Products
Macrogols are commercially available in many countries as powders, granules, and as drinking solutions. The agents are available with or without salts (electrolytes). They have been approved since the 1980s. This article refers to pharmaceuticals. Macrogols such as macrogol 400 are also used as pharmaceutical excipients.
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 (e.g., macrogol 400, macrogol 3350, macrgol 4000, macrogol 6000). The substances are very soluble in water due to their high hydrophilicity. They are ethers.
Effects
Macrogols (ATC A06AD15) have water-binding and laxative properties. They have a high affinity for water due to the numerous polar oxygen atoms, which they bind via H-bridges. A single molecule of PEG 3350 interacts with 100 molecules of water. Macrogols make stool softer and more slippery and increase stool volume. They are neither absorbed nor biotransformed and are excreted unchanged in the stool. Effects occur after about 12 to 48 hours, depending on age, dose, and drug.
Indications
- For symptomatic treatment of constipation.
- For bowel evacuation before diagnostic and surgical procedures.
- To soften the bowel movement, for example, hemorrhoids or an anal fissure.
Dosage
According to the professional information. Dosage depends on the products. The drugs should be administered with an adequate amount of water. Unlike other laxatives, macrogols are gentle on the intestine and can be administered over a long period of time. The effect is dose-dependent.
Active ingredients
- Macrogol 3350
- Macrogol 4000
Macrogol 400 is used as a pharmaceutical excipient.
Contraindications
Contraindications include (selection):
- Hypersensitivity
- Severe inflammatory bowel disease
- Toxic megacolon, symptomatic stenosis
- Perforation or risk of perforation in the digestive tract.
- Intestinal obstruction
- Suspected intestinal obstruction
- Abdominal pain of unknown origin
Full precautions can be found in the drug label.
Interactions
According to the SmPC, there are no known drug-drug interactions. Interactions with digoxin and with hydrocortisone have been described in the scientific literature. Concomitant use reduced the bioavailability of the active ingredients. It is also known from pharmaceutical technology that macrogols are incompatible with a number of active ingredients (e.g., penicillins).
Adverse effects
Possible adverse effects include abdominal pain, bloating, nausea, diarrhea, and vomiting.
