2 The technology
2.1 Lubiprostone (Amitiza, Sucampo Pharma Europe) has a UK marketing authorisation for the 'treatment of chronic idiopathic constipation and associated symptoms in adults when response to diet and non-pharmacological measures (for example, educational measures, physical activity) are inappropriate'. It is given orally at a dose of 24 micrograms twice daily. The summary of product characteristics states that a course of treatment for constipation with lubiprostone is 2 weeks.
2.2 The summary of product characteristics lists the following adverse reactions for lubiprostone: nausea, palpitations, diarrhoea, abdominal distension, flatulence, abdominal discomfort, abdominal pain, indigestion, oedema (including peripheral), chest discomfort, headache, dizziness, dyspnoea, hyperhidrosis and hot flushes. For full details of adverse reactions and contraindications, see the summary of product characteristics.
2.3 The price of lubiprostone 24 microgram capsules is £53.48 for a 56-capsule pack and £29.68 for a 28-capsule pack (prices excluding VAT; eMC Dictionary of Medicines and Devices Browser). The cost of an initial 2‑week course of treatment is £29.68, after which response is assessed, and those people continuing treatment receive the 56-capsule packs. Costs may vary in different settings because of negotiated procurement discounts.