Drugs List

Therapeutic Indications

Uses

Bowel evacuation - prior to investigative procedure

Contraindications

Children under 18 years
Impaired consciousness
Predisposition to aspiration or regurgitation
Predisposition to gastrointestinal perforation
Delayed gastric emptying
Gag reflex impaired
Gastrointestinal obstruction
Gastrointestinal perforation
Hepatic impairment
New York Heart Association class III failure
New York Heart Association class IV failure
Paralytic ileus
Renal impairment
Severe dehydration
Toxic megacolon
Ulcerative colitis

Precautions and Warnings

Debilitation
Elderly
Restricted potassium intake
Restricted sodium intake
Cardiac conduction defects
History of cardiac arrhythmias
Inflammatory bowel disease
New York Heart Association class I failure
New York Heart Association class II failure
Reflux oesophagitis

Contains more than 1 mmol (23 mg) sodium per dose
Observe patients prone to aspiration/regurgitation during administration
Dysphagia: Mixing with starch thickeners may increase risk of aspiration
Avoid solid food for at least 2 hours prior to administration
Ensure patient has adequate fluid intake
Monitor periodically for signs of fluid or electrolyte imbalance

There are 260mmol of sodium and 20mmol of potassium per 4litres of solution.

Addition of polyethylene glycol to a liquid that has been thickened with a starch-based thickener can produce a mixture that is thin and watery.

Pregnancy and Lactation

Pregnancy

Macrogol 3350 is considered safe for use in pregnancy.

At the time of writing there is limited experience concerning exposed pregnancies and their outcomes. No teratogenic effects were seen in animals trials.

Schaefer suggests that as macrogol has a high molecular weight, it is not absorbed enterally and is well tolerated.

The use of all medication in pregnancy should be avoided whenever possible; particularly in the first trimester. Non-drug treatments should also be considered. When essential, a medication with the best safety record over time should be chosen, employing the lowest effective dose for the shortest possible time. Polypharmacy should be avoided. Teratogens taken in the pre-embryonic period, often quoted as lasting until 14 to 17 days post-conception, are believed to have an all-or-nothing effect. Where drugs have a short half-life, and when the date of conception is certain, this may allow women to be reassured where drug exposure has occurred within this time frame. Further advice may be available from the UK National Teratology Information Service (NTIS) and through ToxBase, available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).

Lactation

Macrogol 3350 is considered safe for use in breastfeeding.

Systemic exposure of macrogol 3350 is limited and thus adverse effects on the breast fed infant are not expected.

Neonates, infants born prematurely, those with low birth weight, those with an unstable gastrointestinal function or who have serious illnesses may require special consideration. For any infant, if a drug is prescribed to the nursing mother, it should be at the lowest practical dose and for the shortest time. When drug administration is unavoidable and breastfeeding is to continue, minimisation of exposure of the infant to the drug may sometimes be achieved by timing the maternal doses to just after a feeding episode. Infants exposed to drugs via breast milk should be monitored for unusual signs or symptoms. Interactions between the drug received by the infant from the mother's milk and medication prescribed for the infant should also be considered, for example, when the drug given to the infant may prevent metabolism of the drug received via breast milk.
Specialist advice is available from the UK Drugs in Lactation Advisory Service at https://www.midlandsmedicines.nhs.uk/content.asp?section=6&subsection=17&pageIdx=1

Side Effects

Anal irritation
Anaphylactic shock
Cardiac arrhythmias
Decrease in plasma calcium
Decreased serum sodium
Dermatitis
Disorientation
Flatulence
Insomnia
Malaise
Nausea
Pulmonary oedema
Reduced plasma potassium levels
Rhinorrhoea
Seizures
Sensation of fullness
Stomach pain
Tachycardia
Urticaria
Vomiting

Presentation

Oral formulations of high strength macrogol 3350 (110g)

