Miralax not completely recovered in patients

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Polyethylene glycol 3350 (Miralax®) powder for oral solution is an osmotic laxative indicated in the treatment of constipation. Miralax appears to have no effect on the balance of electrolytes and is not associated with tachyphylaxis.

In patients who are not constipated, Miralax is completely recovered. However, in constipated patients, Miralax recovery is incomplete and highly variable. Miralax is not fermented into hydrogen or methane by colonic microflora in human feces. There is no systemic absorption with oral administration. Onset of effect occurs in two to four days.

Miralax is contraindicated in patients with known or suspected bowel obstruction and in patients who are hypersensitive to polyethylene glycol. Patients with symptoms suggestive of bowel obstruction (nausea, vomiting, abdominal pain or distention) should be evaluated to rule out obstruction before Miralax is initiated. All patients who present with complaints of constipation should have a complete medical exam to detect associated metabolic, endocrine, and neurogenic conditions. In addition, patients should be questioned about any medications they may be taking in order to rule out medication-induced constipation. Patients should be educated about good defacatory and eating habits (such as high fiber diet and plenty of fluids) and lifestyle changes (regular exercise) which may be helpful to produce more regular bowel habits.

Nausea, abdominal bloating, cramping, and flatulence have been reported to occur with the use of Miralax. High doses may produce diarrhea and excessive stool frequency. The elderly are more susceptible to diarrhea as this has occurred in this patient population at the normal recommended dose of 17 grams.

DRUG INTERACTIONS: No specific drug interactions have been identified.

DRUG AND FOOD INTERACTIONS: Miralax must be mixed with water, juice, soda, coffee, or tea prior to administration. The manufacturer’s prescribing information lists no drug/food interactions.

DOSAGE AND ADMINISTRATION: The usual adult dose for Miralax is one 17gm packet day per day in eight ounces of water, juice, soda, coffee, or tea. Approximately two to four days may be required to produce a bowel movement. The safety and effectiveness of Miralax has not been established in pediatric patients.

PREGNANCY: Category C. Animal reproductive studies have not been performed with Miralax. It is not known whether this medication can cause fetal harm when administered to pregnant women or if it can effect reproductive capacity. Administer with caution only when clearly needed. C:\Users\james\Downloads\Miralax not completely recovered in constipated patients (1).mht