Experiences with

Macrogol

Macrogol (or macrogols) is a laxative taken to treat constipation (difficulty pooing).

You can also use it to help clear a build-up of hard poo in your bowel, which can happen if you've been constipated for a long time (faecal impaction).

It can also be given before a colonoscopy (a test to check inside your bowels) to empty your bowels before the test.

Macrogol comes as sachets of powder that you mix with water to make a drink, a ready-mixed liquid to drink, or a liquid that you dilute before drinking.

It's available on prescription and to buy from pharmacies.

Children under 12 years can only take certain brands of macrogol and it must be prescribed for them. Brands prescribed for children include CosmoCol Paediatric and Movicol Paediatric.

Who can take macrogol

Most adults and children aged 12 years and over, including pregnant and breastfeeding women, can take macrogol.

Babies and children under 12 years old can take macrogol with a prescription from a doctor.

Who may not be able to take macrogol

Macrogol is not suitable for some people. To make sure it's safe for you, tell a doctor or pharmacist if you:

• have ever had an allergic reaction to macrogol or any other medicine
• have had a hole or breakage (perforation) in the wall of your intestine
• have ever had a blockage in your intestines or paralysis of the intestine (for example because of intestinal surgery or severe infection)
• have ulcerative colitis, Crohn's disease or a rare condition called toxic megacolon
• need to add thickeners to liquids to help you swallow them
• are being treated for heart failure or an irregular heartbeat – if you are, never take more than 2 full-strength sachets or 4 half-strength sachets in any 1-hour period. Speak to a doctor about how much you can safely take
• have been told you need to follow a low-salt (or low-sodium) diet (especially if you need 3 or more sachets a day for a long time)

Most types of macrogol contain a lot of sodium (sodium is also found in table and cooking salt). Each dose can contain around 10% of your recommended daily amount of sodium.

Do not give macrogol to a child under 12 years old unless a doctor has prescribed it.

Dosage

The amount of macrogol you take depends on how bad your constipation is. Ask a pharmacist for advice if you're not sure.

The usual dose for constipation for adults and children aged 12 years and over is:

• full-strength powder sachets (contains around 13g of macrogol) – 1 sachet, taken 1 to 3 times a day
• half-strength powder sachets (contains around 6g of macrogol) – 1 sachet, taken 2 to 6 times a day in divided doses
• ready-to-drink solution – 1 sachet, taken 1 to 3 times a day
• liquid – 25ml diluted in 100ml of water, taken 1 to 3 times a day

The usual dose of sachets for constipation for children aged under 12 years (paediatric sachets) is:

• 6 to 11 years – 1 sachet, taken twice a day (up to 4 times if recommended by a doctor)
• 12 months to 5 years – 1 sachet a day (up to 4 times a day if recommended by a doctor)
• 1 to 11 months – half to 1 sachet a day

Children under 12 do not need to take all of the drink at one time. They can take half in the morning and half in the evening.

Dosage for faecal impaction

A doctor will tell you if you have faecal impaction and they will advise you on how much macrogol to take.

The usual dose for faecal impaction for adults and children aged 12 years and over is:

• full-strength powder sachets (contains around 13g of macrogol) – 4 sachets on the first day, then increase by 2 sachets a day, to a maximum of 8 sachets a day, taken in divided doses
• half-strength powder sachets (contains around 6g of macrogol) – 8 sachets on the first day, then increase by 4 sachets a day, up to a maximum of 16 sachets a day, taken in divided doses

The usual dose of sachets for faecal impaction for children (paediatric sachets) is:

• 5 to 11 years – 4 sachets on the first day, then increase by 2 sachets a day to a maximum of 12 sachets a day, taken in divided doses
• 12 months to 4 years – 2 sachets on the first day, then 4 sachets a day for 2 days, then 6 sachets a day for 2 days, then 8 sachets a day
• 1 to 11 months – half to 1 sachet once a day

Only give macrogol paediatric sachets to children under 12 years old if a doctor has prescribed it.

How you take macrogol depends on what type you're taking. If you're not sure which type of macrogol you have and how to take it, read the information in the packet or speak to a pharmacist.

You can take macrogol with or without food.

Ready-to-drink sachets

Drink the contents straight from the packet.

Powder sachets

Dissolve each sachet in 125ml (one-quarter of a pint) of water, or 62.5ml (one-eighth of a pint) of water if you're giving paediatric sachets to a child. Stir well, then drink.

These are usually flavoured, but if you or your child do not like the flavour, you can add fruit squash to the drink and the medicine will still work properly.

Never swallow the powder without water. If you have severe faecal impaction, it's important to drink extra fluids (water if possible) every day as well as your usual amount.

