Drug reference

Macrogol 3350 with potassium chloride, sodium bicarbonate and sodium chloride

BNF 80 (2020–2021)

Source: BNF 80 (2020–2021)
PDF pages: 83, 84

Review source pages for extracted sections and age labels. BNF dose snippets show only their first line.

Overview

Indications And Dose

Chronic constipation (dose for ’paediatric’ sachets) | Prevention of faecal impaction (dose for ’paediatric’ sachets) ▶BY MOUTH ▶Child 2–5 years: 1 sachet daily, adjust dose to produce regular soft stools; maximum 4 sachets per day ▶Child 6–11 years: 2 sachets daily, adjust dose to produce regular soft stools; maximum 4 sachets per day Faecal impaction (dose for ’paediatric’ sachets) ▶BY MOUTH ▶Child 5–11 years: 4 sachets on ﬁrst day, then increased in steps of 2 sachets daily, total daily dose to be taken over a 12-hour period, after disimpaction, switch to maintenance laxative therapy; maximum 12 sachets per day Chronic constipation (dose for ’half-strength’ sachets) ▶BY MOUTH ▶Child 12–17 years: 2–6 sachets daily in divided doses usually for up to 2 weeks; maintenance 2–4 sachets daily ▶Adult: 2–6 sachets daily in divided doses usually for up to 2 weeks; maintenance 2–4 sachets daily Faecal impaction (dose for ’half-strength’ sachets) ▶BY MOUTH ▶Child 12–17 years: 8 sachets on ﬁrst day, then increased in steps of 4 sachets daily, total daily dose to be drunk within a 6 hour period, after disimpaction, switch to maintenance laxative therapy if required; maximum 16 sachets per day ▶Adult: 8 sachets on ﬁrst day, then increased in steps of 4 sachets daily, total daily dose to be drunk within a 6 hour period, after disimpaction, switch to maintenance laxative therapy if required; maximum 16 sachets per day Chronic constipation (dose for ’full-strength’ sachets) ▶BY MOUTH ▶Child 12–17 years: 1–3 sachets daily in divided doses usually for up to 2 weeks; maintenance 1–2 sachets daily ▶Adult: 1–3 sachets daily in divided doses usually for up to 2 weeks; maintenance 1–2 sachets daily Faecal impaction (dose for ’full-strength’ sachets) ▶BY MOUTH ▶Child 12–17 years: 4 sachets on ﬁrst day, then increased in steps of 2 sachets daily, total daily dose to be drunk within a 6 hour period, after disimpaction, switch to maintenance laxative therapy if required; maximum 8 sachets per day ▶Adult: 4 sachets on ﬁrst day, then increased in steps of Gastro-intestinal system 2 sachets daily, total daily dose to be drunk within a 6 hour period, after disimpaction, switch to maintenance laxative therapy if required; maximum 8 sachets per day DOSE EQUIVALENCE AND CONVERSION ▶Each ‘paediatric’ sachet contains 6.563 g of macrogol 3350; each ‘half-strength’ sachet contains 6.563 g of macrogol 3350; each ‘full-strength’ sachet contains 13.125 g of macrogol 3350. MOVICOL ® READY TO TAKE SACHETS Chronic constipation ▶BY MOUTH ▶Child 12–17 years: 1–3 sachets daily in divided doses usually for up to 2 weeks; maintenance 1–2 sachets daily ▶Adult: 1–3 sachets daily in divided doses usually for up to 2 weeks; maintenance 1–2 sachets daily Faecal impaction ▶BY MOUTH ▶Child 12–17 years: 4 sachets on ﬁrst day, then increased in steps of 2 sachets daily, total daily dose to be drunk within a 6 hour period; patients should also take an additional 1 litre of ﬂuid daily, after disimpaction, switch to maintenance laxative therapy if required; maximum 8 sachets per day ▶Adult: 4 sachets on ﬁrst day, then increased in steps of 2 sachets daily, total daily dose to be drunk within a 6 hour period; patients should also take an additional 1 litre of ﬂuid daily, after disimpaction, switch to maintenance laxative therapy if required; maximum 8 sachets per day MOVICOL ® LIQUID Chronic constipation ▶BY MOUTH ▶Child 12–17 years: 25 mL 1–3 times a day usually for up to 2 weeks; maintenance 25 mL 1–2 times a day ▶Adult: 25 mL 1–3 times a day usually for up to 2 weeks; maintenance 25 mL 1–2 times a day VISTAPREP ® ORAL POWDER Bowel cleansing before colonoscopy ▶BY MOUTH ▶Adult: 3–4 litres, reconstituted solution taken over 4 hours, generally on the day of procedure; alternatively, it can be taken on the evening before procedure or started on the evening before procedure and completed on the morning of procedure l UNLICENSED USE ▶In children Macrogol 3350 with potassium chloride, sodium bicarbonate and sodium chloride may be used as detailed below, although these situations are considered outside the scope of its licence: . g dose for chronic constipation/prevention of faecal impaction in children aged 6 years h; . g dose titration schedule for faecal impaction in children aged 12–17 years h. ▶In adults Macrogol 3350 with potassium chloride, sodium bicarbonate and sodium chloride may be used as detailed below, although this is considered outside the scope of its licence: g dose titration schedule for faecal impaction l

