Bladder, Bowel and Stoma Handbook

The essential guide to product selection

Medications (Constipation)

Bisacodyl (Bisacodyl BP 10mg)

Bisacodyl (Bisacodyl BP 10mg)

Suppository for constipation. Bisacodyl BP 10mg- Suppisitory. Dosage: Short-term treatment for constipation: Adults and children over 10 years: 1 - 2 coated tablets (5 - 10 mg) daily before bedtime, or 1 suppository (10 mg) for immediate effect. For preparation of diagnostic procedures and preoperatively: Should only be used under medical supervision. Adults and children over 10 years: 2 coated tablets (10 mg) in the morning and 2 coated tablets (10 mg) in the evening and 1 suppository on the following morning is recommended.

Bisacodyl (Dulcolax)

Bisacodyl (Dulcolax)

Stimulant laxative. DULCOLAX 10 mg Suppositories. Dosage: Short-term treatment for constipation: Adults and children over 10 years: 1 to 2 coated tablets (5 - 10 mg) daily before bedtime, or 1 suppository (10 mg) daily for immediate effect. Children 4 – 10 years: 1 coated tablet (5 mg) daily before bedtime, or 1 suppository (5 mg) daily for immediate effect. It is recommended to start with the lowest dose. The dose may be adjusted up to the maximum recommended dose to produce regular stools. The maximum daily dose should not be exceeded. In the management of constipation, once regularity has been restarted dosage should be reduced and can usually be stopped. Children aged 10 years or younger with chronic or persistent constipation should only be treated under the guidance of a physician. Bisacodyl should not be used in children aged 4 years or younger. For preparation of diagnostic procedures and preoperatively: For preparation of diagnostic procedures, in pre- and postoperative treatment and in medical conditions which require defaecation to be facilitated, DULCOLAX should be used under medical supervision. The tablets should be combined with suppositories in order to achieve complete evacuation of the intestine. Adults and children over 10 years: 2 coated tablets (10 mg) in the morning and 2 coated tablets (10 mg) in the evening and 1 suppository (10 mg) on the following morning is recommended. Children aged 4 -10 years of age: 1 coated tablet (5 mg) in the evening and 1 suppository (5 mg) on the following morning is recommended.

Co-Danthrusate

Co-Danthrusate

Stimulant laxative. Each 5 ml containing 60 mg Sodium Docusate BP and 50 mg Dantron BP, Adults: One to three 5ml doses at bedtime. Children One 5ml dose at bedtime

Danthron (Co-danthramer)

Danthron (Co-danthramer)

Stimulant laxative. A lubricant, faecal softener and laxative for the prophylaxis and treatment of constipation in terminally ill patients of all ages. Co-Danthramer 75mg/1000mg per 5ml Oral Suspension. Dosage: Adults: One 5 ml spoonful at bedtime. Children: Not recommended in children under the age of 12. Co-Danthramer 25 mg/200mg per 5ml Oral Suspension. Dosage: Adults: One to two 5 ml spoonfuls at bedtime. Children: Should be avoided in children, but if recommended, a suitable dose is half to one 5 ml spoonful at bedtime.

Docusate Sodium (Dioctyl)

Docusate Sodium (Dioctyl)

Stimulant laxative. Dioctyl 100 mg Capsules. Adults and elderly: Up to 500 mg should be taken daily in divided doses. Treatment should be commenced with large doses, which should be decreased as the condition of the patient improves. For use with barium meals: 400 mg to be taken with the meal. Children under 12 years: Not recommended.

Docusate Sodium (Dulcoease)

Docusate Sodium (Dulcoease)

Stimulant laxative. Dulcoease 100 mg Capsules. Dosage: Adults and children 12 years and above: Up to maximum of 500 mg should be taken daily in divided doses. Treatment should be commenced with large doses such as 100 mg three times daily, which should be adapted to the treatment response. Dulcoease is not recommended for use in children under the age of 12 years.

HyFiber

HyFiber

Bulk-Forming laxative. Hyfiber is a low volume, liquid fibre supplement-made up of 10.3g from polydextrose and 1.7g from fructooligosaccharides (FOS). Dosage – It is recommended that the addition of Hyfiber to the diet should be gradually increased to meet individual requirements. As a guide: Week 1: Discontinue any other fibre products. Give 1 sachet of Hyfiber (30ml) orally (either neat or mixed into a drink of choice) once per day. Week 2: Discontinue any laxative or stool softeners. Increase dosage of Hyfiber to 1 sachet being given twice per day. Week 3: Maintain dosage of 1 sachet twice per day or decrease to 1 sachet once per day as directed by the health professional. Enteral Tube Feeding – Flush feeding tube. Infuse HyFiber via enteral feeding tube using a syringe. Once infused, flush tube and then continue enteral tube feeding as prescribed.

