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polyethylene glycol and electrolytes (GoLytely, MiraLax, Glycolax, GoEvac, CoLav, CoLyte, NuLYTELY, polyethylene glycol electrolyte soln, polyethylene glycol powder, TriLyte)

 

Classes: Laxatives, Osmotic

Dosing and uses of GoLytely, MiraLax (polyethylene glycol)

 

Adult dosage forms and strengths

Polyethylene glycol (PEG) content

powder for oral solution

  • 17g/packet
  • 119g
  • 238g
  • 255g
  • 510g
  • 527g
  • 850g

 

Bowel Preparation

17 g (~1 heaping tbsp) in 8 oz of clear liquid PO q10min until 2 L has been consumed or rectal effluent is clear

NG: 20-30 mL/min

 

Constipation

17 g in 4-8 oz water PO once daily for ≤1 week

 

Administration

Refrigerate before administering to improve palatability

Have patient fast 3-4 hr before administering PEg

Encourage rapid drinking of each portion

MiraLax: Bottle top is measuring cup marked to contain 17 g

Advise patients to hydrate adequately before, during, and after use

 

Pediatric dosage forms and strengths

PEG content

powder for oral solution

  • 17g/packet
  • 119g
  • 238g
  • 255g
  • 510g
  • 527g
  • 850g

 

Bowel Preparation

25-40 mL/kg/hr PO for 4-10 hr until rectal effluent is clear; total dose not to exceed 2 L

 

Constipation

<6 months: Safety and efficacy not established

≥6 months: 0.5-1.5 g/kg PO once daily for no longer than 2 weeks; adjusted to effect; not to exceed 17 g/day

 

GoLytely, MiraLax (polyethylene glycol) adverse (side) effects

Frequency not defined

Abdominal bloating

Abdominal cramping

Abdominal distention

Colonic mucosal aphthous ulcerations

Diarrhea

Flatulence

Ischemic colitis

Nausea

 

Warnings

Contraindications

Hypersensitivity

 

Cautions

Osmotic laxative products may produce colonic mucosal aphthous ulcerations, including reports of more serious cases of ischemic colitis necessitating hospitalization

Avoid use in patients with bowel obstruction, megacolon, perforated bowel, ulcerative colitis, toxic colitis, gastric retention

Not indicated for children <2 years because of risk of hypoglycemia, dehydration, and hypokalemia

When using PEG as laxative, do not give for >1 week

Electrolyte imbalance reported with prolonged use

Risk of fluid and electrolyte abnormalities, arrhythmias, seizures, and renal impairment

Use with caution in renal insufficiency; ensure adequate hydration, and consider laboratory testing

Directly observe administration to patients at risk for aspiration

Products are not for direct ingestion but require dilution with water

 

Pregnancy and lactation

Pregnancy category: C

Lactation: No data available

 

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 GoLytely, MiraLax (polyethylene glycol)

Mechanism of action

Osmotic laxative; causes water retention in stool, causing increase in stool frequency

 

Absorption

Not absorbed

Bioavailability: 0.2%

Onset: 24-96 hr

 

Elimination

Excretion: Feces (93%), urine (0.2%)