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Contra Indications

Intestinal obstruction. intestinal perforation. paralytic ileus. severe inﬂammatory conditions of the intestinal tract (including Crohn’s disease, ulcerative colitis and toxic megacolon). use of ’paediatric’ sachets for faecal impaction in impaired cardiovascular function (no information available) (in children) VISTAPREP ® ORAL POWDER Impaired consciousness. Gastro-intestinal system impaired swallowing reﬂex. moderate-to-severe heart failure—limited safety information available. risk of regurgitation or aspiration. severe dehydration—limited safety information available

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Cautions

Cardiovascular impairment (should not take more than 2 ’full-strength’ sachets or 4 ’half-strength’ sachets in any one hour). impaired consciousness (with high doses). impaired gag reﬂex (with high doses). reﬂux oesophagitis (with high doses) VISTAPREP ® ORAL POWDER Chronic inﬂammatory bowel disease. elderly. heart rhythm abnormalities. reﬂux oesophagitis

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Safety

Side Effects

Electrolyte imbalance (discontinue if symptoms occur). ﬂatulence. gastrointestinal discomfort. nausea. vomiting

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Pregnancy

Manufacturers advise may be used—limited data available.

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Hepatic Impairment

VISTAPREP ® ORAL POWDER Manufacturer advises avoid (limited information available).

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Renal Impairment

▶In children Manufacturers advise avoid use of ’paediatric’ sachets for faecal impaction—no information available. VISTAPREP ® ORAL POWDER Manufacturer advises avoid— limited safety information available.

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Dose and formulations

Directions For Administration

Manufacturers advise dissolve contents of each ’half-strength’ sachet of oral powder in 62.5 mL of water, and each ’full-strength’ sachet of oral powder in 125 mL of water; after reconstitution the solution should be kept in a refrigerator—for further information consult product literature. ▶In children Manufacturers advise dissolve contents of each ’paediatric’ sachet of oral powder in 62.5 mL of water; after reconstitution the solution should be kept in a refrigerator—for further information consult product literature. MOVICOL ® LIQUID Manufacturer advises dilute 25 mL of oral concentrate with 100 mL of water; after dilution the solution should be discarded if unused after 24 hours. VISTAPREP ® ORAL POWDER Manufacturer advises dissolve the contents of each sachet in 1 L water; if not consumed immediately, the reconstituted solution should be kept in a refrigerator and discarded if unused after 48 hours.