Ispaghula Husk (Fybogel/Ispogel)

Ispaghula Husk (Fybogel/Ispogel)

Bulk-Forming laxative. Posology-Adults: One sachet, morning and evening. Elderly: There is no indication that dosage needs to be modified for the elderly. Paediatric Population-Children over 12 years: One sachet, morning and evening. Children aged 6 to 12 years: Half to one level 5ml spoonful depending on size and age, morning and evening. Children under 6: The use in children under 6 years of age is not recommended, The effect start 12-24hours later./Each sachet contains 3.5 g ispaghula husk. Excipient with known effect: Also contains 80.00 mg of aspartame (E951) and 68.81 mg of sodium

Lactulose (Duphalac)

Lactulose (Duphalac)

Osmotic laxative. Lactulose 3.335 g/5 ml. Starting dose: Adults and adolescents: 15-45 ml, corresponding to 1-3 sachets, Children (7-14 years old): 15ml, corresponding to 1 sachet, Children (1-6 years old): 5-10ml, infants under 1 year old: up to 5ml. Maintenance dose: Adults and adolescents: 15-30 ml, corresponding to 1-2 sachets, Children (7-14 years): 10-15 ml, corresponding to 1 sachet*, Children (1-6 years): 5-10 ml, Infants under 1 year: up to 5 ml

Linaclotide (Constella)

Linaclotide (Constella)

Chronic Constipation Medication. Each capsule contains 290 micrograms of linaclotide. Dosage for adults- The recommended dose is one capsule (290 micrograms) once daily.

Lubiprostone (Amitiza)

Lubiprostone (Amitiza)

Chronic Constipation Medication. Lubiprostone is a chloride-channel activator that acts locally in the gut to increase intestinal fluid secretion and intestinal motility, resulting in a laxative effect. For Adult 24â¯micrograms twice daily for 2–4 weeks, discontinue if no response after initial 2 weeks.

Macrogol (Movicol)

Macrogol (Movicol)

Osmotic laxative. MOVICOL 13.8g sachet, powder for oral solution, Chronic constipation-A course of treatment for constipation with MOVICOL does not normally exceed 2 weeks, although this can be repeated if required. Adults, adolescents and older people: 1 –3 sachets daily in divided doses, according to individual response. For extended use, the dose can be adjusted down to 1 or 2 sachets daily. Children (below 12 years old): Not recommended. Alternative MOVICOL products are available for children. Faecal impaction-A course of treatment for faecal impaction with MOVICOL does not normally exceed 3 days. Adults, adolescents and older people: 8 sachets daily, all of which should be consumed within a 6 hour period. Children (below 12 years old): Not recommended. Alternative MOVICOL products are available for children. Patients with impaired cardiovascular function: For the treatment of faecal impaction the dose should be divided so that no more than two sachets are taken in any one hour.

Magnesium Salts (Epsom Salts)

Magnesium Salts (Epsom Salts)

Osmotic laxative. Epsom Salts BP- Magnesium Sulfate Heptahydrate BP 100% W/W. Dosage- Orally: Adults and children over 12 years: 5-15g (1 – 3 teaspoons) to be taken as required in 250 ml of water, which may be flavoured with citrus juices. The elderly: To be used with caution, not exceeding the adult dose.

Methylcellulose (Celevac)

Methylcellulose (Celevac)

Bulk-Forming laxative. Methylcellulose is a simple bulking agent which also occurs naturally. The tablets work by absorbing water and increasing in size to make bulk in the stomach or bowels. This action helps to restore normal bowel function in both constipation and diarrhoea. It can also give a feeling of fullness which can help to reduce your appetite for food. Posology-Colostomy and ileostomy control and for simple diarrhoea: 3-6 tablets twice daily with the minimum of liquid. Liquids should be avoided for 30 minutes before and after each dose. Dosage should be adjusted to give stools of the required consistency. Diverticular disease and ulcerative colitis: 3-6 tablets twice daily adjusted according to the degree of constipation (with 300 ml of liquid), diarrhoea (with a little liquid) or spastic pain. Simple constipation: 3-6 tablets twice daily to be taken with at least 300 ml of liquid. The dose may be reduced as normal bowel function is restored. As an aid to appetite control and the treatment of obesity: 3 tablets with at least 300 ml of warm liquid, half an hour before each meal and between meals when hunger pangs are severe. Method of administration-It is recommended that the tablets should be broken in the mouth before swallowing. Celevac Tablets swell in contact with water and should therefore be swallowed carefully. It is not recommended that these tablets be taken before going to bed.

Naloxegol Moventig

Naloxegol Moventig

Chronic Constipation Medication. Moventig 12.5 mg film-coated tablets/ Moventig 25 mg film-coated tablets. Dosage adults- The recommended dose of Moventig is 25 mg once daily.

Prucalapride (Resolor)

Prucalapride (Resolor)

Chronic Constipation Medication. Resolor 1 mg film-coated tablets-Each film-coated tablet contains 1 mg prucalopride (as succinate). Excipients with known effect: Each film-coated tablet contains 142.5 mg lactose (as monohydrate). Posology-Adults: 2 mg once daily with or without food, at any time of the day. Older people (>65 years): Start with 1 mg once daily (see section 5.2); if needed the dose can be increased to 2 mg once daily

Psyllium (Metamucil Fiber Capsules)

Psyllium (Metamucil Fiber Capsules)

Metamucil is the only leading fiber supplement brand with 100% natural psyllium fiber — and that makes all the difference. Bulk-Forming laxative. Metamucil Orange Powder 30 count singles (Sugar and Sugar-Free versions) and the Metamucil Orange 48 dose Powder (Sugar and Sugar-Free versions) Adults 12 yrs. and older: One serving in 8 ounces of liquid at the first sign of irregularity. Can be taken up to 3 times daily. 6–11 yrs.: ½ packet or ½ adult serving size in 8 ounces of liquid, up to 3 times daily For children under 6 yrs. A healthcare provider should be consulted.

Senna (Senokot)

Senna (Senokot)

Stimulant laxative. Each tablet contains powdered Alexandrian Senna fruit (pods) (Cassia senna L. (C. acutifolia Delile)) and Tinnevelly Senna fruit (pods) (Cassia angustifolia Vahl) equivalent to 7.5mg hydroxyanthracene glycosides, calculated as sennoside B. Each tablet also contains 15.82 mg lactose monohydrate

Sodium Citrate (Micralax)

Sodium Citrate (Micralax)

Enema. Micralax Micro-enema. Adults and children aged 3 years and over: Administer the contents of one micro-enema rectally, inserting the full length of the nozzle. No lubricant is needed as a drop of the mixture is sufficient

Sodium Hydrogen Carbonate (Lecicarbon A/Lecicarbon C Suppository)

Sodium Hydrogen Carbonate (Lecicarbon A/Lecicarbon C Suppository)

Suppository for constipation. Lecicarbon A Suppository. Dosage: Adults: Unless otherwise directed, insert one suppository into the rectum when needed. If necessary, this can be repeated after 30 – 60 minutes. Children: Lecicarbon A should not be used in children. Lecicarbon C Suppository. ONLY FOR CHILDREN. Children: Unless otherwise directed, insert one suppository into the rectum when needed. If necessary, this can be repeated after 30 – 60 minutes.

Sodium Picosulphate (Dulcolax Pico)

Sodium Picosulphate (Dulcolax Pico)

Stimulant laxative. Dulcolax® Pico Liquid, 5 mg / 5 ml, oral solution. Dosage: For oral administration. The following dosages are recommended to be taken at night to produce evacuation the following morning. It is recommended to start with the lowest dose. The dose may be adjusted up to the maximum recommended dose to produce regular stools. The maximum recommended daily dose should not be exceeded. Adults and children over 10 years of age: One to two 5 ml spoonfuls (5 - 10 mg) per day. Children under 10 years of age: Not to be taken by children under 10 years of age without medical advice. Children aged 4 - 10 years: Half to one 5 ml spoonful (2.5 - 5 mg) per day. Children under 4 years of age: The recommended dosage is 0.25 mg per kilogram body weight per day (1 ml of Dulcolax Pico Liquid contains 1 mg sodium picosulfate).

Sterculia (Normacol)

Sterculia (Normacol)

Bulk-Forming laxative. The active ingredient is Sterculia BP 62% w/w. Posology Adults: 1 or 2 sachets or 1-2 heaped 5ml spoonfuls, once or twice daily after meals. Older People: As adult dose. Paediatric population Children: (6-12 years): one half the above amount NORMACOL is not recommended for children under 6 years of age