Macrogol 3350

Products

Macrogol 3350 is commercially available as a powder for making an oral solution (e.g., Transipeg, Movicol, generics). It is included in drugs in combination with salts (potassium chloride, sodium chloride, sodium hydrogen sulfate) but can also be administered without them (e.g., Chung et al., 2009). Macrogol 4000 is also commercially available without salts. In 2016, a ready-to-drink solution for oral use was also approved.

Structure and properties

Macrogols are mixtures of linear polymers with the general formula H-(OCH2-CH2)n-OH, indicating the average number of oxyethylene groups. The macrogol type is defined by a number indicating the average molecular mass. Macrogol 3350 is a white, solid, odorless substance with a waxy or paraffin-like appearance. It is very soluble in water due to its high hydrophilicity. This is unlike, for example, some dietary fibers, which are also used as laxatives. Low molecular weight macrogols such as macrogol 400 exist as viscous liquids.

Effects

Macrogol 3350 (ATC A06AD65) has a high affinity for water due to its numerous polar oxygen atoms and binds numerous water molecules. Since it is not absorbed, stool volume increases and macrogol 3350 thus has a laxative effect. It is neither absorbed nor metabolized and, according to the scientific literature, is also well suited for children and more effective than lactulose. The appropriate age limitations in the product information should be considered.

Indications

Macrogol 3350 is approved for the symptomatic treatment of constipation and for bowel evacuation.

Dosage

According to package insert. The drug is dissolved in water.

Contraindications

  • Hypersensitivity
  • Toxic megacolon
  • Inflammatory colonic diseases
  • Intestinal obstruction
  • Lower abdominal pain of unknown origin
  • Intestinal perforation

Full precautions can be found in the drug label.

Interactions

According to the drug label, there are no known interactions. However, according to the literature, interactions cannot be completely ruled out. Interactions of macrogols with digoxin and hydrocortisone have been described.

Adverse effects

Possible adverse effects include diarrhea, nausea, vomiting, lower abdominal pain, and hypersensitivity reactions.