Methylcellulose (Citrucel) is a bulk-forming laxative. It increases the bulk of stools resulting in improved intestinal motility and regularizing bowel movements.

Methylcellulose (Citrucel) Uses:

• Constipation:

  • It is used as an adjunct to diet and other therapies in the treatment of constipation and to restore and maintain bowel regularity.

Methylcellulose (Citrucel) Dose in Adults:

Methylcellulose (Citrucel) Dose in the treatment of Constipation: Oral:

• Citrucel tablet:

  • As much as six times a day, two caplets as needed.

  • Twelve caplets are the maximum daily dose.

• Citrucel powder:
  • In 8 oz (240 mL) of cold water, dissolve 2 grams, or one heaping tablespoon.
  • Up to three times per day, the dose may be raised by one heaping tablespoon as needed.
• Citrucel powder (sugar-free):
  • 1 rounded tablespoon of 2 grams in 8 ounces (240 mL) of cold water
  • If necessary, the dosage may be raised by one rounded tablespoon up to three times each day.

Methylcellulose (Citrucel) Dose in Children:

Methylcellulose (Citrucel) Dose in the treatment of Constipation: Oral:

• Children 6 to 11 years:

  • Citrucel tablet:
    • One caplet as required up to six times per day;
    • The maximum dose per day is 6 caplets.
  • Citrucel powder:
    • 2.5 level teaspoons of 1 gm in 8 oz (240 mL) of cold water
    • If necessary, up to three times per day, increase the dosage by 2.5 level tablespoons.
  • Citrucel powder (sugar-free):
    • 1 g  equivalent to 2 level teaspoons in 8 oz (240 mL) of cold water;
    • increase the dose as needed by 2 level teaspoons up to thrice daily.

• Children ≥12 years of age and Adolescents:

  • Refer to adult dosing.

Pregnancy Risk Category: N (Not assigned)

• It is considered safe for the treatment of constipation in pregnancy when administered with an adequate amount of fluid.

Dose in Kidney Disease:

The manufacturer has not provided any adjustments in the dose in patients with kidney disease.

Dose in Liver disease:

The manufacturer has not provided any adjustment in the dose in patients with liver disease.

Side effects of Methylcellulose (Citrucel):

• hypersensitivity reactions manifesting as a skin rash, urticaria, itching, and wheezing.
• Excessive bowel gas and flatulence
• Stool impaction (If bowel movements do not occur after three days of the drug intake, consult a healthcare provider).

Methylcellulose (Citrucel) Contraindications and warnings:

• Hypersensitivity reactions (avoid in patients allergic to the drug)
• Stool impaction and bowel obstruction
• Acute abdomen (acute appendicitis or acute/ subacute intestinal obstruction)
• Gastrointestinal ulcerations and adhesions
• Rectal bleeding or another gastrointestinal active bleed
• Difficulty swallowing.

Methylcellulose: Drug Interactions

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 improvement or worsening of the gastrointestinal symptoms. Bowel obstruction may occur if not taken with an adequate amount of fluid.

How to administer Methylcellulose (Citrucel)?

• It is administered orally.
• Each dose is taken with at least 240 ml (8 ounces) of water or other liquid to prevent choking.

Mechanism of action of Methylcellulose (Citrucel):

• Methylcellulose absorbs water from the gastrointestinal tract, making the stool softer. 
• It makes the stool bulkier, which improves transit through the GI tract. This also regulates bowel movements.

International Brand Names of Methylcellulose:

• Soluble Fiber Therapy
• Muciplasma
• Oftan MC
• Tear cell
• Bulk
• Davilose
• Lacril
• Lacrisyn
• Celevac
• Citrucel
• Cologel
• Citrucel
• GoodSense Fiber
• Dacryolarmes
• Methylcellulose-Bournonville

Methylcellulose Brand Names in Pakistan:

Vechlor - Vega Pharmaceuticles limited