A fixed-dose combination laxative containing a contact stimulant (sodium picosulfate), a lubricant stool softener (liquid paraffin), and an osmotic laxative (milk of magnesia). It provides a multi-modal approach for the effective relief of constipation by stimulating colonic peristalsis, softening hard stool, and drawing water into the bowel lumen.
Adult: 10 ml (one measuring cup usually provided) once daily, preferably at bedtime. Do not exceed the recommended dose.
Note: Shake the bottle well before use. Use the provided measuring cup. Take orally, preferably with a glass of water at bedtime. Do not take immediately after meals. Do not lie down immediately after ingestion to prevent reflux and potential aspiration of liquid paraffin.
The combination exerts a synergistic effect. Sodium picosulfate is a prodrug converted by colonic bacteria to an active metabolite that directly stimulates the colonic mucosa, enhancing propulsive peristalsis. Liquid paraffin coats the stool and intestinal mucosa, softening hard stool and reducing water absorption from the fecal mass. Milk of magnesia (magnesium hydroxide) is poorly absorbed and exerts an osmotic effect, drawing water into the intestinal lumen, increasing intraluminal pressure, and stimulating motility.
Pregnancy: Category C (US FDA). Avoid in first trimester. Use only if clearly needed and under strict medical supervision, as stimulant laxatives may theoretically stimulate uterine contractions. Bulk-forming or osmotic laxatives (like lactulose) are generally preferred.
Driving: Generally safe. However, if dizziness or weakness occurs as a side effect, patients should avoid driving or operating machinery.
| Digoxin | Hypokalemia induced by laxatives can potentiate digoxin toxicity. | Major |
| Diuretics (e.g., Furosemide, Hydrochlorothiazide) | Increased risk of electrolyte depletion (hypokalemia, hyponatremia). | Major |
| Corticosteroids | Additive risk of hypokalemia. | Moderate |
| Oral Contraceptives, Antiepileptics (e.g., Phenytoin), Anticoagulants (e.g., Warfarin) | Liquid paraffin may impair absorption of fat-soluble drugs, reducing their efficacy. | Moderate |
| Tetracycline, Fluoroquinolone antibiotics | Magnesium can chelate these drugs in the gut, significantly reducing their absorption. Administer at least 2-3 hours apart. | Major |
| Oral Potassium Supplements | Concurrent use with laxatives may reduce potassium absorption or increase potassium loss. | Moderate |
Same composition (Sodium Picosulfate (3.33mg) + Liquid Paraffin (1.25ml) + Milk Of Magnesia (3.75ml)), different brands: