Description

Polyethylene Glycol 3350 exerts an osmotic action in the gut, which induces a laxative effect. Polyethylene Glycol 3350 increases the stool volume, which triggers colon motility via neuromuscular pathways. Electrolytes combined with Polyethylene Glycol 3350 are exchanged across the intestinal barrier (mucosa) with serum electrolytes and excreted in fecal water without net gain or loss of sodium, potassium and water. Sodium chloride is the major extracellular cation. It is important in electrolyte and fluid balance, osmotic pressure control and water distribution as it restores sodium ions. It is used as a source of electrolytes and water for hydration, treatment of metabolic acidosis, priming solution in haemodialysis and treatment of hyperosmolar diabetes. It is also used as diluents for infusion of compatible drug additives. Sodium bicarbonate raises blood and urinary pH by dissociation to provide bicarbonate ions, which neutralises the hydrogen ion concentration. It also neutralises gastric acid via production of carbon dioxide. Potassium chloride is a major cation of the intracellular fluid. It plays an active role in the conduction of nerve impulses in the heart, brain and skeletal muscle; contraction of cardiac skeletal and smooth muscles; maintenance of normal renal function, acid-base balance, carbohydrate metabolism and gastric secretion.

Polyethylene Glycol 3350 and electrolytes is contraindicated in patients with known hypersensitivity to the active substance or any of the excipients, intestinal perforation or obstruction, crohn’s disease and ulcerative colitis.

Generally well tolerated. However side effects like allergic reactions, electrolyte disturbances particularly hyperkalaemia and hypokalaemia, abdominal pain, diarrhea, headache, peripheral edema may appear.

Use in Pregnancy: There is no experience of the use of Polyethylene Glycol 3350 during pregnancy and lactation. It should only be used if considered essential by the physician.  Use in Lactation: It is unknown whether Polyethylene Glycol 3350 is excreted in human breast milk.

Patients with impaired cardiovascular function: For the treatment of fecal impaction the dose should be divided so that no more than two sachets are taken in any one hour.  If patients develop any symptoms indicating shifts of fluid/electrolytes (e.g. edema, shortness of breath, increasing fatigue, dehydration, cardiac failure) Movilax should be stopped immediately and any abnormality should be treated appropriately. Prolonged use with all laxatives is undesirable and may lead to dependence.

Severe pain or distention can be treated by nasogastric aspiration. Extensive fluid loss by diarrhea or vomiting may require correction of electrolyte disturbances.

Osmotic purgatives