Bulk-Producing Laxatives, Oral

What are other names for this medicine?

Type of medicine: laxative

Generic and brand names: bulk producing fiber laxative; guar gum; calcium polycarbophil; psyllium; Benefiber; Citrucel; Citrucel Sugar Free; Equalactin; Fiberall; Fiberall Orange Flavor; FiberCon; Fiber-Lax; FiberNorm; Genfiber; Genfiber Orange Flavor; Hydrocil Instant; Konsyl; Konsyl D; Konsyl Easy Mix; Konsyl Fiber; Konsyl Orange; Maltsupex; Metamucil Orange Flavor; Metamucil Sugar Free; Mitrolan; Modane Bulk; Natural Fiber Laxative; Perdiem Fiber Therapy; Reguloid Orange; Reguloid Sugar Free; Serutan; Syllact; Unifiber

What is this medicine used for?

Laxatives are taken by mouth to:

• relieve constipation
• prevent constipation after surgery or heart attack
• prevent dry, hard stools.

Psyllium may also be used as part of a cholesterol-lowering program.

Different kinds of laxatives work in different ways. Make sure you know which kind you are taking. The different types of oral laxatives include:

Bulk-formers

Bulk-forming laxatives absorb liquid in the intestines and swell to form a soft, bulky stool. Your bowel is then moved normally because of the bulky mass. Some bulk-forming laxatives, like psyllium and polycarbophil, may also be used to treat diarrhea.

Hyperosmotics

Hyperosmotic laxatives help cause bowel movements by absorbing water into the bowel from body tissues. There are 3 types of hyperosmotic laxatives taken by mouth--the saline, the lactulose, and the polymer types.

The saline type works very fast. They are not used for long-term or repeated constipation. With smaller doses than those used for the laxative effect, some saline laxatives are used as antacids. They may be used for other conditions as determined by your healthcare provider.

The lactulose type produces results more slowly and can be used for long-term treatment of ongoing constipation. Lactulose may also be used in the treatment of other conditions. It is available only by prescription.

The polymer (polycarbophil) type softens the stool and increases the number of bowel movements. It is used for short periods of time to treat constipation.

Lubricants

Oral lubricant laxatives, such as mineral oil, coat the bowel and the stool mass with a waterproof film. This keeps moisture in the stool. The stool stays softer and moves easier.

Stimulants

Stimulant laxatives (such as the bisacodyl type) increase the muscle contractions that move along the stool mass. This type of laxative is used to help empty the bowels before certain medical procedures. Stimulants also are more likely to cause side effects.

Stool softeners

Stool softeners (such as the docusate type) help liquids mix into the stool and prevent dry, hard stool masses. It is often recommended for people who should avoid straining during bowel movements.

Combinations

There are many products that you can buy for constipation that contain more than one type of laxative. For example, a product may contain both a stool softener and a stimulant laxative.

Ask your healthcare provider or pharmacist which product is best for you.

What should my healthcare provider know before I take this medicine?

Before taking this medicine, tell your healthcare provider if you have ever had:

• an allergic reaction to any medicine
• dehydration
• diabetes
• heart disease
• high blood pressure
• a blockage in your intestines, Crohn's disease, or ulcerative colitis
• kidney disease
• rectal bleeding
• symptoms of appendicitis or an inflamed bowel (abdominal pain, cramps, bloating, nausea, and vomiting)
• trouble swallowing.

If you are on a sodium-restricted diet, do not take laxatives that contain sodium.

Females of childbearing age: Tell your healthcare provider if you are pregnant or plan to become pregnant. Take only those laxatives that are recommended by your healthcare provider. Do not breast-feed while taking this medicine without your healthcare provider's approval.

How do I use it?

Take laxatives as directed by your healthcare provider, or follow the directions on the package label. Do not take more laxative or take it more often than directed. Drink several glasses of water during the day to help soften your bowel movement.

Laxatives may come as capsules, tablets, wafers, powdered or granulated products, or in liquid form. Swallow tablets and capsules whole. Chew wafers thoroughly. Mix powdered or granulated products with water or fruit juice. Do not take them dry. Liquids may be taken in or with water or fruit juice.

For this medicine to work properly and to prevent side effects, you must drink at least 8 oz of water or fruit juice when you take a laxative.

What should I watch out for?

Some products contain large amounts of sodium or sugar. If you have diabetes, these products may affect your blood sugar level and change the amount of insulin or other diabetes medicines you may need. Talk to your healthcare provider about this. Ask your pharmacist or healthcare provider if you are not sure which product is the best for you.

For young children, ask your healthcare provider or pharmacist which laxatives to use.

Do not use for more than 1 week without your healthcare provider's approval. Long-term use can make your body depend on the laxative for regular bowel movements. If you are always constipated, talk to your healthcare provider. You may need to change your diet or prescription medicine.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Serious (report these to your healthcare provider right away): dizziness, flushing, sweating, severe abdominal cramps, trouble swallowing, trouble breathing, unusual tiredness or weakness, skin rash, nausea, vomiting, confusion, irregular heartbeat, muscle aches, rectal bleeding.

Other: diarrhea, gas, rectal irritation, brown or reddish urine, constipation (if too little water is taken with the laxative).

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

Bulk-forming laxatives may interfere with the absorption of other medicines. It is best to take other medicines 2 hours before or after you take this laxative.

• antibiotics such as demeclocycline (Declomycin), doxycycline (Doryx, Periostat, Vibramycin, Vibra-Tabs), minocycline (Dynacin, Vectrin), oxytetracycline (Terramycin), and tetracycline (Sumycin, Tetrex)
• digoxin (Digitek, Lanoxicaps, Lanoxin)
• nitrofurantoin (Furadantin, Macrobid, Macrodantin)
• potassium-sparing diuretics such as amiloride (Midamor), spironolactone (Aldactone), triamterene (Dyrenium), and triamterene/hydrochlorothiazide (Dyazide, Maxzide)
• salicylates such as aminosalicylic acid (Paser), aspirin (Ascriptin, Bayer, Bufferin, Ecotrin, Halfprin), choline magnesium trisalicylate (Tricosal, Trilisate), choline salicylate (Arthropan), salsalate (Amigesic, Disalcid, Salflex)
• warfarin (Coumadin).

Keep a list of all your medicines (prescription, nonprescription, supplements, natural remedies, and vitamins) with you. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

How should I store this medicine?

Store this medicine at room temperature. Keep the container tightly closed. Protect it from heat, high humidity, and bright light.

This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicine in the trash.

Keep all medicines out of the reach of children.

Do not share medicines with other people.