psyllium (Fiberall, Metamucil, Perdiem Fiber)
Classes: Laxatives, Bulk-Producing; Gastrointestinal, Herbals
Dosing and uses of Fiberall, Metamucil (psyllium)
Constipation
2.5-7.5 g in 8 oz of water PO, up to 30 g/d divided PO or
1 teaspoonful or 1 tbs in 8 oz of water PO qD-TID, depending on product
Other Indications & Uses
Off-label: IBS, hypercholesterolemia
Pediatric dosage forms and strengths
Constipation
<6 years old: Safety & efficacy not established
6-12 years old: 1.25-15 g/day PO in 8 oz of water in divided doses
>12 years old: 2.5-7.5 g in 8 oz of water PO, up to 30 g/day in divided doses
Fiberall, Metamucil (psyllium) adverse (side) effects
1-10%
Abdominal cramping
Constipation
Flatulence
Frequency not defined
Impaction
Warnings
Contraindications
Hypersensitivity, GI obstruction, fecal impaction, symptoms of appendicitis or acute surgical abdomen, GI ulceration, dysphagia, rectal bleeding
Cautions
Powder should be mixed in 8oz of water or juice
Pts with phenylketonuria as sugar free products contain phenylalanine
Pregnancy and lactation
Pregnancy category: B
Lactation: no data available; not absorbed, therefore it is unlikely to pose the risk in breast-feeding
Pregnancy categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA: Information not available.
Pharmacology of Fiberall, Metamucil (psyllium)
Onset: 12-72 hr
Metabolism: not absorbed from GI tract
Mechanism of action
Bulk-producing laxative
