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1.6 Laxatives

 

NICE CG99 Constipation in Children and Young People May 10

1.6.1 Bulk-forming laxatives

1st        FYBOGEL (orange flavour)    

1.6.2 Stimulant laxatives

1st        SENNA   
1st     GLYCEROL Suppositories  
1st     BISACODYL  
2nd     DOCUSATE SODIUM  
2nd     NORGALAX Enema  
2nd     CO-DANTHRAMER Liquid (palliative care only)   

1.6.3 Faecal softeners

        ARACHIS OIL Enema   

1.6.4 Osmotic laxatives

1st      MACROGOL COMPOUND POWDER (e.g. Cosmocol / Laxido) Sachets   
1st     MAGNESIUM HYDROXIDE Mixture  
1st        FLEET PHOSPHATE ENEMA   
2nd     LACTULOSE  
        Lactulose is also used in the treatment of liver disease  

1.6.5 Bowel Cleansing Solutions

RCR   Guidelines for the Presciption and Administration of Bowel Cleanising Agents 
Bowel cleansing solutions would usually be administered in the hospital setting. They are used before colonic surgery, colonoscopy, or radiological examination to ensure the bowel is free of solid contents. They are NOT treatments for constipation.

 

1st      PICOLAX   
1st     KLEAN-PREP  
2nd     MOVIPREP  
3rd     FLEET PHOSPHO-SODA  

1.6.7 5HT4-receptor agonists

IBS-C - The following medications should be considered 2nd line after antispasmodics and laxatives (1st line) and before tricyclic antidepressants and SSRIs (3rd line due to undesirable side effects) in the treatment of IBS with Constipation.

 

    SPC   LINACLOTIDE     
      LUBIPROSTONE    
        NICE TA318 Lubiprostone for treating chronic idiopathic constipation  July 14
      PRUCALOPRIDE    
        NICE TA211 Prucalopride for the treatment of chronic constipation in women Dec 10

 

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