Hydrocil Instant


psyllium

Fiberall, Fibrelief (UK), Fibro-Lax, Fibro-XL, Fybogel (UK), Hydrocil Instant, Isogel (UK), Ispagel (UK), Karacil (CA), Konsyl, Metamucil, Metamucil Orange Flavor, Metamucil Sugar Free, Modane Bulk, Natural Fiber Therapy, Prodiem Plain (CA), Regulan (UK), Reguloid, Reguloid Sugar Free

Pharmacologic class: Psyllium colloid

Therapeutic class: Bulk-forming laxative

Pregnancy risk category B

Action

Stimulates lining of colon, increasing peristalsis and water absorption of stool and promoting evacuation

Availability

Chewable pieces: 1.7 g/piece, 3.4 g/piece

Granules: 2.5 g/tsp, 4.03 g/tsp

Powder: 3.3 g/tsp, 3.4 g/tsp, 3.5 g/tsp, 4.94 g/tsp

Powder (effervescent): 3.4 g/packet, 3.7 g/packet

Wafers: 3.4 g/2 wafers

Indications and dosages

Chronic constipation; ulcerative colitis; irritable bowel syndrome

Adults and children ages 12 and older: 30 g daily in divided doses of 2.5 to 7.5 g/dose P.O. in 8 oz of water or juice

Contraindications

• Hypersensitivity to drug

• Intestinal obstruction

• Abdominal pain or other appendicitis symptoms

• Fecal impaction

Precautions

Use cautiously in:

• phenylketonuria

• pregnant patients.

Administration

• Mix powder with 8 oz of cold liquid (such as orange juice) to mask taste.

• Give diluted drug immediately after mixing, before it congeals. Follow with another glass of fluid.

Adverse reactions

GI: nausea; vomiting; diarrhea (with excessive use); abdominal cramps with severe constipation; anorexia; esophageal, gastric, small-intestine, or rectal obstruction (with dry form)

Respiratory: asthma (rare)

Other: severe allergic reactions including anaphylaxis

Interactions

None significant

Patient monitoring

• Monitor patient's bowel movements.

• Check for signs and symptoms of severe (but rare) allergic reactions, such as anaphylaxis and asthma.

Patient teaching

• Tell patient to dissolve in 8 oz of cold beverage and drink immediately, followed by another glass of liquid.

• Caution patient not to take without dissolving in liquid.

• Instruct patient to take after meals if drug decreases his appetite.

• Tell patient drug usually causes bowel movement within 12 to 24 hours but may take as long as 3 days.

See Instruct patient to immediately stop taking drug and notify prescriber if signs and symptoms of allergic reaction occur.

• Advise diabetic patient to use sugar-free drug form.

• Instruct patient with phenylketonuria to avoid forms containing phenylalanine.

• As appropriate, review all other significant and life-threatening adverse reactions.