Usage
- Polycarbophil is prescribed for the treatment of occasional constipation and diarrhea. It is also used to manage irritable bowel syndrome (IBS) symptoms, particularly in cases of constipation predominance. In some cases, it is utilized post-surgically to promote regular bowel movements.
- Pharmacological Classification: Bulk-forming laxative.
- Mechanism of Action: Polycarbophil is a hydrophilic agent, meaning it absorbs water. This increases the bulk and softness of the stool, promoting peristalsis and facilitating easier bowel movements. It also acts by increasing the water content of the stool, making it softer and easier to pass. It is minimally absorbed systemically, and its effects are localized to the gastrointestinal tract.
Alternate Names
- Calcium polycarbophil
- Brand Names: FiberCon, Fiber Lax, Fiber-Lax, Fiber-Tabs, Equalactin, Konsyl
How It Works
- Pharmacodynamics: Polycarbophil increases stool bulk and water content, which stimulates bowel movements. Its action is primarily physical, relying on its water-absorbing properties rather than chemical or receptor-mediated effects. This leads to increased intraluminal pressure and stimulates peristalsis. The effects are generally observed within 12-72 hours after administration.
- Pharmacokinetics:
- Absorption: Minimally absorbed in the gastrointestinal tract.
- Metabolism: Not metabolized.
- Elimination: Excreted unchanged in the feces.
- Mode of Action: Polycarbophil absorbs water in the colon, increasing stool bulk and stimulating peristalsis. By softening the stool, it eases the passage of bowel movements. It is considered a bulk-forming laxative as it adds bulk to the stool. This type of laxative is preferred in conditions where straining during defecation should be avoided (e.g., hemorrhoids, anal fissures). It does not stimulate colonic secretions, so it is not dehydrating.
- Receptor Binding, Enzyme Inhibition, or Neurotransmitter Modulation: Polycarbophil has no known interactions with receptors, enzymes, or neurotransmitters.
Dosage
Standard Dosage
Adults:
- 1250 mg (two 625mg tablets or caplets) taken orally one to four times a day with at least 8 ounces (a full glass) of water. The maximum daily dose is six grams.
- For occasional constipation relief, two tablets with at least 8 ounces of water, one to four times daily. Maximum 8 tablets in 24 hours.
Children:
- Children below 6 years: Administer under physician supervision; 625 mg (one tablet) with 8 oz of water orally once a day or every 12 hours; not to exceed 1.25 g/day.
- Children 6-12 years: 625 mg (one tablet or caplet) with at least 8 ounces of liquid orally one to four times a day.
- Children above 12 years: 1250 mg with 8 oz of water orally every 6 hours; not to exceed 6 g/day.
Special Cases:
- Elderly Patients: Start at the lower end of the dosing range and adjust as needed, monitoring closely for dehydration or fecal impaction. Adequate fluid intake is essential.
- Patients with Renal Impairment: Use with caution due to potential fluid restrictions. Close monitoring of fluid and electrolyte balance is recommended. Alternative laxatives may be more appropriate.
- Patients with Hepatic Dysfunction: No specific dosage adjustments are typically needed, as polycarbophil is minimally absorbed systemically.
- Patients with Comorbid Conditions: In patients with swallowing difficulties, polycarbophil should be used cautiously due to the risk of choking if not taken with sufficient fluid.
Clinical Use Cases
- Intubation, Surgical Procedures, Mechanical Ventilation, Intensive Care Unit (ICU) Use, Emergency Situations: Polycarbophil is not indicated for use in these acute clinical scenarios. It is intended for the management of chronic or occasional constipation, and its delayed onset of action (12–72 hours) makes it unsuitable for emergency situations.
Dosage Adjustments:
- Dose modifications should be considered in elderly patients and those with renal impairment. Consult the “Special Cases” section above for specific recommendations.
