OralConstipationAdult: As powder for oral solution or conventional/effervescent granules for oral suspension: 3.5 g bid (morning and evening). The last dose must not be taken just before bedtime. Dosage recommendations may vary among individual products and between countries (refer to specific product or local guidelines).
Child: 6 to <12 years As powder for oral solution or conventional granules for oral suspension (each level 5-mL spoonful contains ispaghula husk 1.75 g): 2.5-5 mL bid (morning and evening), to be given as a half or whole level spoonful mixed in water; ≥12 years As powder for oral solution or conventional/effervescent granules for oral suspension: Same with adult dose. Dosage recommendations may vary among individual products and between countries (refer to specific product or local guidelines).
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Should be taken on an empty stomach. Take before meals w/ a full glass of water.
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Powder and conventional/effervescent granules for oral solution or suspension: Mix contents in at least 150 mL of water or other fluids (e.g. fruit juice). Stir well and drink immediately. The amount of fluid required for reconstitution may vary among individual products (refer to detailed product guidelines).
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Hypersensitivity. Intestinal obstruction, faecal impaction, colonic atony, natural or drug-induced reduction of gut motility, abnormal constrictions of the gastrointestinal tract, diseases of the oesophagus or cardia, undiagnosed rectal bleeding; sudden change in bowel habit that persists for >2 weeks; difficulty swallowing or any throat problems.
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Debilitated patients. Children and elderly. Pregnancy and lactation.
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Significant: Hypersensitivity reactions, including bronchospasm and anaphylaxis (particularly associated with ingestion or inhalation of the powder or granules in susceptible patients); intestinal or oesophageal obstruction, faecal impaction.
Gastrointestinal disorders: Abdominal distension, flatulence.
Eye disorders: Allergic conjunctivitis.
Respiratory, thoracic and mediastinal disorders: Rhinitis.
Skin and subcutaneous tissue disorders: Rash.
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Ensure adequate fluid intake during treatment. If constipation persists for more than 3 days or abdominal pain/faecal irregularities occur, discontinue use and seek medical advice.
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Symptoms: Abdominal discomfort, flatulence, and intestinal obstruction. Management: Symptomatic treatment. Maintain adequate fluid intake.
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May decrease or delay the gastrointestinal absorption of coumarin derivatives, cardiac glycosides, lithium, vitamins (e.g. vitamin B12), and minerals (e.g. Ca, Fe, Zn).
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Description:
Mechanism of Action: Ispaghula husk, a soluble fibre bulk-forming laxative, consists of the episperm and collapsed adjacent layers removed from Plantago ovata seeds. It absorbs water in the gastrointestinal tract to form a mucilaginous mass which increases faecal volume, thereby promoting peristalsis and reducing transit time.
Synonym(s): Psyllium husk.
Onset: Relief of constipation: 12-72 hours.
Pharmacokinetics:
Metabolism: <10% of the mucilage undergoes hydrolysis in the stomach forming free arabinose.
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A06AC01 - ispaghula (psylla seeds) ; Belongs to the class of bulk-producing laxatives.
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Buckingham R (ed). Ispaghula. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 03/04/2024. Evagel Powder for Oral Solution 3.5 g (Apex Pharmacy Marketing Sdn. Bhd.). National Pharmaceutical Regulatory Agency - Ministry of Health Malaysia. https://www.npra.gov.my. Accessed 16/05/2024. Fybogel (Reckitt Benckiser Healthcare [UK] Limited). MHRA. https://products.mhra.gov.uk. Accessed 16/05/2024. Ispagel Orange (Bristol Laboratories Limited). MHRA. https://products.mhra.gov.uk. Accessed 03/04/2024. Ispaghula [Psyllium]. UpToDate Lexidrug, Lexi-Drugs Multinational Online. Waltham, MA. UpToDate, Inc. https://online.lexi.com. Accessed 03/04/2024. Joint Formulary Committee. Ispaghula Husk. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 03/04/2024. Mucilin Husk Powder (Paradigm Pharmaceuticals Inc). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed. Accessed 03/04/2024.
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