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psyllium (Metamucil, Fiberall)
Tradenames: Metamucil, Fiberall. (from plantago seed)
Indications:
- relief of constipation
- may aid in the management of diarrhea
- bowel preparation
- irritable bowel syndrome
Contraindications:
1) fecal impactation
2) GI obstruction
pregnancy-category B
safety in lactation ?
Dosage:
- 1 to 2 tablespoons PO QD/BID/TID, mixed with at least 8 oz of fluid
Pharmacokinetics:
1) elimination: not absorbed
2) some effect may be seen in 12-24 hours
3) full effect may not be apparent for 2-3 days
Adverse effects:
1) gastrointestinal
- gaseous abdominal distension
- abdominal cramping
- belching
- diarrhea
- constipation
- intestinal obstruction
- flatulence [4]
2) aerosolization of powder
- bronchospasm
- anaphylaxis on inhalation in susceptible individuals
- rhinoconjunctivitis
Drug interactions:
1) binds to many medications decreasing absorption
- give other medications 1 hour before or 3-4 hours after psyllium
2) specific medications affected include:
a) warfarin
b) digoxin
c) K+ sparing diuretics
d) salicylates
e) tetracyclines
f) nitrofurantoin
Mechanism of action:
1) adds bulk in the form of insoluble fiber to the stool
2) bulk promotes peristalsis & reduces fecal transit time
General
laxative
References
- The Pharmacological Basis of Therapeutics, 9th ed.
Gilman et al, eds. Permagon Press/McGraw Hill, 1996
- Drug Information & Medication Formulary, Veterans Affairs,
Central California Health Care System, 1st ed., Ravnan et al
eds, 1998
- Drug information Handbook, Lacy, C, Lexi-Comp, Inc.
- Anand BS
Fast Five Quiz: Flatulence
Medscape. Nov 1, 2022
https://reference.medscape.com/viewarticle/982818
Component-of
cortisol/lidocaine/polycarbophil/psyllium
cortisol/lidocaine/psyllium
polycarbophil/psyllium/senna
psyllium/senna