BNF for Children 2011-2012

62 1.6.4 Osmotic laxatives BNFC 2011–20121 Gastro-intestinal systemLicensed use not licensed for use in children forhepatic encephalopathyIndication and doseConstipation (may take up to 48 hours to act). By mouthChild 1 month–1 year 2.5 mL twice daily,adjusted according to responseChild 1–5 years 2.5–10 mL twice daily, adjustedaccording to responseChild 5–18 years 5–20 mL twice daily, adjustedaccording to responseHepatic encephalopathy. By mouthChild 12–18 years 30–50 mL 3 times daily; adjustdose to produce 2–3 soft stools per dayLactulose (Non-proprietary)Solution, lactulose 3.1–3.7 g/5 mL with other ketoses.Net price 300-mL pack = £2.10, 500-mL pack = £2.59Brands include Duphalac c D, Lactugal c , Regulose cMACROGOLS(Polyethylene glycols)Cautions discontinue if symptoms of fluid andelectrolyte disturbance; see also preparations belowContra-indications intestinal perforation or obstruction,paralytic ileus, severe inflammatory conditionsof the intestinal tract (such as Crohn’s disease, ulcerativecolitis, and toxic megacolon); see also preparationsbelowPregnancy manufacturers advise use only if essential—noinformation availableBreast-feeding manufacturers advise use only ifessential—no information availableSide-effects abdominal distension and pain, nausea,flatulenceLicensed use Movicol c Paediatric Plain notlicensed for use in faecal impaction in childrenunder 5 years, or for chronic constipation in childrenunder 2 yearsIndication and doseSee under preparations belowMacrogol Oral Powder, Compound (Non-proprietary)Oral powder, macrogol ‘3350’ (polyethylene glycol‘3350’) 13.125 g, sodium bicarbonate 178.5 mg, sodiumchloride 350.7 mg, potassium chloride 46.6 mg/sachet, net price 20-sachet pack = £4.45, 30-sachetpack = £6.68. Label: 13Brands include Laxido c Orange, Molaxole cCautions patients with cardiovascular impairment should nottake more than 2 sachets in any 1 hourDoseChronic constipation. By mouthChild 12–18 years 1–3 sachets daily in divided dosesusually for up to 2 weeks; maintenance, 1–2 sachets dailyAdministration Mix contents of each sachet in half aglass (approx. 125 mL) of waterFaecal impaction. By mouthChild 12–18 years 4 sachets on first day, then increasedin steps of 2 sachets daily to max. 8 sachets daily; totaldaily dose to be drunk within a 6 hour periodAdministration Mix contents of 2 sachets in a glass(approx. 250 mL) of water. After reconstitution the solutionshould be kept in a refrigerator and discarded ifunused after 6 hoursMovicol c (Norgine)Oral powder, macrogol ‘3350’ (polyethylene glycol‘3350’) 13.125 g, sodium bicarbonate 178.5 mg, sodiumchloride 350.7 mg, potassium chloride 46.6 mg/sachet, net price 20-sachet pack (lime- and lemonflavoured)= £4.45, 30-sachet pack (lime- and lemonorchocolate- or plain- flavoured) = £6.68, 50-sachetpack (lime- and lemon- or plain- flavoured) = £11.13.Label: 13Note Amount of potassium chloride varies according toflavour of Movicol c as follows: plain-flavour (sugar-free) =50.2 mg/sachet; lime and lemon flavour = 46.6 mg/sachet;chocolate flavour = 31.7 mg/sachet. 1 sachet when reconstitutedwith 125 mL water provides K + 5.4 mmol/litreCautions patients with cardiovascular impairment should nottake more than 2 sachets in any 1 hourDoseChronic constipation. By mouthChild 12–18 years 1–3 sachets daily in divided dosesusually for up to 2 weeks; maintenance, 1–2 sachets dailyAdministration Mix contents of each sachet in half aglass (approx. 125 mL) of waterFaecal impaction. By mouthChild 12–18 years 4 sachets on first day, then increasedin steps of 2 sachets daily to max. 8 sachets daily; totaldaily dose to be drunk within a 6 hour periodAdministration Mix contents of 2 sachets in a glass(approx. 250 mL) of water. After reconstitution the solutionshould be kept in a refrigerator and discarded ifunused after 6 hoursMovicol c -Half (Norgine)Oral powder, sugar-free, macrogol ‘3350’ (polyethyleneglycol ‘3350’) 6.563 g, sodium bicarbonate89.3 mg, sodium chloride 175.4 mg, potassium chloride23.3 mg/sachet, net price 20-sachet pack (limeand lemon flavour) = £2.67, 30-sachet pack = £4.01.Label: 13Cautions patients with impaired cardiovascular function shouldnot take more than 4 sachets in any 1 hourDoseChronic constipation. By mouthChild 12–18 years 2–6 sachets daily in divided dosesusually for up to 2 weeks; maintenance, 2–4 sachets dailyAdministration Mix contents of each sachet in quarter ofa glass (approx. 60–65 mL) of waterFaecal impaction. By mouthChild 12–18 years 8 sachets on first day, then increasedin steps of 4 sachets daily to max. 16 sachets daily; totaldaily dose to be drunk within 6 hoursAdministration Mix contents of 4 sachets in a glass(approx. 250 mL) of water. After reconstitution the solutionshould be kept in a refrigerator and discarded ifunused after 6 hoursMovicol c Paediatric Plain (Norgine) AOral powder, sugar-free, macrogol ‘3350’ (polyethyleneglycol ‘3350’) 6.563 g, sodium bicarbonate