Sorbitol is a sugar alcohol that is often used as a sweetener in various food products. It occurs naturally in fruits like apples, pears, peaches, and prunes. It's also synthesized from glucose and is commonly found in sugar-free and diabetic-friendly foods because it has fewer calories than regular sugar and doesn't spike blood sugar levels as much. Additionally, sorbitol has a cooling effect, making it useful in some oral care products like toothpaste and mouthwash. However, consuming large amounts of sorbitol can have a laxative effect, causing gastrointestinal discomfort and diarrhea, so it's often used in moderation.

Sorbitol (Agarol) is a type of sugar that has got cathartic properties and is also used as an artificial sweetener. It is used for bladder irrigation during urethral procedures.

Sorbitol Uses:

• It is used as a bladder irrigant in patients undergoing transurethral resection of the prostate, or other transurethral surgical procedures.
• It is also used as a laxative (as an osmotic laxative) and to facilitate the passage of kayexalate (sodium polystyrene sulfonate) through the intestinal tract.
• It may be used for the following purposes as well
  • used as a diuretic.
  • Humectant
  • Sweetening agent;

Sorbitol (Agarol) Dose in Adults

Sorbitol (Agarol) Dose in the treatment of Hyperosmotic laxative (single dose, at infrequent intervals):

• Oral Dose: 30 to 45 milliliters (mL) of a 70% sorbitol solution. This means if you have a 70% solution, you'd take 30 to 45 mL of it orally.
• Rectal Enema: 120 mL of a 25% to 30% sorbitol solution. So, you'd use 120 mL of a solution that's 25% to 30% sorbitol.
• With Sodium Polystyrene Sulfonate: You might take 15 mL of a 70% sorbitol solution orally until you get diarrhea (usually around 10 to 20 mL every 2 hours), or use 20 to 100 mL of sorbitol as a vehicle for the sodium polystyrene sulfonate resin.
• For Transurethral Surgical Procedures: If it's used for irrigation during surgery, you might use a 3% to 3.3% sorbitol solution.

So, the amount and concentration vary depending on how it's being used and the specific situation.

Sorbitol (Agarol) Dose in Childrens

Sorbitol (Agarol) Dose in the treatment of Constipation:

• Oral Dose (70% Solution):
  • For children aged 12 years and above, the usual dose is 30 to 45 milliliters (mL) once a day as needed.
  • Maximum single dose should not exceed 60 mL.
  • Some patients may require higher daily doses, up to 60 to 90 mL, divided throughout the day.
  • For infants, children, and adolescents, an alternate dosing is 1 to 3 mL per kilogram of body weight per day, divided into once or twice daily doses.
  • Typically, adolescents use 30 to 90 mL per day.
• Rectal Enema (25% to 30% Solution):
  • For children aged 2 to under 12 years, the dose is 30 to 60 mL once daily as needed.
  • For children aged 12 years and above, including adolescents, the dose is 120 mL once daily as needed.

Sorbitol (Agarol) Dose in the treatment of slow fecal disimpaction:

Oral Dose (70% Solution):

• Infants, children, and adolescents typically take 2 milliliters (mL) per kilogram (kg) of body weight, twice daily.
• This regimen is followed for 7 days according to limited available data from studies (Pashankar 2005; Wyllie 2011).

Sorbitol (Agarol) Dose in the treatment of Toxic ingestion as an adjunct with charcoal:

Oral Dose (35% Solution):

• Children and adolescents typically receive 4.3 milliliters (mL) per kilogram (kg) of body weight.
• This dose is given once, and it's recommended to administer it along with the initial charcoal dose of 1 gram per kilogram of body weight.

Pregnancy Risk Factor C

• There haven't been studies done on animals to see if there are any effects on pregnancy or the baby.

Use during breastfeeding:

• Manufacturers recommend that lactating mothers use the drug with caution.

Dose in Kidney Disease:

• The manufacturer's instructions don't include any changes in dosage for people with kidney problems.

Dose in Liver disease:

• The manufacturer's instructions don't specify any adjustments in dosage for individuals with liver issues.

Side effects of Sorbitol (Agarol):

• Cardiovascular:
  • Edema
• Endocrine & Metabolic:
  • Electrolyte Depletion
  • Hyperglycemia
  • Hypovolemia
  • Lactic Acidosis
• Gastrointestinal:
  • Abdominal Distress
  • Diarrhea
  • Nausea
  • Vomiting
  • Xerostomia

Contraindications to Sorbitol (Agarol):

• For self-medication of anuria (the absence of urine production), over-the-counter labeling advises against using it for more than 7 days and cautions against use if you experience abdominal pain, nausea, or vomiting.

Warnings and precautions

Fluid and electrolyte imbalances:

• Using large volumes of the solution may lead to fluid overload and potentially cause electrolyte imbalances.

Cardiopulmonary disease

• Exercise caution when using the solution in patients with severe heart or lung conditions.

Renal impairment

• Be cautious when using the solution in patients with kidney problems.

Incapable to metabolizesorbitol

• Exercise caution when using the solution in patients who are unable to metabolize sorbitol.

Sorbitol: 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:

• Fluid Overload and Electrolyte Disturbances: Keep an eye out for signs of fluid overload or changes in electrolyte levels after using large volumes of the solution.
• Gastrointestinal Distress: Watch for symptoms like bloating and flatulence, which can indicate gastrointestinal discomfort.

How to administer Sorbitol (Agarol)?

Sorbitol Syrup:

• It is administered after meals with a glass of water or mixed with a beverage.

Sorbitol for Rectal administration:

• The 70% sorbitol solution is mixed with water in a ratio of 1:2.3 to make a solution of 25% - 30% concentration.
• The final mixture is then administered rectally gently with the tubings provided by the manufacturer.

Urethral administration:

• A 3.3% urethral solution is used for bladder irrigation. Follow the manufacturer's drug prescribing information manual.

Mechanism of action of Sorbitol (Agarol):

• A polylcoholic sugar that works as an osmotic cathartic.

The beginning of action:

• Rectal: Starts working within 0.25 to 1 hour after administration.

Absorption:

• Oral, Rectal: Sorbitol is poorly absorbed when taken by mouth or administered rectally.

Metabolism:

• Sorbitol is primarily metabolized in the liver, where it is converted to fructose.

International Brand Names of Sorbitol:

• Agarol
• Ardeanutrisol SO
• Cystosol
• klysma Sorbit
• Medevac
• Progras
• Resulax
• Sladial
• Sorbilande
• Sorbilax
• Sorbit Fresenius
• Sorbit Leopold
• Sorbit Mayrhofer
• Sorbitol Aguettant
• Sorbitol Baxter
• Sorbitol Delalande
• Sorbitol-Infusionslosung
• Syn M.D.

Sorbitol Brand Names in Pakistan:

No Brands Available in Pakistan.