GUTTALAX ® is a sodium picosulfate based drug
THERAPEUTIC GROUP: Laxatives - Stimulating laxative
Indications GUTTALAX ® Sodium Picosulfate
GUTTALAX ® is indicated for the short-term treatment of occasional constipation.
Mechanism of action GUTTALAX ® Sodium Picosulfate
Sodium picosulfate, taken orally through GUTTALAX ® is able to reach the intestinal mucosa of the large intestine intact, where it is hydrolyzed in its active form by the local bacterial flora, and carries out the laxative action through a contact mechanism.
The pharmacokinetic properties of this active principle make GUTTALAX ® little available for intestinal absorption, allowing an "optimization of the laxative activity, which occurs on average between the sixth and twelfth hour, and reducing the urinary excretion of metabolites to a minimum. glucuronates.
Like other stimulating laxatives belonging to the category of triarylmethane derivatives, the derivatives of sodium picosulfate can act in the intestinal mucosa, stimulating the nerve endings and increasing the peristalsis of the colon, with consequent evacuation.
Studies carried out and clinical efficacy
SODIUM PICOSULFATE IN THE TREATMENT OF CHRONIC CONSTIPATION
Int J Clin Pract. 2007 Jun; 61: 944-50.
Randomized, placebo-controlled, double-blind study to investigate the efficacy and safety of the acute use of sodium picosulphate in patients with chronic constipation.
Wulkow R, Vix JM, Schuijt C, Peil H, Kamm MA, Jordan C.
Short-term treatment, particularly for 3 days, with 7 mg of sodium picosulfate in patients with repeated episodes of constipation in the last 3 months, has been shown to be particularly effective and safe in improving symptoms, ensuring an increase in the frequency of evacuation without exertion and a reduction in abdominal pain
2.SODIUM PICOSULFATE AND COLON CLEANING
Acta Cir Bras. 2008; 23 Suppl 1: 108-11
Comparison of colon-cleansing methods in preparation for colonoscopy - comparative efficacy of solutions of mannitol, sodium picosulfate and monobasic and dibasic sodium phosphates.
Miki P Jr, Lemos CR, Popoutchi P, Garcia RL, Rocha JJ, Feres O.
Proper colon cleansing is an important practice so that colonoscopy can guarantee a good diagnostic result without any bacterial infections. The administration of sodium picosulfate as a laxative has been shown to be useful in ensuring proper colon cleansing, without side effects that could compromise the inspection procedure.
3.SODIUM PICOSULFATE AND UREA AND ELECTROLYTES
Nurs Stand. 2005 Jul 20-26; 19: 41-5.
Effects of oral sodium picosulphate Picolax on urea and electrolytes.
Ryan F, Anobile T, Scutt D, Hopwood M, Murphy G.
This study conducted on 147 patients suffering from constipation, and treated with sodium picosulfate, has shown how the assumption of this active ingredient according to therapeutic schemes, can lead to a reduction in plasma concentrations of urea, sodium and potassium without however causing clinically relevant side effects.
Method of use and dosage
GUTTALAX ® 7.5mg oral drops of sodium picosulfate per ml: 7 - 8 drops per day, taken in a little water, should be sufficient to overcome episodes of occasional constipation. However, in case of stubborn constipation it is possible to increase the dose to 15-20 drops.
GUTTALAX ® soft capsules of 2.5 mg of sodium picosulfate: the recommended dose is 2-3 capsules per day.
In both cases, treatment with this medicine should be limited to a few days, given the uselessness and danger of prolonged administration, preferring the evening intake so that the laxative effect can manifest itself the following morning.
Medical supervision is necessary in case of administration of GUTTALAX ® children under the age of 10, and in case of any increase in dosage.
Warnings GUTTALAX ® Sodium Picosulfate
The intake of stimulant laxatives should be linked exclusively to the need to overcome episodes of temporary constipation.
The finding of a continuous and prolonged constipation over time, should instead foresee a different therapeutic protocol, in which nutrition represents one of the supporting bases (see diet for constipation).
In fact, it is known that the assumption of laxatives, including GUTTALAX ® at high doses and prolonged over time, can be associated with chronic diarrhea with alteration of the electrolyte balance, followed by loss of the functionality of the active ingredient and intestinal atony.
Medical monitoring would be necessary in the case of patients suffering from hypertension, heart disease, endocrine-metabolic disorders and in children under 10 years of age.
GUTTALAX ® does not interfere with the normal ability to drive vehicles and use machines.
PREGNANCY AND BREASTFEEDING
During the entire period of pregnancy and the subsequent lactation period, it would be advisable to avoid taking GUTTALAX ® to use it only in case of real need and under strict medical supervision, given the absence of well-documented clinical trials capable of highlighting all the possible adverse reactions of sodium picosulfate and its metabolites on the health of the fetus and neonate.
Interactions
The intake of GUTTALAX ® should take place at least two hours after that of other drugs, given the ability of laxatives to reduce intestinal transit time and the consequent absorption of nutrients and active ingredients.
On the contrary, the concomitant intake of gastric antacids could reduce the intestinal availability of sodium picosulfate, causing a significant decrease in the therapeutic effects of GUTTALAX ®
The increased intestinal excretion induced by stimulant laxatives could expose the patient to the risk of hypokalaemia and related electrolyte imbalance, especially in case of concomitant intake of diuretics or adrenocotricosteroids.
Contraindications GUTTALAX ® Sodium Picosulfate
The administration of GUTTALAX ® should be avoided in case of nausea, diarrhea and various affections of the gastrointestinal tract, even of an acute nature, such as in the course of appendicitis, intestinal and biliary tract obstructions, dehydration and hepatic insufficiency.
Naturally, sodium picosulfate is contraindicated in case of hypersensitivity to the active ingredient or to triarylmethane derivatives.
Undesirable Effects - Side Effects
The intake of GUTTALAX ® could cause the onset of side effects mainly affecting the gastrointestinal tract, such as nausea, cramps, diarrhea and abdominal pain. More rarely, symptoms associated with hypersensitivity to the active substance, such as edema and skin reactions, have been observed.
Definitely more serious and potentially dangerous are the side effects due to the quantitative abuse of GUTTALAX ® which manifest themselves with acute abdominal pain, hypokalaemia, chronic diarrhea, dehydration, myalgia and muscle fatigue, and in some cases even kidney stones.
Prolonged administration of GUTTALAX ® strongly discouraged, could instead be responsible for the progressive loss of efficacy of the drug, with consequent reduction of intestinal tone and peristalsis, and constipation.
Note
GUTTALAX ® is an OTC drug, without a prescription, therefore freely salable.
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