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Medicinal Forms

There can be variation in the licensing of different medicines containing the same drug. Oral solution CAUTIONARY AND ADVISORY LABELS 13 ELECTROLYTES: May contain Bicarbonate, chloride, potassium, sodium ▶Movicol (Forum Health Products Ltd) Macrogol ’3350’ 105 gram per 1 litre, Potassium 5.4 mmol per 1 litre, Bicarbonate 17 mmol per 1 litre, Chloride 53 mmol per 1 litre, Sodium 65 mmol per 1 litre Movicol Liquid sugar-free | 500 ml p £5.41 DT = £5.41 Macrogol ’3350’ 13.125 gram, Potassium 27 mmol per 1 litre, Bicarbonate 85 mmol per 1 litre, Chloride 267 mmol per 1 litre, Sodium 325 mmol per 1 litre Movicol Ready to Take oral solution 25ml sachets sugar-free | 30 sachet p £7.72 DT = £7.72 Powder CAUTIONARY AND ADVISORY LABELS 10, 13 ELECTROLYTES: May contain Bicarbonate, chloride, potassium, sodium ▶Macrogol 3350 with potassium chloride, sodium bicarbonate and sodium chloride (Non-proprietary) Macrogol ’3350’ 105 gram per 1 litre, Potassium 5.4 mmol per 1 litre, Bicarbonate 17 mmol per 1 litre, Chloride 53 mmol per 1 litre, Sodium 65 mmol per 1 litre Macrogol compound oral powder sachets sugar free sugar-free | 20 sachet p £2.47–£4.45 sugar-free | 30 sachet p £6.68 DT = £3.71 Macrogol compound oral powder sachets sugar free plain sugar-free | 20 sachet p £3.11 sugar-free | 30 sachet p £3.76 DT = £3.71 Macrogol compound oral powder sachets sugar free citrus sugar-free | 30 sachet p £4.38 DT = £3.71 ▶CosmoCol (Stirling Anglian Pharmaceuticals Ltd) Macrogol ’3350’ 105 gram per 1 litre, Potassium 5.4 mmol per 1 litre, Bicarbonate 17 mmol per 1 litre, Chloride 53 mmol per 1 litre, Sodium 65 mmol per 1 litre CosmoCol Paediatric oral powder 6.9g sachets sugar-free | 30 sachet P £2.99 DT = £4.38 CosmoCol Orange Flavour oral powder sachets sugar-free | 20 sachet p £2.75 sugar-free | 30 sachet p £3.95 DT = £3.71 CosmoCol Lemon and Lime Flavour oral powder sachets sugar-free | 20 sachet p £2.75 sugar-free | 30 sachet p £3.95 DT = £3.71 CosmoCol Half oral powder 6.9g sachets sugar-free | 30 sachet p £2.99 DT = £4.38 CosmoCol Orange Lemon and Lime oral powder sachets sugar-free | 30 sachet p £3.95 DT = £3.71 CosmoCol Plain oral powder sachets sugar-free | 30 sachet p £3.95 DT = £3.71 ▶Laxido (Galen Ltd) Macrogol ’3350’ 105 gram per 1 litre, Potassium 5.4 mmol per 1 litre, Bicarbonate 17 mmol per 1 litre, Chloride 53 mmol per 1 litre, Sodium 65 mmol per 1 litre Laxido Orange oral powder sachets sugar free sugar-free | 20 sachet p £2.75 sugar-free | 30 sachet p £3.95 DT = £3.71 Laxido Paediatric Plain oral powder 6.9g sachets sugar-free | 30 sachet P £2.99 DT = £4.38 ▶Molaxole (Mylan) Macrogol ’3350’ 105 gram per 1 litre, Potassium 5.4 mmol per 1 litre, Bicarbonate 17 mmol per 1 litre, Chloride 53 mmol per 1 litre, Sodium 65 mmol per 1 litre Molaxole oral powder sachets sugar-free | 20 sachet p £3.78 sugar-free | 30 sachet p £5.68 DT = £3.71 ▶Movicol (Forum Health Products Ltd, Norgine Pharmaceuticals Ltd) Macrogol ’3350’ 105 gram per 1 litre, Potassium 5.4 mmol per 1 litre, Bicarbonate 17 mmol per 1 litre, Chloride 53 mmol per 1 litre, Sodium 65 mmol per 1 litre Movicol Chocolate oral powder 13.9g sachets sugar-free | 30 sachet p £8.11 DT = £3.71 Movicol Paediatric Plain oral powder 6.9g sachets sugar-free | 30 sachet P £4.38 DT = £4.38 Movicol oral powder 13.8g sachets lemon & lime sugar-free | 20 sachet p £5.41 sugar-free | 30 sachet p £8.11 DT = £3.71 sugar-free | 50 sachet p £13.49 Movicol Paediatric Chocolate oral powder 6.9g sachets sugar-free | 30 sachet P £4.38 DT = £4.38 Movicol Plain oral powder 13.7g sachets sugar-free | 30 sachet p £8.11 DT = £3.71 sugar-free | 50 sachet p £13.49 ▶VistaPrep (Tillotts Pharma Ltd) Macrogol ’3350’ 105 gram per 1 litre, Potassium 5.4 mmol per 1 litre, Bicarbonate 17 mmol per 1 litre, Chloride 53 mmol per 1 litre, Sodium 65 mmol per 1 litre VistaPrep oral powder 110g sachets sugar-free | 4 sachet p £7.92

