Macrogol

What is Macrogol

Macrogol, also known as polyethylene glycol (PEG), is used as a medication to treat constipation in children and adults. It is also used to empty the bowels before a colonoscopy.

Macrogol ointment pvp iodine

What are the uses of this medicine?

• Constipation

Macrogol 4000, pharmaceutical quality

Macrogol 3350, often in combination with electrolytes, is used for short-term relief of constipation as well as for long-term use in constipation of various causes, including in multiple sclerosis and Parkinson's disease patients (an often-overlooked non-motor symptom) as well as constipation caused by pharmaceutical drugs such as opioids and anticholinergics.

• Excipient

Macrogol is used as an excipient in many pharmaceutical products. For example, PEG-2000 is one of the excipients in the Moderna COVID-19 vaccine.

• PEGylation

Macrogols are also attached to biopharmaceutical drugs to slow down their degradation in the human body and increase their duration of action, as well as to reduce immunogenicity. This process is called PEGylation.

How does this medicine work?

Macrogol is an osmotically acting laxative, that is an inert substance that passes through the gut without being absorbed into the body. It relieves constipation because it causes water to be retained in the bowel instead of being absorbed into the body. This increases the water content and volume of the stools in the bowel, making them softer and easier to pass, as well as improving gut motility.

Who Should Not Use this medicine?

Contraindications for macrogol taken orally as a laxative are intestinal perforation, bowel obstruction, ileus, inflammatory bowel diseases, and toxic megacolon.

The doses of macrogol as an excipient are too low to have relevant contraindications.

Allergy to macrogol is rare, and usually appears as an allergy to an increasing number of seemingly unrelated products, including cosmetics, drugs that use it as an excipient, and peri-procedural substances such as ultrasound gel.

Is this medicine FDA approved?

It was approved for medical use in the United States in 1999.

How should this medicine be used?

• do not take more than directed unless advised by your doctor
• the bottle top is a measuring cap marked to contain 17 grams of powder when filled to the indicated line
• adults and children 17 years of age and older:

    -fill to top of line in cap which is marked to indicate the correct dose (17 g)

    -stir and dissolve in any 4 to 8 ounces of beverage  (cold, hot or room temperature) and then drink

    -use once a day

    -use no more than 7 days

• Children 16 years of age or under:  ask a doctor

What are the dosage forms and brand names of this medicine?

Macrogol is sold as a non-prescription preparation in the form of powder. When sold for gut cleansing (and as a laxative), it is usually in combination with salts such as sodium bicarbonate, sodium chloride and potassium chloride to help mitigate the possibility of electrolyte imbalance and dehydration. Brand names include SoftLax, Purelax, MiraLax, Laxido, Glycoprep, Movicol, Cololyt, Osmolax, and others.

It is dissolved in water to create a clear and odorless solution which is then drunk. While most consumers find the taste of macrogol itself to be very mild and unobjectionable, the electrolytes contained in formulations for purging and cleansing give the solution an extremely salty and bitter taste.

Polyethylene glycol-electrolyte solution is a prescription product sold under various brand names including Colyte, Gavilyte, Golytely, Nulytely, Moviprep, and Trilyte

What side effects can this medication cause?

Oral macrogol is generally well tolerated. Possible side effects include

• headache
• bloating
• nausea
• allergies
• electrolyte imbalance, mainly hypokalaemia (low blood potassium levels) and hyperkalaemia (high blood potassium levels).
• With excessive use, it can cause diarrhea.

What special precautions should I follow?

Do not use

• if you have kidney disease, except under the advice and supervision of a doctor

Ask a doctor before use if you have

• nausea, vomiting or abdominal pain
• a sudden change in bowel habits that lasts over 2 weeks
• irritable bowel syndrome

Ask a doctor or pharmacist before use if you are

• taking a prescription drug

When using this product

• you may have loose, watery, more frequent stools

Stop use and ask a doctor if

• you have rectal bleeding or your nausea, bloating, cramping or abdominal pain gets worse. These may be signs of a serious condition.
• you get diarrhea
• you need to use a laxative for longer than 1 week.

What to do in case of emergency/overdose?

• In case of overdose, call the poison control helpline of your country. In the United States, call 1-800-222-1222.

• Overdose related information is also available online at poisonhelp.org/help.
• In the event that the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services. In the United States, call 911.

Can this medicine be used in pregnancy?

If pregnant or breast-feeding,

ask a health professional before use.

In case of overdose, get medical help or contact a Poison Control Center right away. (1-800-222-1222)

Can this medicine be used in children?

Keep out of reach of children.

In case of overdose, get medical help or contact a Poison Control Center right away. (1-800-222-1222)

What should I know about storage and disposal of this medication?

• store at 20°-25°C (68°-77°F) tamper-evident: do not use if printed foil seal under cap is missing, open or broken
• do not take more than directed unless advised by your doctor
• the enclosed scoop is a measuring device designed to contain 17 grams of powder when filled to the top (level scoop)
• adults and children 17 years of age and older:
• fill scoop completely with product to obtain the correct dose (17 g). Level scoop with knife or flat object.
• stir and dissolve in any 4 to 8 ounces of beverage (cold, hot or room temperature) then drink
• use once a day
• use no more than 7 days
• children 16 years of age or under: ask a doctor

Macrogol Resources
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