Side Effects
Common Side Effects:
- Mild stomach pain
- Bloating
- Gas
- Flatulence
Rare but Serious Side Effects:
- Allergic reactions (rash, itching, swelling, dizziness, trouble breathing)
- Choking (if taken without adequate fluid)
- Rectal bleeding
- Fecal impaction (especially in elderly patients)
Long-Term Effects:
- No significant long-term adverse effects have been reported, but prolonged use without adequate fluid intake could lead to dehydration or electrolyte imbalances.
Adverse Drug Reactions (ADR):
- Allergic reactions (as described above)
- Esophageal obstruction or choking (if taken without sufficient water)
Contraindications
- Intestinal obstruction or fecal impaction
- Hypersensitivity to polycarbophil
- Difficulty swallowing
- Patients with fluid restrictions
Drug Interactions
- Polycarbophil can potentially reduce the absorption of other medications taken within 1–2 hours.
- Specifically, it may interact with:
- Tetracycline antibiotics (doxycycline, minocycline, tetracycline)
- Digoxin
- Phenytoin
- There is a theoretical risk of hypercalcemia in patients with predisposing conditions, as polycarbophil contains calcium.
Pregnancy and Breastfeeding
- Pregnancy Safety Category: Not absorbed systemically and generally considered safe for use during pregnancy.
- Breastfeeding: No data in nursing women; not absorbed and should be safe to use in nursing women.
Drug Profile Summary
- Mechanism of Action: Absorbs water to increase stool bulk and stimulate peristalsis.
- Side Effects: Bloating, gas, stomach discomfort. Rarely, allergic reactions or choking.
- Contraindications: Intestinal obstruction, difficulty swallowing, hypersensitivity.
- Drug Interactions: May reduce the absorption of some medications taken concurrently.
- Pregnancy & Breastfeeding: Generally considered safe.
- Dosage: Adults: 1250 mg 1–4 times/day; Children: 625–1250 mg based on age, with adequate fluid.
- Monitoring Parameters: Monitor bowel movements, hydration status, and electrolyte balance in susceptible individuals.
Popular Combinations
- Polycarbophil is sometimes combined with docusate sodium (a stool softener) for managing constipation.
Precautions
- General Precautions: Take with plenty of fluids to prevent esophageal obstruction or choking. Consult a doctor if constipation persists for more than 7 days.
- Specific Populations:
- Pregnant Women: Although considered safe, consult a doctor before use.
- Breastfeeding Mothers: Consult a doctor before use.
- Children & Elderly: Adjust dose as needed and monitor closely.
- Lifestyle Considerations: Increase dietary fiber and fluid intake for optimal bowel function.
FAQs (Frequently Asked Questions)
Q1: What is the recommended dosage for Polycarbophil?
A: Adults: 1250 mg (two tablets) taken orally 1-4 times a day with a full glass of water. Children: 625-1250 mg based on age and under the guidance of a physician, always with at least 8 ounces of fluid.
Q2: How does Polycarbophil work?
A: It absorbs water in the colon, increasing stool bulk and promoting bowel movements.
Q3: What are the common side effects?
A: Bloating, gas, abdominal discomfort.
Q4: Who should not take Polycarbophil?
A: Patients with bowel obstruction, swallowing difficulties, or hypersensitivity to the drug.
Q5: Can pregnant or breastfeeding women take it?
A: It’s generally considered safe, but consult a doctor before use.
Q6: How long does it take to work?
A: Effects usually appear within 12 to 72 hours.
Q7: What if I miss a dose?
A: Take the missed dose as soon as you remember, unless it’s almost time for the next dose. Do not double the dose.
Q8: Can it interact with other medications?
A: Yes, it can potentially decrease the absorption of certain drugs. Inform your doctor about all the medications you are currently taking.
Q9: How should Polycarbophil be taken?
A: Take it orally with at least 8 ounces (240 ml) of water or other fluid per dose. Tablets should be chewed completely before swallowing. Caplets should be swallowed whole with plenty of water. Do not take it dry, as choking can occur.
Q10: Can I take Polycarbophil long-term?
A: While it is typically safe for long-term use, consult a doctor about prolonged treatment. Ensure adequate fluid intake.