Drugs List

Therapeutic Indications

Uses

Bowel evacuation - prior to investigative procedure

Dosage

Adults

Elderly

Contraindications

Children under 18 years
Impaired consciousness
Predisposition to aspiration or regurgitation
Predisposition to gastrointestinal perforation
Delayed gastric emptying
Gag reflex impaired
Gastrointestinal obstruction
Gastrointestinal perforation
Hepatic impairment
New York Heart Association class III failure
New York Heart Association class IV failure
Paralytic ileus
Renal impairment
Severe dehydration
Toxic megacolon
Ulcerative colitis

Precautions and Warnings

Debilitation
Elderly
Restricted potassium intake
Restricted sodium intake
Cardiac conduction defects
History of cardiac arrhythmias
Inflammatory bowel disease
New York Heart Association class I failure
New York Heart Association class II failure
Reflux oesophagitis

Contains more than 1 mmol (23 mg) sodium per dose
Observe patients prone to aspiration/regurgitation during administration
Dysphagia: Mixing with starch thickeners may increase risk of aspiration
Avoid solid food for at least 2 hours prior to administration
Ensure patient has adequate fluid intake
Monitor periodically for signs of fluid or electrolyte imbalance

There are 260mmol of sodium and 20mmol of potassium per 4litres of solution.

Addition of polyethylene glycol to a liquid that has been thickened with a starch-based thickener can produce a mixture that is thin and watery.

Pregnancy and Lactation

Pregnancy

Macrogol 3350 is considered safe for use in pregnancy.

At the time of writing there is limited experience concerning exposed pregnancies and their outcomes. No teratogenic effects were seen in animals trials.

Schaefer suggests that as macrogol has a high molecular weight, it is not absorbed enterally and is well tolerated.

The use of all medication in pregnancy should be avoided whenever possible; particularly in the first trimester. Non-drug treatments should also be considered. When essential, a medication with the best safety record over time should be chosen, employing the lowest effective dose for the shortest possible time. Polypharmacy should be avoided. Teratogens taken in the pre-embryonic period, often quoted as lasting until 14 to 17 days post-conception, are believed to have an all-or-nothing effect. Where drugs have a short half-life, and when the date of conception is certain, this may allow women to be reassured where drug exposure has occurred within this time frame. Further advice may be available from the UK National Teratology Information Service (NTIS) and through ToxBase, available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).

Lactation

Macrogol 3350 is considered safe for use in breastfeeding.

Systemic exposure of macrogol 3350 is limited and thus adverse effects on the breast fed infant are not expected.

Neonates, infants born prematurely, those with low birth weight, those with an unstable gastrointestinal function or who have serious illnesses may require special consideration. For any infant, if a drug is prescribed to the nursing mother, it should be at the lowest practical dose and for the shortest time. When drug administration is unavoidable and breastfeeding is to continue, minimisation of exposure of the infant to the drug may sometimes be achieved by timing the maternal doses to just after a feeding episode. Infants exposed to drugs via breast milk should be monitored for unusual signs or symptoms. Interactions between the drug received by the infant from the mother's milk and medication prescribed for the infant should also be considered, for example, when the drug given to the infant may prevent metabolism of the drug received via breast milk.
Specialist advice is available from the UK Drugs in Lactation Advisory Service at https://www.midlandsmedicines.nhs.uk/content.asp?section=6&subsection=17&pageIdx=1

Side Effects

Anal irritation
Anaphylactic shock
Cardiac arrhythmias
Decrease in plasma calcium
Decreased serum sodium
Dermatitis
Disorientation
Flatulence
Insomnia
Malaise
Nausea
Pulmonary oedema
Reduced plasma potassium levels
Rhinorrhoea
Seizures
Sensation of fullness
Stomach pain
Tachycardia
Urticaria
Vomiting

Overdosage

It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.

The following number will direct the caller to the relevant local centre (0844) 892 0111

Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).

Further Information

Last Full Review Date: June 2017

Reference Sources

Drugs During Pregnancy and Lactation: Treatment Options and Risk Assessment, 3rd edition (2015) ed. Schaefer, C., Peters, P. and Miller, R. Elsevier, London.

Summary of Product Characteristics: VistaPrep 110g powder for oral solution. Tillotts Pharma UK Limited. Revised October 2016

MHRA Drug Safety Update April 2021
Available at: https://www.mhra.gov.uk
Last accessed: 13 May 2021