BNF for Children 2011-2012

BNFC 2011–2012 1.6.4 Osmotic laxatives 6389.3 mg, sodium chloride 175.4 mg, potassium chloride25.1 mg/sachet, net price 30-sachet pack = £4.45.Label: 13Cautions with high doses, impaired gag reflex, reflux oesophagitis,impaired consciousnessContra-indications cardiovascular impairment, renal impairment–—noinformation availableDoseChronic constipation, prevention of faecal impaction. By mouthChild under 1 year ½–1 sachet dailyChild 1–6 years 1 sachet daily; adjust dose to produceregular soft stools (max. 4 sachets daily)Child 6–12 years 2 sachets daily; adjust dose to produceregular soft stools (max. 4 sachets daily)Administration Mix content of each sachet in quarter ofa glass (approx. 60–65 mL) of waterFaecal impaction. By mouthChild under 1 year ½–1 sachet dailyChild 1–5 years (treat until impaction resolves) 2sachets on first day, then 4 sachets daily for 2 days, then 6sachets daily for 2 days, then 8 sachets dailyChild 5–12 years (treat until impaction resolves) 4sachets on first day, then increased in steps of 2 sachetsdaily to max. 12 sachets dailyAdministration Mix each sachet in quarter of a glass(approx. 60–65 mL) of water; total daily dose to be takenover a 12-hour periodMAGNESIUM SALTSCautions see also notes above; interactions: Appendix1 (antacids)Contra-indications acute gastro-intestinal conditionsHepatic impairment avoid in hepatic coma if risk ofrenal failureRenal impairment avoid or reduce dose; increasedrisk of toxicitySide-effects colicIndication and doseConstipation see under preparations belowMagnesium hydroxideMagnesium Hydroxide Mixture, BPAqueous suspension containing about 8% hydratedmagnesium oxide. Do not store in cold placeDose. By mouthChild 3–12 years 5–10 mL with water at bedtime whenrequiredChild 12–18 years 30–45 mL with water at bedtimewhen requiredBowel cleansing preparationsSection 1.6.5PHOSPHATES (RECTAL)Cautions see also notes above; with enema, electrolytedisturbances, congestive heart failure, ascites,uncontrolled hypertension, maintain adequate hydrationContra-indications acute gastro-intestinal conditions(including gastro-intestinal obstruction, inflammatorybowel disease, and conditions associated withincreased colonic absorption)Renal impairment use enema with cautionSide-effects local irritation; with enema, electrolytedisturbancesIndication and doseConstipation, bowel evacuation before abdominalradiological procedures, endoscopy, andsurgeryFor dose see preparationsCarbalax c (Chemidex)Suppositories, sodium acid phosphate (anhydrous)1.3 g, sodium bicarbonate 1.08 g, net price 12 = £2.01Dose. By rectumChild 12–18 years 1 suppository, inserted 30 minutesbefore evacuation required; moisten with water beforeuseFleet c Ready-to-use Enema (Casen-Fleet)Enema, sodium acid phosphate 21.4 g, sodium phosphate9.4 g/118 mL, net price 133-mL pack (delivers118 mL dose) with standard tube = 57pDose. By rectumChild 3–7 years 40–60 mL once dailyChild 7–12 years 60–90 mL once dailyChild 12–18 years 90–118 mL once dailyPhosphates Enema BP Formula BEnema, sodium dihydrogen phosphate dihydrate12.8 g, disodium phosphate dodecahydrate 10.24 g,purified water, freshly boiled and cooled, to 128 mL.Net price 128 mL with standard tube = £2.98, withlong rectal tube = £3.98Dose. By rectumChild 3–7 years 45–65 mL once dailyChild 7–12 years 65–100 mL once dailyChild 12–18 years 100–128 mL once dailySODIUM CITRATE (RECTAL)Cautions see notes aboveContra-indications acute gastro-intestinal conditionsIndication and doseConstipation for dose see under preparationsMicolette Micro-enema c (Pinewood)Enema, sodium citrate 450 mg, sodium lauryl sulphoacetate45 mg, glycerol 625 mg, together withcitric acid, potassium sorbate, and sorbitol in a viscoussolution, in 5-mL single-dose disposable packswith nozzle. Net price 5 mL = 38pDose. By rectumChild 3–18 years 5–10 mL as a single doseMicralax Micro-enema c (UCB Pharma)Enema, sodium citrate 450 mg, sodium alkylsulphoacetate45 mg, sorbic acid 5 mg, together withglycerol and sorbitol in a viscous solution in 5-mLsingle-dose disposable packs with nozzle. Net price5 mL = 41pDose. By rectumChild 3–18 years 5 mL as a single dose1 Gastro-intestinal system