whether the medicine is still needed.
- Watching for troublesome or persistent diarrhoea or tummy pain.
- Checking for any new or unexplained bowel symptoms that need further assessment.
Side effects
- Tummy pain or cramping, especially early in treatment.
- Diarrhoea, which may settle as the bowel adjusts.
- Bloating, wind or nausea in some people.
Key interactions
- Bile-acid sequestrant medicines work in an opposite way and can reduce its effect, so spacing or review may be needed.
- It may affect the absorption of some other medicines, so tell your team about everything you take.
- Tell your prescriber or pharmacist about all your medicines, including ones bought without a prescription.
Available as: Tablets taken by mouth before food.
Answers
Elobixibat: frequently asked questions
What is elobixibat used for?
It is a laxative used for chronic (long-term) constipation, often when other laxatives have not given enough relief.
How does it work?
It stops bile acids being reabsorbed so that more reach the large bowel, where they draw in water and stimulate movement to soften and shift the stool.
Why do I take it before food?
It works on the bile acids your body releases when you eat, so it is taken before food, usually before the first meal of the day.
Why does it give me tummy pain or diarrhoea?
Tummy pain and diarrhoea are the most common side effects, especially early on as the bowel adjusts; report it if it is troublesome or persistent.
Is it different from other laxatives?
Yes, it works on bile acids in the bowel rather than in the ways most other laxatives do, which is why it can help when those have not.
The wider class
About Laxative (bile-acid transporter inhibitor)
Elobixibat belongs to the laxative (bile-acid transporter inhibitor) class. For how the class as a whole works, its shared safety principles and monitoring, see the full guide.
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Authoritative sources
- BNF
- NICE CKS
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