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Clinical care

Patient And Carer Advice

Patients or carers should be counselled on how to take the oral powder and oral solution. Medicines for Children leaflet: Movicol for constipation www.medicinesforchildren.org.uk/movicol-constipation VISTAPREP ® ORAL POWDER Manufacturer advises treatment can be stopped if bowel motions become watery and clear.

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Dose text by age group

Child 2–5 years

1 sachet daily, adjust dose to produce

First-line fragment. Read the complete Indications and Dose section above.

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Child 6–11 years

2 sachets daily, adjust dose to produce

First-line fragment. Read the complete Indications and Dose section above.

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Child 5–11 years

4 sachets on ﬁrst day, then increased in

First-line fragment. Read the complete Indications and Dose section above.

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Child 12–17 years

2–6 sachets daily in divided doses

First-line fragment. Read the complete Indications and Dose section above.

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Adult

2–6 sachets daily in divided doses usually for up

First-line fragment. Read the complete Indications and Dose section above.

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Child 12–17 years

8 sachets on ﬁrst day, then increased

First-line fragment. Read the complete Indications and Dose section above.

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Adult

8 sachets on ﬁrst day, then increased in steps of

First-line fragment. Read the complete Indications and Dose section above.

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Child 12–17 years

1–3 sachets daily in divided doses

First-line fragment. Read the complete Indications and Dose section above.

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Adult

1–3 sachets daily in divided doses usually for up

First-line fragment. Read the complete Indications and Dose section above.

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Child 12–17 years

4 sachets on ﬁrst day, then increased

First-line fragment. Read the complete Indications and Dose section above.

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Adult

4 sachets on ﬁrst day, then increased in steps of

First-line fragment. Read the complete Indications and Dose section above.

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Child 12–17 years

1–3 sachets daily in divided doses

First-line fragment. Read the complete Indications and Dose section above.

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Adult

1–3 sachets daily in divided doses usually for up

First-line fragment. Read the complete Indications and Dose section above.

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Child 12–17 years

4 sachets on ﬁrst day, then increased

First-line fragment. Read the complete Indications and Dose section above.

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Adult

4 sachets on ﬁrst day, then increased in steps of

First-line fragment. Read the complete Indications and Dose section above.

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Child 12–17 years

25 mL 1–3 times a day usually for up

First-line fragment. Read the complete Indications and Dose section above.

