III. Contraindications

IV. Mechanism

  1. Poorly absorbed, hyperosmolar agent

V. Medications

  1. Polyethylene Glycol 3350 (PEG, Miralax, Restoralax, GaviLax, GlycoLax)
    1. Available as 17 grams per capful or scoop
    2. Indicated for Constipation and available OTC
    3. No salty taste
  2. Polyethylene Glycol with Electrolytes (GoLytely, Colyte, NuLytely, Plenvu, MoviPrep)
    1. Indicated for Colonoscopy Preparation and requires prescription
    2. See Colonoscopy Bowel Preparation for dosing protocols

VI. Dosing: Polyethylene Glycol 3350 (PEG, Miralax)

  1. See Colonoscopy Bowel Preparation for dosing protocols
  2. Onset of action with 24-48 hours
  3. Preparation of Liquid 17 g in 8 ounces
    1. Use PEG powder 17 grams (one capful)
    2. Dissolve in 240 ml (8 ounces) water or juice
    3. May chill PEG solution or mix with flavoring (e.g. Crystal Light) to improve taste
      1. If for Colonoscopy prep, avoid colored flavoring that might interfere with visibility
  4. Individual Serving Dosing added to liquid (round to closest measurable dose)
    1. One quarter capful contains 4 g
    2. One heaping teaspoon contains 5.5 g
    3. One half capful contains 8.5 g
    4. Two heaping teaspoons contain 11 g
    5. Three quarters capful contains 13 g
    6. One capful contains 17 g
  5. Disimpaction Dose
    1. Use for 1 to 3 days until soft stool output
    2. Adult: 17 grams (1 capful or scoop) in 8 oz orally daily
    3. Child (over age 6 months)
      1. Start 1 to 1.5 g/kg/day (15 ml/kg/day) orally in liquid divided twice daily
      2. Adjust dose for two soft, painless stools per day
      3. Taper dose over time (see maintenance dosing below)
  6. Maintenance Dose
    1. Avoid daily use beyond 14 days
    2. Adult: 8.5 to 17 grams (1/2 to 1 capful) orally daily
    3. Child: 0.2 to to 0.8 g/kg/day (up to 1 g/kg/day)

VII. Efficacy

  1. Safe, well tolerated and effective for Constipation
  2. More effective and better tolerated than Lactulose

VIII. Adverse Effects

  1. Abdominal Pain
  2. Flatulence
  3. Neurotoxicity (case reports)
    1. In 2017, studies initiated to determine if young children absorb Ethylene Glycol with neurotoxicity based on case reports
    2. Rare case reports of tics, Tremors, OCD behavior
    3. No evidence at this point that this is a significant concern
    4. (2017) Presc Lett 24(4): 23

IX. Safety

  1. Appears safe in children and adults
  2. Pregnancy Category C
  3. Unknown Safety in Lactation (but not absorbed)

XI. References

Images: Related links to external sites (from Bing)

Related Studies

Cost: Medications

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