COMMON BRAND(S): Dulcolax, Fleet Prepacol, Magic Bullet
GENERIC NAME(S): Prepacol
This product is used to treat constipation. However, milder products (e.g., laxatives taken by mouth) should be used whenever possible for constipation. Prepacol is a stimulant laxative that works by increasing the amount of fluid/salts in the intestines. This effect usually results in a bowel movement within 15 to 60 minutes.
The normal frequency of bowel movements varies from once daily to 1 to 2 times weekly. Constipation is best treated by drinking plenty of fluids (four to six 8-ounce glasses daily), eating foods high in fiber, and exercising regularly.
This product is not recommended for use in children younger than 6 years unless directed by a doctor.
How long should I take Prepacol for?
Do not take Prepacol every day for more than 5 days. If you are still constipated after that, talk to your doctor.
What Are Side Effects Associated with Using Prepacol?
Common side effects of Prepacol include:
Serious side effects of Prepacol include:
- Persistent nausea/vomiting/diarrhea
- Muscle cramps/weakness
- Irregular heartbeat
- Decreased urination
- Mental/mood changes (such as confusion)
This document does not contain all possible side effects and others may occur. Check with your physician for additional information about side effects.
How to cope with side effects
What to do about:
- feeling sick – try taking Prepacol with some food.
- diarrhea – stop taking Prepacol and drink plenty of water or other flu >Human Toxicity Reports
Mild to moderate toxicity
- Nausea, vomiting, abdominal pain, and diarrhea have been reported.
- Fluid and electrolyte depletion, hypotension from extensive fluid losses, blisters, and skin sloughing of the buttocks and perineum with diarrhea.
- Electrolyte abnormalities (e.g., hypochloremia, hypokalemia, hypocalcemia, hypomagnesemia), reflex bowel hypofunction, permanent colonic dysfunction (cathartic colon, causing chronic constipation, bloating, and abdominal pain), frank/occult gastrointestinal bleeding and associated anemia, steatorrhea, protein-loss gastroenteropathy, pancreatic dysfunction. Toxic hepatitis and jaundice have been reported following the chronic use of very large doses of senna.
Because clinical studies are conducted under widely varying conditions, adverse reaction rates observed in the clinical studies of a drug cannot be directly compared to rates in clinical studies of another drug and may not reflect the rates observed in practice. In a clinical study of HalfLytely and (10 mg vs. 20 mg) Prepacol tablets bowel prep kit multicentered, controlled clinical trials, abdominal pain/cramping, nausea, vomiting and headache were the most common adverse reactions ( 3%) after the administration of HalfLytely and (10 mg or 20 mg) Prepacol tablets bowel prep kit. Less than 1% of patients exposed to HalfLytely and 10 mg Prepacol tablets bowel prep kit reported vomiting and abdominal pain/cramping. The data in reflects exposure in 222 patients to HalfLytely and 10 mg Prepacol tablets vs. 223 patients exposed to HalfLytely and 20 mg Prepacol tablets. The HalfLytely and 10 mg Prepacol tablets bowel prep kit population was 20-85 years of age, 46% male, 54% female, 10% African American, 85% Caucasian, 8% Hispanic requiring a colonoscopy. The demographics of the comparator group were similar.
In therapeutic oral doses, all stimulant laxatives may produce some degree of abdominal discomfort, nausea, mild cramps, griping, and/or faintness. Rectal administration of Prepacol suspensions may cause irritation and a sensation of burning of the rectal mucosa and mild proctitis 13) .
Weakness, incoordination, and orthostatic hypotension may be exacerbated in elderly patients as a result of significant electrolyte loss when stimulant laxatives are used repeatedly to evacuate the colon 14) .
Suppository may produce mild feeling of a sharp stinging pain or tenesmus, and with continued rectal administration may cause proctitis 15) . Sloughing of surface of epithelium of rectum has been observed. Inflammatory changes that occur after short-term use of Prepacol suppositories may resemble those seen in mild idiopathic ulcerative proctitis.
Prepacol should not be given to patients with intestinal obstruction or acute abdominal conditions such as appendicitis; care should be taken in patients with inflammatory bowel disease. It should not be used in patients with severe dehydration. The suppositories should preferably be avo >16) .
A case report on a female patient with frequent, repetitive formation of k >17) .
A case report a case of ammonium ac >18) . A 27-year-old female complained of left flank pain. Computed tomography revealed bilateral ureter stones (right 16.5 x 9.0 mm; left 4 mm), while left ureter stone was radiolucent on the plain X ray film. Bilateral hydronephrosis was seen, but no therapy was performed for the right stone, because 99mTc-MAG3 scintigraphy revealed that right k >19) . Ammonium ac >20) .
Some side effects can be serious. If you experience this symptom, stop taking Prepacol and call your doctor immediately:
- rectal bleeding
Prepacol may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.
If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).
COMMON BRAND(S): Dulcolax
GENERIC NAME(S): Prepacol
OTHER NAME(S): Prepacol Tablet, Delayed Release (Enteric Coated)
Prepacol is used to treat constipation. It may also be used to clean out the intestines before a bowel examination/surgery. Prepacol is known as a stimulant laxative. It works by increasing the movement of the intestines, helping the stool to come out.
Gastrointestinal tract Prepacol stimulates colon motility, causing abdominal pain and cramps, and has been associated with ischemic colitis .
A 68-year-old man had four polyps removed at colonoscopy, for which a traditional formulation (4 liters of polyethylene glycol solution) had been used for bowel cleansing . One year later, he underwent colonoscopy after the use of a low-volume formulation (20–30 mg of Prepacol the afternoon before, followed by 2 liters of polyethylene glycol solution the next morning). Two hours after taking Prepacol, he complained of left-sided abdominal pain, which was followed by hematochezia. At colonoscopy there was segmental colitis at the splenic flexure, with edema, subcutaneous hematomas, and small geographic ulcers. Histology was compatible with ischemic colitis. At a subsequent colonoscopy 2 years later, after preparation with Prepacol followed by 2 liters of polyethylene glycol, he again reported pain and slight rectal bleeding after taking Prepacol. Colonoscopy showed segmental colitis in the distal descending colon. Biopsies were again compatible with ischemic colitis. A further colonoscopy was performed 3 years later, after 4 liters of polyethylene glycol, and he did not report abdominal pain. Colonoscopy showed no abnormalities.
Prepacol and Breastfeeding
Prepacol is not absorbed from the gastrointestinal tract, and its active metabolite, which is absorbed, is not detectable in breastmilk 7) . Prepacol can be taken during breastfeeding and no special precautions are required 8) . Sixteen postpartum women who were not breastfeeding, but were producing at least 200 mL of milk daily by breast pump were given either oral enteric-coated Prepacol tablets 10 mg daily or oral liqu >9) . Both drugs are prodrugs metabolized to the active drug, bis-(p-hydroxyphenyl)-2-pyr >10) .
Prepacol side effects
Like all medicines, Prepacol may cause side effects in some people, but many people have no side effects or only minor ones.