Usual Adult Dose for Bowel Preparation

Oral:
TABLET: 5 to 15 mg orally once a day as needed

• Duration of therapy: Up to 1 week

Rectal:
ENEMA: 10 mg rectally once a day as needed
SUPPOSITORY: 10 mg (1 suppository) rectally once a day as needed
Duration of therapy: Up to 1 week

Comments:

• Enemas typically produce a bowel movement within 5 to 20 minutes; patients should contact their healthcare provider if a bowel movement is not produced within 20 minutes of use.
• Suppositories usually produce a bowel movement within 15 to 60 minutes, while tablets usually take 6 to 12 hours.
• Antacids and/or milk products should not be used within 1 hour of taking tablet formulations.
• Stomach/abdominal discomfort, cramps, faintness, and rectal burning (suppository formulations only) may occur with use.

Uses:

• ENEMA: For relief of occasional constipation OR bowel cleansing before rectal examinations
• SUPPOSITORY AND TABLET: For temporary relief of occasional constipation and irregularity

Usual Adult Dose for Constipation

Oral:
TABLET: 5 to 15 mg orally once a day as needed

• Duration of therapy: Up to 1 week

Rectal:
ENEMA: 10 mg rectally once a day as needed
SUPPOSITORY: 10 mg (1 suppository) rectally once a day as needed
Duration of therapy: Up to 1 week

Comments:

• Enemas typically produce a bowel movement within 5 to 20 minutes; patients should contact their healthcare provider if a bowel movement is not produced within 20 minutes of use.
• Suppositories usually produce a bowel movement within 15 to 60 minutes, while tablets usually take 6 to 12 hours.
• Antacids and/or milk products should not be used within 1 hour of taking tablet formulations.
• Stomach/abdominal discomfort, cramps, faintness, and rectal burning (suppository formulations only) may occur with use.

Uses:

• ENEMA: For relief of occasional constipation OR bowel cleansing before rectal examinations
• SUPPOSITORY AND TABLET: For temporary relief of occasional constipation and irregularity

Usual Pediatric Dose for Bowel Preparation

Oral:
TABLET:
Under 6 years: Dose adjustment(s) may be required; however, no specific guidelines have been suggested.
6 to less than 12 years: 5 mg orally once a day as needed
12 years and older: 5 to 15 mg orally once a day as needed
Duration of therapy: Up to 1 week

Rectal:
ENEMA:
Under 12 years: Not recommended.
12 years and older: 10 mg rectally once a day as needed
Duration of therapy: Up to 1 week

SUPPOSITORY:
Under 6 years:
6 to less than 12 years: 5 mg (0.5 suppository) rectally once a day as needed
12 years and older: 10 mg (1 suppository) rectally once a day as needed
Duration of therapy: Up to 1 week

Comments:

• Enemas typically produce a bowel movement within 5 to 20 minutes; patients should contact their healthcare provider if a bowel movement is not produced within 20 minutes of use.
• Suppositories usually produce a bowel movement within 15 to 60 minutes, while tablets usually take 6 to 12 hours.
• Antacids and/or milk products should not be used within 1 hour of taking tablet formulations.
• Stomach/abdominal discomfort, cramps, faintness, and rectal burning (suppository formulations only) may occur with use.

Uses:

• ENEMA: For relief of occasional constipation OR bowel cleansing before rectal examinations
• SUPPOSITORY AND TABLET: For temporary relief of occasional constipation and irregularity

Usual Pediatric Dose for Constipation

Oral:
TABLET:
Under 6 years: Dose adjustment(s) may be required; however, no specific guidelines have been suggested.
6 to less than 12 years: 5 mg orally once a day as needed
12 years and older: 5 to 15 mg orally once a day as needed
Duration of therapy: Up to 1 week

Rectal:
ENEMA:
Under 12 years: Not recommended.
12 years and older: 10 mg rectally once a day as needed
Duration of therapy: Up to 1 week

SUPPOSITORY:
Under 6 years:
6 to less than 12 years: 5 mg (0.5 suppository) rectally once a day as needed
12 years and older: 10 mg (1 suppository) rectally once a day as needed
Duration of therapy: Up to 1 week

Comments:

• Enemas typically produce a bowel movement within 5 to 20 minutes; patients should contact their healthcare provider if a bowel movement is not produced within 20 minutes of use.
• Suppositories usually produce a bowel movement within 15 to 60 minutes, while tablets usually take 6 to 12 hours.
• Antacids and/or milk products should not be used within 1 hour of taking tablet formulations.
• Stomach/abdominal discomfort, cramps, faintness, and rectal burning (suppository formulations only) may occur with use.

Uses:

• ENEMA: For relief of occasional constipation OR bowel cleansing before rectal examinations
• SUPPOSITORY AND TABLET: For temporary relief of occasional constipation and irregularity

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

Data not available

Precautions

CONTRAINDICATIONS:
TABLETS:

• Patients who cannot swallow without chewing

Safety and efficacy of suppositories and tablets have not been established in patients younger than 6 years.

Safety and efficacy of enemas have not been established in patients younger than 12 years.

Consult WARNINGS section for additional precautions.

AU PRECAUTIONS:
CONTRAINDICATIONS:
SUPPOSITORIES:

• Hypersensitivity to the active component or any of the ingredients
• Patients with acute surgical abdomen
• Patients with conditions where laxatives are contraindicated
• Patients with intestinal obstruction
• Patients with undiagnosed abdominal symptoms

TABLETS:

• Hypersensitivity to the active component or any of the ingredients
• Patients with anal fissure, ulcerated hemorrhoids, and/or ulcerative proctitis with mucosal damage
• Patients with dehydration and/or hypokalemia
• Patients with conditions where laxatives are contraindicated
• Patients with signs/symptoms of acute abdominal situations (e.g., ileus, intestinal obstruction, any other undiagnosed abdominal pain), appendicitis, or inflammatory bowel disease, including colic, cramps, nausea, or vomiting

Safety and efficacy of tablets have not been established in patients younger than 6 years.

Safety and efficacy of suppositories have not been established in patients younger than 10 years.

Consult WARNINGS section for additional precautions.

Dialysis

Data not available

Other Comments

Administration advice:

• Tablets should be swallowed whole with a glass of water; patients should avoid chewing or crushing this formulation.
• Antacids and milk products should be separated by 1 hour.
• Suppositories should be administered rectally and retained for approximately 15 to 20 minutes; the suppository should be unwrapped and inserted into the rectum with the pointed end first.
• Enema nozzles may be coated with a lubricant to facilitate in insertion; half doses may be given via inserting halt the point of the tube.

Storage requirements:

• ENEMA: Store below 30C; some experts recommend storing this formulation at 2 to 8C.
• SUPPOSITORY: Store below 25C
• TABLET: Protect from light and excessive humidity

Patient advice:

• Inform patients that this drug may cause a vasovagal response (e.g., dizziness, syncope), and they should avoid driving or operating machinery if these side effects occur.
• Advise patients to speak to their healthcare provider if they become pregnant, intend to become pregnant, or are breastfeeding.

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