Macrogol: Indication, Dosage, Side Effect, Precaution

This information is not country-specific. Please refer to the Myanmar prescribing information.

Generic Medicine Info

Indications and Dosage

Oral
Constipation

Adult: As macrogol 4000 powd: 10-20 g once daily. As macrogol 3350 powd: Initially, 17 g once daily, may be increased to bid depending on the response. Max treatment duration: 1 wk.
Child: As macrogol 4000 powd: ≥8 yr Initially, 10 g every other day, may be increased up to 20 g once daily. Max treatment duration: 3 mth. As macrogol 3350 powd: 4-5 yr Initially, 8.5 g once daily, may be increased up to a max of 17 g once daily according to response. 6-12 yr 17 g once daily. May be increased or decreased according to response. Max: 25.5 g daily. ≥12 yr Same as adult dose. Max treatment duration: 3 mth.

Reconstitution

Dissolve powd in 120-240 mL of liq (e.g. water, juice, soda, coffee, tea).

Contraindications

GI disorders (e.g. ileus, intestinal obstruction, ulcerative colitis, toxic megacolon, Crohn’s disease, digestive perforation, painful abdominal syndrome).

Special Precautions

Patient w/ CV disease e.g. CHF, ascitic conditions. Renal impairment. Childn. Pregnancy and lactation.

Adverse Reactions

Significant: Fluid and electrolyte imbalance, hypersensitivity reactions (e.g rash, urticaria, oedema).
GI: Nausea, vomiting, diarrhoea, anal irritation, bloating, abdominal distention, cramps, pain, urgency to defecate, fecal incontinence.

Monitoring Parameters

Assess for symptoms of bowel obstruction prior to treatment.

Overdosage

Symptoms: Diarrhoea, vomiting, abdominal pain, fluid and electrolyte imbalance. Management: Supportive therapy to correct fluid and electrolyte disturbance.

Action

Description: Macrogols or polyethylene glycol (PEG) are long linear polymers w/ osmotic activity. It binds water molecules and retains water in the stool, thus increasing the vol of intestinal fluids causing laxative effect.
Onset: W/in 1 hr.
Pharmacokinetics:
Absorption: Poorly absorbed from the GI tract.
Excretion: Mainly via faeces (93%); urine (0.2%).

Storage

Store between 20-25°C.

MIMS Class

Laxatives, Purgatives

ATC Classification

A06AD15 - macrogol ; Belongs to the class of osmotically acting laxatives.

References

Anon. Hyperosmotic Laxatives. AHFS Clinical Drug Information [online]. Bethesda, MD. American Society of Health-System Pharmacists, Inc. https://www.ahfscdi.com/. Accessed 21/07/2017.

Anon. Polyethylene Glycol 3350. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 21/07/2017.

Buckingham R (ed). Macrogols. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 21/07/2017.

Dulcobalance 10 g Powder for Oral Solution in Sachet (Ipsen Ltd). MHRA. https://products.mhra.gov.uk/. Accessed 21/07/17.

Miralax Powder for Solution (Bayer HealthCare LLC.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 21/07/2017.

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