Indications
This entry covers oral solutions that combine electrolytes (Sodium Chloride, Potassium Chloride and Sodium Bicarbonate, sometimes with Sodium Sulphate) with Macrogol (Polyethylene Glycol). These products are used to treat constipation, to clear impacted stools (faecal impaction), and, in higher volumes, to empty the bowel before a colonoscopy, X-ray or bowel surgery.
How It Works
Macrogol is not absorbed. It holds water in the bowel, which softens stools and increases their volume so they pass more easily. The added electrolytes keep the body’s salt and water balance steady, so the fluid used to wash through the bowel is not drawn from, or lost from, the body.
Dosage and Administration
Follow the label or your doctor’s instructions exactly, because the dose differs between constipation treatment and bowel preparation. For constipation, measure the stated amount and mix it with water or take as supplied, usually once or twice daily. For bowel preparation, drink the full volume over the set times and follow the diet and fasting instructions given by the hospital. Children’s doses are set by the doctor.
Interactions
- Other medicines taken by mouth within about 1 hour before or during bowel preparation may be flushed out and not absorbed; ask your doctor about timing (especially for oral contraceptives, anti-epileptics and diabetes medicines).
- Thickening agents added to drinks for swallowing problems may not work with Macrogol.
- Use with diuretics or heart medicines needs care because of fluid and salt shifts.
Contraindications
- Bowel blockage or perforation, or risk of these.
- Severe inflammatory bowel disease (such as severe ulcerative colitis or toxic megacolon).
- Severe dehydration or uncorrected salt imbalance.
- Allergy to Macrogol or any ingredient.
Side Effects
Common side effects include bloating, stomach cramps, nausea, wind and diarrhoea. During bowel preparation, vomiting and anal soreness may occur.
Get urgent medical help if you have severe stomach pain, persistent vomiting, signs of dehydration (dizziness, very little urine, extreme thirst), fits, an irregular heartbeat, blood in the stool, or signs of a serious allergic reaction.
Pregnancy and Lactation
Macrogol is hardly absorbed and is generally considered suitable for constipation in pregnancy and breastfeeding when advised by a doctor. Bowel preparation doses should be used only when a doctor decides the test is needed.
Precautions and Warnings
- Drink enough clear fluids during bowel preparation to avoid dehydration.
- Older people and those with heart or kidney disease, or swallowing problems, need medical supervision.
- See a doctor if constipation lasts more than 2 weeks or keeps coming back; do not use for long periods without advice.
- Do not drive soon after taking a bowel preparation, as you will need frequent toilet visits.
Overdose
Too much can cause severe diarrhoea, vomiting, dehydration and salt imbalance. Stop taking it, drink fluids and contact a doctor; severe cases are treated in hospital.
Therapeutic Class
Osmotic laxative and bowel cleansing preparation (Macrogol with electrolytes).
Storage
Store below 30°C in a dry place, away from light and out of the reach of children. Once mixed or opened, use within the time stated on the label.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.