• Management of simple or chronic constipation, particularly if associated with a low-fiber diet.
• Useful in situations in which straining should be avoided (after MI, rectal surgery, prolonged bed rest).
• Used in the management of chronic watery diarrhea.

Contraindicated in:

• Hypersensitivity
• Abdominal pain, nausea, or vomiting (especially when associated with fever)
• Serious adhesions
• Dysphagia.

Use Cautiously in:

• Some dosage forms contain sugar, aspartame, or excessive sodium and should be avoided in patients on restricted diets
• OB: Lactation: Has been used safely.

GI: cramps, intestinal or esophageal obstruction, nausea, vomiting.

Resp: bronchospasm.

Drug-Drug:

• May ↓ absorption of warfarin, salicylates, or digoxin.

(Generic available)

• Powder: 3.3–3.5 g/dose or packet^OTC;
• Effervescent powder: 3–3.5 g/dose or packet^OTC;
• Granules: 2.5 g/dose^OTC;
• Wafers: 3.4 g/dose^OTC;

• PO (Adults): 1–2 tsp/packet/wafer (3–6 g psyllium) in or with a full glass of liquid 2–3 times daily. Up to 30 g daily in divided doses.
• PO (Children >6 yr): 1 tsp/packet/wafer (1.5–3 g psyllium) in or with 4–8 oz glass of liquid 2–3 times daily. Up to 15 g daily in divided doses.

Alramucil, Cillium, Effer-Syllium, Fiberall, Fibrepur, Hydrocil, Konsyl, Metamucil, Modane Bulk, Mylanta Natural Fiber Supplement, Naturacil Caramels, Perdiem, Pro-Lax, Reguloid Natural, Serutan, Siblin, Syllact, Vitalax, V-Lax

• Combines with water in the intestinal contents to form an emollient gel or viscous solution that promotes peristalsis and reduces transit time.

• Relief and prevention of constipation.

Therapeutic Classification: laxatives

Pharmacologic Classification: bulk forming agents

Absorption: Not absorbed from the GI tract.

Distribution: No distribution occurs.

Metabolism/Excretion: Excreted in feces.

Half-life: Unknown.

Karacil, Natural Source Fibre Laxative, Prodiem

(laxative effect)

• Encourage patient to use other forms of bowel regulation, such as increasing bulk in the diet, increasing fluid intake, and increasing mobility. Normal bowel habits are individualized and may vary from 3 times/day to 3 times/wk.
• May be used for long-term management of chronic constipation.
• Instruct patients with cardiac disease to avoid straining during bowel movements (Valsalva maneuver).
• Advise patient not to use laxatives when abdominal pain, nausea, vomiting, or fever is present.

SILL-i-yum