Polyethylene glycol 3350 (GlycoLax, MiraLax) is an osmotic laxative that is used for the treatment of occasional constipation and for bowel preparation before colonoscopic procedures.

Polyethylene glycol 3350 Uses:

• Occasional Constipation:
  • It is indicated for the treatment of occasional constipation
• Off Label Use of Polyethylene glycol 3350 in Adults:
  • It is used for bowel preparation before colonoscopy

Polyethylene glycol 3350 (GlycoLax, MiraLax) Dose in Adults

Polyethylene glycol 3350 (GlycoLax, MiraLax) Dose in the treatment of Bowel preparation before colonoscopy (off-label):

• Oral: 17 g (~1 heaping tablespoon) in 240 mL (8 ounces) of clear liquid every ten minutes until 2,000 mL of volume are consumed.
• Start within 6 hours after administering bisacodyl delayed-release tablets or magnesium citrate.

Polyethylene glycol 3350 (GlycoLax, MiraLax) Dose in the treatment of occasional Constipation:

• Oral: 17 g (~1 heaping tablespoon) dissolved in 120 to 240 mL (4 to 8 ounces) of beverage, once a day;
• Do not use it for more than 1 to 2 weeks (product specific) unless directed by a health care provider.
• In clinical trials, doses up to 34 g once a day have been used and found to be effective but the risk factors of adverse effects are higher.

Polyethylene glycol 3350 (GlycoLax, MiraLax) Dose in Childrens

Dose in the treatment of Bowel preparation: Limited data available:

• Children >2 years and Adolescents:
  • Oral: 1.5 g/kg/day for 4 days;
  • The maximum daily dose is 100 g/day.

Dose in the treatment of Constipation: Limited data available:

• Infants, Children, and Adolescents:
  • Oral: 0.2 to 0.8 g/kg/day.
  • A higher initial dose of 1 g/kg has been suggested.
  • The maximum daily dose is 17 g/day.
  • Note: Dosage should be individualized to achieve the desired effect, infants and young children may require higher doses than school-aged children.

Dose in the treatment of slow fecal impaction: Limited data available:

• Children and Adolescents:
  • Oral: 1 to 1.5 g/kg daily for 3 to 6 consecutive days.
  • The maximum daily dose is 100 g/day.
  • Following the disimpaction of stools, a maintenance dose of 0.4 g/kg per day should be continued for 2 months or more.

Polyethylene glycol 3350 (GlycoLax, MiraLax) Pregnancy Category: C

• When administered orally, polyethylene glycol (PEG), is only minimally absorbed and is less likely to cause fetal malformations.
• It is better to not use this medication while pregnant. You should instead consider other recommended medications.
• This drug can be used to treat bowel issues before colonoscopic procedures.

Use while you breastfeed

• Breastfeeding may be permitted because it is not well absorbed.

Dose in Kidney Disease:

There are no dosage adjustments provided in the manufacturer's labeling.   

Dose in Liver disease:

There are no dosage adjustments provided in the manufacturer's labeling.   

Common Side Effects of Polyethylene glycol 3350 (GlycoLax, MiraLax):

• Gastrointestinal:
  • Gastrointestinal Signs And Symptoms
  • Diarrhea

Less Common Side Effects Of Polyethylene Glycol 3350:

• Gastrointestinal:
  • Flatulence
  • Nausea
  • Abdominal Pain
  • Loose Stools
  • Abdominal Distention

Frequency Not Defined.

• Gastrointestinal:
  • Dyspepsia
  • Eructation
  • Stomach Discomfort
• Hematologic & Oncologic:
  • Rectal Hemorrhage

Contraindications to Polyethylene glycol 3350 (GlycoLax, MiraLax):

• Hypersensitivity to polyethyleneglyl or any other component of the formulation
• Patients who have bowel obstruction, suspected or known.

OTC labeling

• If the patient is hypersensitive or has chronic kidney disease, avoid self-medication.

Canadian labeling: Additional contraindications not in US labeling

• Relaxa is not recommended for children younger than 18 years, unless recommended otherwise by a doctor

Warnings & Precautions

• Inadequate electrolyte levels:
  • Excessive, prolonged, or frequent use can lead to electrolyte imbalance and dehydration.
• Hypersensitivity
  • It is best to avoid patients who are allergic to the drug. You should seek immediate medical attention if you experience rash, swelling, or difficulty breathing.
• Bowel obstruction
  • Patients suffering from intestinal obstruction should not be taking it. These symptoms include abdominal pain, abdominal distension and nausea.
• Renal impairment
  • Patients with kidney disease must be cautious and should only use this drug under the supervision of a qualified healthcare professional.

Polyethylene glycol 3350: Drug Interaction

Note: Drug Interaction Categories:

• Risk Factor C: Monitor When Using Combination
• Risk Factor D: Consider Treatment Modification
• Risk Factor X: Avoid Concomitant Use

Monitoring Parameters:

Monitor for blood pressure, hydration status, and electrolytes.   

How to administer Polyethylene glycol 3350 (GlycoLax, MiraLax)?

Oral:

• Occasional constipation:
  • Mix the powder with 120 - 240mL (4-8 ounces), water, soda, juice, or coffee until it dissolves. Take it out immediately.
• Bowel preparation for colonoscopy (off label use)
  • Take bisacodyl delayed-release tablets or magnesium citrate before you start to take polyethylene glycol.
  • Mix the powder and 240mL (8 ounces) of clear liquid. Prepare the solution after 6 hours or when bowel movements are complete. 
  • Next, prepare the solution and immediately give it to the patient.

Mechanism of action of Polyethylene glycol 3350 (GlycoLax, MiraLax):

Polyethylene glycol 3350 is an osmotic laxative that causes water retention in the stool and increases stool frequency.

 Onset of action:

• Oral: 24 to 96 hours

Absorption:

• Minimal (<0.28%)

Excretion:

• Feces (93%);
• urine (0.2%)

International Brand Names of Polyethylene glycol 3350:

• GaviLAX
• GlycoLax
• HealthyLax
• MiraLax
• PEGyLAX

Polyethylene glycol 3350 Brand Names in Pakistan:

No Brands Available in Pakistan.