II. Indications
III. Contraindications
IV. Mechanism
- Poorly absorbed, hyperosmolar agent
V. Medications
- Polyethylene Glycol 3350 (PEG, Miralax, Restoralax, GaviLax, GlycoLax)
- Available as 17 grams per capful or scoop
- Indicated for Constipation and available OTC
- No salty taste
- Polyethylene Glycol with Electrolytes (GoLytely, Colyte, NuLytely, Plenvu, MoviPrep)
- Indicated for Colonoscopy Preparation and requires prescription
- See Colonoscopy Bowel Preparation for dosing protocols
VI. Dosing: Polyethylene Glycol 3350 (PEG, Miralax)
- See Colonoscopy Bowel Preparation for dosing protocols
- Onset of action with 24-48 hours
- Preparation of Liquid 17 g in 8 ounces
- Use PEG powder 17 grams (one capful)
- Dissolve in 240 ml (8 ounces) water or juice
- May chill PEG solution or mix with flavoring (e.g. Crystal Light) to improve taste
- If for Colonoscopy prep, avoid colored flavoring that might interfere with visibility
- Individual Serving Dosing added to liquid (round to closest measurable dose)
- One quarter capful contains 4 g
- One heaping teaspoon contains 5.5 g
- One half capful contains 8.5 g
- Two heaping teaspoons contain 11 g
- Three quarters capful contains 13 g
- One capful contains 17 g
- Disimpaction Dose
- Use for 1 to 3 days until soft stool output
- Adult: 17 grams (1 capful or scoop) in 8 oz orally daily
- Child (over age 6 months)
- Start 1 to 1.5 g/kg/day (15 ml/kg/day) orally in liquid divided twice daily
- Adjust dose for two soft, painless stools per day
- Taper dose over time (see maintenance dosing below)
- Maintenance Dose
- Avoid daily use beyond 14 days
- Adult: 8.5 to 17 grams (1/2 to 1 capful) orally daily
- Child: 0.2 to to 0.8 g/kg/day (up to 1 g/kg/day)
VII. Efficacy
- Safe, well tolerated and effective for Constipation
- More effective and better tolerated than Lactulose
VIII. Adverse Effects
- Abdominal Pain
- Flatulence
- Neurotoxicity (case reports)
- In 2017, studies initiated to determine if young children absorb Ethylene Glycol with neurotoxicity based on case reports
- Rare case reports of tics, Tremors, OCD behavior
- No evidence at this point that this is a significant concern
- (2017) Presc Lett 24(4): 23
IX. Safety
- Appears safe in children and adults
- Pregnancy Category C
- Unknown Safety in Lactation (but not absorbed)
X. Resources
- Polyethylene Glycol 3350 (DailyMed)
XI. References
- (2023) Management of Constipation, Presc Lett, #390108
- Hamilton (2020) Tarascon Pocket Pharmacopoeia
- Gremse (2002) Clin Pediatr 41:225-9 [PubMed]
- Pashankar (2003) Arch Pediatr Adolesc Med 157:661-4 [PubMed]
- Voskuijl (2004) Gut 53:1590-4 [PubMed]
Images: Related links to external sites (from Bing)
Related Studies
| polyethylene glycol (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| POLYETHYLENE GLYCOL 3350 POWD | Generic OTC | $0.02 per gram |
| peg (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| PEG 3350-ELECTROLYTE SOLUTION | Generic | $0.01 per ml |
| PEG-3350 AND ELECTROLYTES SOLN | Generic | $0.01 per ml |
| PEG3350-SOD SUL-NACL-KCL-ASCB-C 100-7.5-2.691-1.015-5.9-4.7G | Generic | $76.45 each |