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Adult

25 mL 1–3 times a day usually for up to 2 weeks;

First-line fragment. Read the complete Indications and Dose section above.

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Adult

3–4 litres, reconstituted solution taken over

First-line fragment. Read the complete Indications and Dose section above.

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Age labels are extracted for navigation. Check the complete source section and current local guidance before clinical use.

Drug reference

Macrogol 3350 with potassium chloride, sodium bicarbonate and sodium chloride

BNF 80 (2020–2021)

Source: BNF 80 (2020–2021)
PDF pages: 83, 84

Review source pages for extracted sections and age labels. BNF dose snippets show only their first line.

Overview

Indications And Dose

PDF page 83

Contra Indications

PDF pages 83, 84

Cautions

PDF page 84

Safety

Side Effects

Electrolyte imbalance (discontinue if symptoms occur). ﬂatulence. gastrointestinal discomfort. nausea. vomiting

PDF page 84

Pregnancy

Manufacturers advise may be used—limited data available.

PDF page 84

Hepatic Impairment

VISTAPREP ® ORAL POWDER Manufacturer advises avoid (limited information available).

PDF page 84

Renal Impairment

PDF page 84

Dose and formulations

Directions For Administration

PDF page 84

Medicinal Forms

PDF page 84

Clinical care

Patient And Carer Advice

PDF page 84

Dose text by age group

Child 2–5 years

1 sachet daily, adjust dose to produce

First-line fragment. Read the complete Indications and Dose section above.

PDF page 83

Child 6–11 years

2 sachets daily, adjust dose to produce

First-line fragment. Read the complete Indications and Dose section above.

PDF page 83

Child 5–11 years

4 sachets on ﬁrst day, then increased in

First-line fragment. Read the complete Indications and Dose section above.

PDF page 83

Child 12–17 years

2–6 sachets daily in divided doses

First-line fragment. Read the complete Indications and Dose section above.

PDF page 83

Adult

2–6 sachets daily in divided doses usually for up

First-line fragment. Read the complete Indications and Dose section above.

PDF page 83

Child 12–17 years

8 sachets on ﬁrst day, then increased

First-line fragment. Read the complete Indications and Dose section above.

PDF page 83

Adult

8 sachets on ﬁrst day, then increased in steps of

First-line fragment. Read the complete Indications and Dose section above.

PDF page 83

Child 12–17 years

1–3 sachets daily in divided doses

First-line fragment. Read the complete Indications and Dose section above.

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Adult

1–3 sachets daily in divided doses usually for up

First-line fragment. Read the complete Indications and Dose section above.

PDF page 83

Child 12–17 years

4 sachets on ﬁrst day, then increased

First-line fragment. Read the complete Indications and Dose section above.

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Adult

4 sachets on ﬁrst day, then increased in steps of

First-line fragment. Read the complete Indications and Dose section above.

PDF page 83

Child 12–17 years

1–3 sachets daily in divided doses

First-line fragment. Read the complete Indications and Dose section above.

PDF page 83

Adult

1–3 sachets daily in divided doses usually for up

First-line fragment. Read the complete Indications and Dose section above.

PDF page 83

Child 12–17 years

4 sachets on ﬁrst day, then increased

First-line fragment. Read the complete Indications and Dose section above.

PDF page 83

Adult

4 sachets on ﬁrst day, then increased in steps of

First-line fragment. Read the complete Indications and Dose section above.

PDF page 83

Child 12–17 years

25 mL 1–3 times a day usually for up

First-line fragment. Read the complete Indications and Dose section above.

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Adult

25 mL 1–3 times a day usually for up to 2 weeks;

First-line fragment. Read the complete Indications and Dose section above.

PDF page 83

Adult

3–4 litres, reconstituted solution taken over

First-line fragment. Read the complete Indications and Dose section above.

PDF page 83

Age labels are extracted for navigation. Check the complete source section and current local guidance before clinical use.