It's also important with faecal impaction for you (or a child aged 12 years or older) to drink the daily dose within a 6-hour period. If your child is under 12 years old, make sure they drink the full daily dose within 12 hours.

Liquid (in a bottle)

You need to dilute the liquid before drinking it.

Open the bottle and measure 25ml (or five 5ml spoonfuls). If you do not have a 5ml medicine spoon, ask a pharmacist for one. Do not use a kitchen teaspoon as it will not measure the right amount.

Pour this into half a glass of water (100ml). Stir well until all the liquid has been evenly mixed and it looks clear, then drink it.

Make sure you or your child finish the whole drink. You can drink it in one go or sip it over 30 minutes. It might help to use a straw. You can make the mixture in advance if you need to take it to work or school.

How long to take it for

You can take macrogol for as long as the constipation lasts, or for as long as a doctor has recommended. This will usually be for up to 2 weeks.

Usually, it's best to only take macrogol when you have constipation. You can stop taking it for short-term constipation if you're going to the toilet as normal.

However, a doctor may recommend taking it for many months if you or your child have serious constipation or take medicines that cause constipation.

For long-term treatment, the dose can usually be lowered to either 1 or 2 sachets a day.

For faecal impaction, you'll usually only need to take macrogol for up to 3 days, but you may be given a lower dose to take for a little longer.

If you forget to take it

If you forget a dose of macrogol, just skip the missed dose and take the next dose at the usual time.

Never take 2 doses at the same time. Never take an extra dose to make up for a forgotten one.

If a doctor has told you to take macrogol every day and you often forget doses, it may help to set an alarm to remind you. You could also ask a pharmacist for advice on other ways to help you remember to take your medicine.

If you take too much

Taking an extra dose of macrogol is unlikely to harm you. You may get diarrhoea and stomach pain but this should ease within a day or two. If it does not, stop taking macrogol and wait for the diarrhoea and stomach pain to pass.

If you're worried, talk to a doctor or pharmacist for advice.

Common side effects

These common side effects of macrogol happen in more than 1 in 100 people. There are things you can do to help cope with them:

These side effects usually get better if you reduce the amount of macrogol or after you have had a poo. Talk to a doctor or pharmacist if the side effects bother you or do not go away.

Serious side effects

Call a doctor or call 111 straight away if you get any of these rare but serious side effects:

• severe diarrhoea or vomiting
• feeling more tired than usual
• shortness of breath
• swollen ankles, feet or legs (oedema)
• muscle weakness
• irregular heartbeat

These side effects might mean that there have been changes in the electrolytes in your blood. A doctor can check this with an electrolyte test.

Serious allergic reaction

In rare cases, it's possible to have a serious allergic reaction (anaphylaxis) to macrogol.

These are not all the side effects of macrogol. For a full list see the leaflet inside your medicines packet.

Macrogol and pregnancy

Macrogol can be taken during pregnancy. Constipation is more common at the end of pregnancy and just after having a baby.

If you're pregnant, your doctor or midwife may advise you to first try to treat constipation without taking a medicine.

You can do this by eating more fibre (like potatoes, high-fibre cereals, wholemeal bread, brown rice or wholewheat pasta, fruit and vegetables) and drinking plenty of fluids. You'll also be encouraged to do gentle exercise.

If dietary and lifestyle changes do not work, your doctor or midwife may recommend a laxative such as macrogol.

Macrogol and breastfeeding

It is always better to treat constipation without taking a medicine first. If diet and lifestyle changes do not work, your doctor or midwife may recommend a laxative.

You can take macrogol while breastfeeding. It does not pass into breast milk so it's very unlikely to cause any side effects in your baby.

If you have any concerns about your baby, talk to your health visitor, midwife, pharmacist or doctor.

Macrogol and fertility

There's no good evidence to suggest that taking macrogol reduces fertility in either men or women.

Cautions with other medicines

Some medicines, such as epilepsy medicines like levetiracetam or phenytoin, may not work as well if you take macrogol at the same time.

Check with your pharmacist or doctor if you're taking epilepsy medicines.

Taking macrogol with other laxatives

For most people, 1 laxative will be enough to relieve constipation.

Occasionally, you may need to take 2 different types of laxatives at the same time to get your bowels moving again.

Only take 2 laxatives together if a doctor recommends it as there's more risk of getting side effects.

Mixing macrogol with herbal remedies and supplements

There's not enough information to say that complementary medicines, herbal remedies and supplements are safe to take with macrogol. They're not tested in the same way as pharmacy and prescription medicines. They're generally not tested for the effect they have on other medicines.

Related links

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