1. Clinical Overview
Polyethylene Glycol 3350 (PEG 3350) is a high-molecular-weight, non-absorbable, osmotic laxative. In the Indian context, the 13.125gm sachet is a standard adult dose for the treatment of occasional constipation. It works by drawing and retaining water in the intestinal lumen via osmosis, softening the stool, increasing stool volume, and stimulating peristalsis, leading to a bowel movement. It is considered a first-line pharmacologic therapy for constipation due to its efficacy and safety profile.
| Onset | Duration | Bioavailability |
|---|---|---|
| 24 to 72 hours | Dose-dependent, effect lasts until the administered dose is excreted. | Negligible (0.0%). It is not systemically absorbed from the gastrointestinal tract. |
2. Mechanism of Action
Polyethylene Glycol 3350 is a long-chain polymer that acts as an osmotic agent. After oral administration and dissolution in water, it creates a hyperosmotic solution in the gut. This solution draws water into the intestinal lumen by osmosis from the surrounding tissues and plasma, following the concentration gradient. The increased intraluminal water content hydrates and softens hardened stool, increases stool volume, and distends the bowel wall. This distension stimulates colonic peristalsis, promoting propulsion and evacuation of bowel contents.
3. Indications & Uses
- Treatment of occasional constipation
- Management of functional constipation (chronic idiopathic constipation)
4. Dosage & Administration
Adult Dosage: 13.125 gm (one sachet) dissolved in 150-200 ml of water, orally, once daily. Dose may be adjusted based on response (range: 13.125 gm every other day to 26.25 gm per day in divided doses).
Administration: Empty the entire contents of one sachet into a glass. Add 150-200 ml of cool or room temperature water (not hot). Stir vigorously until completely dissolved. Drink immediately. Can be taken with or without food. Maintain adequate daily fluid intake (at least 2 liters). Do not use for more than 2 weeks unless directed by a physician.
5. Side Effects
Common side effects may include:
- Abdominal bloating
- Flatulence
- Abdominal cramping or pain
- Nausea
- Loose stools or diarrhea
6. Drug Interactions
| Drug | Effect | Severity |
|---|---|---|
| Oral Medications (e.g., Digoxin, Warfarin, Antiepileptics, Oral Contraceptives) | May theoretically reduce absorption of concurrently administered oral drugs due to increased gastrointestinal transit time. A separation of at least 2 hours is recommended. | Moderate |
| Other Laxatives or Enemas | Concomitant use may increase the risk of excessive diarrhea, cramping, and electrolyte imbalance. | Moderate |
7. Patient Counselling
- DO dissolve the powder completely in a full glass of water before drinking.
- DO maintain adequate daily fluid intake (6-8 glasses of water).
- DO contact your doctor if constipation persists beyond 1 week of use.
- DO separate the dose from other oral medications by at least 2 hours.
- DON'T take the powder dry.
- DON'T use in the presence of nausea, vomiting, or severe abdominal pain without consulting a doctor.
- DON'T use for longer than 2 weeks unless directed by your physician.
8. Toxicology & Storage
Overdose: Symptoms are an extension of side effects: severe, watery diarrhea leading to dehydration, hypovolemia, electrolyte disturbances (hyponatremia, hypokalemia), abdominal pain, and cramping.
Storage: Store in a cool, dry place, below 30°C. Protect from moisture. Keep the sachet in the outer pouch until use. Keep out of reach of children.