Sodium picosulfate oral
- Drugs List
- Therapeutic Indications
- Dosage
- Contraindications
- Precautions and Warnings
- Pregnancy and Lactation
- Side Effects
- Monograph
Presentation
Oral formulations containing sodium picosulfate.
Drugs List
Therapeutic Indications
Uses
Constipation
Dosage
The onset of action is approximately 6 to 12 hours.
Adults
Relief of constipation
5mg to 10mg at night until regularity established, when the dose can be reduced or stopped.
Children
Relief of constipation
Children aged over 12 years
5mg to 10mg at night until regularity established, when the dose can be reduced or stopped.
The following alternative dosing schedule may be suitable (not licensed for children under 12 years):
Children aged 10 to 12 years (unlicensed)
5mg to 10mg once daily at night.
Children aged 4 to 10 years (unlicensed)
2.5mg to 5mg once daily night.
Children aged 1 month to 4 years (unlicensed)
250micrograms/kg once daily at night (maximum dose 5mg).
Contraindications
Abdominal pain of unknown cause
Neonates under 1 month
Acute inflammatory bowel disease
Acute surgical abdomen
Appendicitis
Gastrointestinal obstruction
Paralytic ileus
Severe dehydration
Precautions and Warnings
Children aged 1 month to 12 years
Alcoholism
Epileptic disorder
Hepatic disorder
Pregnancy
Advise ability to drive/operate machinery may be affected by side effects
Not all available brands/formulations are licensed for use in children
Restore electrolyte & fluid balance in case of dehydration
Contains alcohol
Contains hydroxybenzoate
If daily use is required, investigate the cause of constipation
Prolonged use may cause fluid/electrolyte imbalance and hypokalaemia
Discontinue if severe nausea, vomiting or abdominal distress occurs
Avoid long term use
Advise patient to seek medical advice if symptoms persist for > 5 days
Prolonged excessive use may lead to fluid and electrolyte imbalance, diarrhoea, hypokalaemia, and may precipitate rebound constipation. Intestinal loss of fluids can promote dehydration. Symptoms may include thirst and oliguria. Sodium picosulfate must be discontinued in patients suffering from fluid loss where dehydration may be harmful (e.g. renal insufficiency, elderly patients)
Dizziness or syncope has been reported during the use of sodium picosulfate, consistent with defecation syncope (or syncope attributable to straining at stool), or with vasovagal response to abdominal pain which may be related to the constipation that prompted the use of laxatives.
Sodium picosulfate should only be used if bulk-forming and osmotic laxatives are ineffective or contraindicated.
The oral liquid contains ethanol 4.8% (up to 480mg per dose).
Pregnancy and Lactation
Pregnancy
Use sodium picosulfate with caution during pregnancy.
The manufacturer advises that at the time of writing there are no adequate and well-controlled studies in pregnant women. There is no evidence of undesirable or damaging effects with the use of sodium picosulfate during pregnancy.
Lactation
Sodium picosulfate is considered safe for use during breastfeeding.
The manufacturer states that clinical data shows that neither the active moiety of sodium picosulfate nor its glucuronides are excreted into the milk of healthy lactating females.
Counselling
Advise patients to seek medical advice if they require treatment continuously for more than five days unless under medical supervision.
Advise patient that a bowel movement is usually produced in 6 to 12 hours.
Advise patient that their ability to drive or operate machinery may be affected by side effects such as dizziness and/or syncope.
Advise patient to seek medical advice and stop treatment if they experience severe abdominal pain associated with nausea and vomiting.
Side Effects
Abdominal cramps
Abdominal discomfort
Abdominal pain
Allergic reaction
Angioedema
Diarrhoea
Dizziness
Hypersensitivity reactions
Nausea
Pruritus
Rash
Skin reactions
Syncope
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: February 2021
Reference Sources
Summary of Product Characteristics: Dulcolax Adult Pico Liquid, 5mg/5ml oral solution. Sanofi. Revised March 2020.
Summary of Product Characteristics: Dulcolax Twelve Plus Pico Liquid, 5mg/5ml oral solution. Sanofi. Revised November 2021.
NICE Evidence Services Available at: www.nice.org.uk Last accessed: 09 September 2022
Medscape UK | Univadis prescription drug monographs & interactions are based on FDB Multilex Content
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