Rule out organic diseases & establish diagnosis of moderate to severe IBS-C before use. Discontinue in prolonged (eg, >1 wk) or severe diarrhoea until resolved. Control electrolyte if prone to disturbance of water or electrolyte balance (eg, elderly, CV diseases, diabetes, HTN). Not recommended in chronic intestinal tract inflammatory conditions (eg, Crohn's disease & ulcerative colitis). Pregnancy & lactation. Childn <18 yr. Elderly >65 yr.
Increased risk of diarrhoea w/ proton pump inhibitors, laxatives or NSAIDs. May reduce the efficacy of OCs & medicinal products absorbed in the intestinal tract w/ a narrow therapeutic index (eg, levothyroxine).
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