Polyethylene Glycol (PEG) 3350 is a high-molecular-weight, non-absorbable osmotic laxative. In the Indian context, the formulation of 13.125gm/25ml is a concentrated oral solution used for bowel cleansing prior to colonoscopy or surgery, and for the treatment of occasional constipation. It works by drawing and retaining water in the intestinal lumen via osmotic forces, softening stool and increasing stool volume to induce peristalsis and evacuation without causing significant electrolyte imbalance.
Adult: **Constipation:** 13.125gm (25ml) diluted in 120-240ml of water, once daily. **Bowel Preparation:** Dose is regimen-dependent. Typically, the total dose is split (e.g., 2-4 liters of reconstituted solution). A common split-dose regimen: Evening before procedure: Consume 2 liters of solution (each liter contains ~52.5gm PEG). Morning of procedure: Consume 1-2 liters. *Must follow specific brand/prescription instructions.*
Note: **CRITICAL:** The 13.125gm/25ml is a CONCENTRATE. MUST be diluted in the specified amount of water (as per package insert) before ingestion, typically in a full glass (200-250ml). For bowel prep, it is dissolved in large volumes of water. Drink each portion quickly rather than sipping slowly. Can be chilled to improve palatability. Do not add flavorings or other substances unless specified. For split-dose prep, fast for 3-4 hours before starting and consume only clear liquids until procedure.
Polyethylene Glycol 3350 is a non-absorbable, osmotically active polymer. After oral administration and dilution, it increases the osmotic pressure within the lumen of the intestine. This draws water from the surrounding tissues (paracellular space) into the bowel via osmosis, thereby increasing the water content and volume of the stool. The increased intraluminal fluid volume hydrates hard stool, softens its consistency, and distends the colonic wall. This distension stimulates propulsive colonic motility (peristalsis), leading to bowel evacuation. It does not involve stimulation of colonic nerves or alteration of normal electrolyte secretion/absorption when given with electrolytes.
Pregnancy: Category C (US FDA). Considered low risk as it is not absorbed. Often used for constipation and necessary bowel prep in pregnancy when benefits outweigh risks. Consult physician.
Driving: Unlikely to affect ability. However, patients undergoing bowel prep may experience weakness, dizziness, or frequent need for toilet access, which can impair driving. Advise not to drive during the preparation period.
| Oral Medications (e.g., antibiotics, contraceptives, anticonvulsants, cardiac drugs) | May reduce absorption of concurrently administered oral drugs due to rapid gastrointestinal transit. Can lead to therapeutic failure. | Major |
| Diuretics, ACE Inhibitors, ARBs, NSAIDs | Increased risk of electrolyte imbalance (e.g., hyponatremia, hypokalemia) when used with PEG-ELS formulations. | Moderate |
| Other Laxatives (especially stimulant types) | Increased risk of severe cramping and electrolyte loss. Not recommended concurrently. | Moderate |