← Search & browse all drugs
ALIMENTARY TRACT AND METABOLISM › DRUGS FOR CONSTIPATION › DRUGS FOR CONSTIPATION › Osmotically acting laxatives
macrogol, combinations
A06AD65
Forms & Strengths
- Macrogol 3350 with electrolytes powder for oral solution
- Macrogol 4000 with electrolytes powder for oral solution
- Macrogol with sodium picosulfate powder/liquid
Adult Dosing
- Constipation: 1 to 3 sachets daily in divided doses, adjusted according to response
- Fecal impaction: 8 sachets daily (dissolved in 1 liter of water), taken over a 6-hour period for up to 3 days
- Bowel cleansing: Follow specific protocol (typically 4 liters of solution consumed prior to procedure)
Pediatric Dosing
- Chronic constipation (1 month to 11 years): Initial dose 0.7 g/kg/day, adjusted to 1-1.5 g/kg/day as needed
- Fecal impaction (5 to 11 years): 4 sachets on day 1, increasing by 2 sachets per day up to 12 sachets daily
- Not recommended for children under 1 month for chronic constipation
Indications
- Treatment of chronic constipation
- Resolution of fecal impaction defined as refractory constipation with fecal loading
- Bowel cleansing prior to colonoscopy or surgery
Mechanism of Action
- Osmotic action of macrogol (polyethylene glycol) retains water in the bowel lumen
- Softens stools and stimulates peristalsis via colonic distension
- Added electrolytes prevent net sodium and potassium absorption or loss across the intestinal mucosa
Contraindications
- Hypersensitivity to macrogols or any excipient
- Intestinal perforation or obstruction due to structural disorders
- Severe inflammatory conditions of the intestinal tract (e.g., Crohn's disease, ulcerative colitis)
- Toxic megacolon or ileus
Adverse Reactions
- Abdominal pain, distension, and borborygmi
- Nausea, vomiting, and flatulence
- Diarrhea and loose stools
- Anorectal discomfort
- Allergic reactions (urticaria, rash, anaphylaxis)
Drug Interactions
- Potential impaired efficacy of co-administered oral medications due to accelerated gastrointestinal transit
- Theoretical risk of reduced absorption of drugs with narrow therapeutic index (e.g., antiepileptics, immunosuppressants)
- May counteract the effect of thickening agents designed for dysphagia
Curated Content: Needs Vetting Before Put to Clinical Use