Gastrointestinal tract Prontolax 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 Prontolax the afternoon before, followed by 2 liters of polyethylene glycol solution the next morning). Two hours after taking Prontolax, 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 Prontolax followed by 2 liters of polyethylene glycol, he again reported pain and slight rectal bleeding after taking Prontolax. 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.
Getting the most from your treatment
- Do not take indigestion remedies at the same time as Prontolax tablets. This is because Prontolax tablets have a special coating on them which is affected by antacid preparations. If you need to take something for indigestion, make sure you take it more than two hours before you take Prontolax, or alternatively wait for two hours after you have taken Prontolax.
- A healthy diet containing fibre (whole grain breads and cereals, bran, fruit and green leafy vegetables) with six to eight full glasses of water each day and daily exercise are important in maintaining healthy bowel function. For people who have problems with constipation, food such as pastries, puddings, sugar, sweets, cheese and cake can make matters worse.
- You can read more about how to prevent or treat constipation in the separate leaflets called Constipation (for adults) and Constipation in Children.
How long does it take for Prontolax to work?
Prontolax tablet taken by mouth normally causes a bowel movement within 6 to 12 hours. If you do not have a regular bowel movement after taking Prontolax, do not take any more medication and talk to your doctor.
Prontolax suppositories take 10 to 45 minutes to work, so it’s best to stay close to a toilet.
Prontolax tablets bowel prep kit is contraindicated in the following conditions:
- Known allergies to polyethylene glycol or other components of the kit
- Gastrointestinal (GI) obstruction
- Bowel perforation
- Toxic colitis
- Toxic megacolon
For Healthcare Professionals
Applies to Prontolax: compounding powder, oral delayed release tablet, rectal enema, rectal suppository
How to cope with side effects
What to do about:
- feeling sick – try taking Prontolax with some food.
- diarrhea – stop taking Prontolax 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) Prontolax 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) Prontolax tablets bowel prep kit. Less than 1% of patients exposed to HalfLytely and 10 mg Prontolax tablets bowel prep kit reported vomiting and abdominal pain/cramping. The data in reflects exposure in 222 patients to HalfLytely and 10 mg Prontolax tablets vs. 223 patients exposed to HalfLytely and 20 mg Prontolax tablets. The HalfLytely and 10 mg Prontolax 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 Prontolax 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 Prontolax suppositories may resemble those seen in mild idiopathic ulcerative proctitis.
Prontolax 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) .
REPRESENTATIVE TRADE NAMES
Prontolax – Generic, Dulcolax®
Product labeling at DailyMed, National Library of Medicine, NIH
What Is Dulcolax Laxative?
Prontolax is a laxative that stimulates bowel movements.
Prontolax is used to treat constipation or to empty the bowels before surgery, colonoscopy, x-rays, or other intestinal medical procedure.
Prontolax may also be used for purposes not listed in this medication guide.
Follow all directions on your medicine label and package. Tell each of your healthcare providers about all your medical conditions, allergies, and all medicines you use.
You should not use Prontolax if you are allergic to it, or if you have:
- stomach pain, nausea, or vomiting.
Ask a doctor or pharmacist if it is safe for you to use this medicine if you have other medical conditions, especially:
- a sudden change in bowel habits lasting 2 weeks or longer;
- hemorrhoids or anal fissures (small tears in the skin tissues around your rectum);
- ulcerative colitis, inflammatory bowel disease, or other intestinal disorder;
- a history of perforation (a hole or tear) of your intestines;
- an eating disorder (anorexia or bulimia); or
- (for Prontolax tablets) if you cannot swallow without chewing.
Older adults should not use rectal Prontolax without a doctor's advice.
It is not known whether Prontolax will harm an unborn baby. Do not use this medicine without a doctor's advice if you are pregnant.
It is not known whether Prontolax passes into breast milk or if it could harm a nursing baby. Do not use this medicine without a doctor's advice if you are breast-feeding a baby.
Do not give this medicine to a child younger than 2 years old without the advice of a doctor.
Prontolax (bis ak’ oh dil) is a mild laxative that is available over-the-counter and is commonly used to treat mild constipation and bowel irregularity. Prontolax is believed to act by direct stimulation of intestinal peristalsis. Prontolax is a diphenylmethane derivative and is structurally similar to phenolphthalein. It is administered in an enteric coated form and is minimally absorbed, acting locally on the large intestine. Prontolax has been in general use since the 1950s and is available in multiple forms including tablets of 5 mg, suppositories of 10 mg and as a liquid solution for oral use generically and under multiple trade names such as Dulcolax, Fleet’s enema, Correctal and Carter’s Little Pills. Prontolax is often used for bowel cleansing before operations or colonoscopy. Common side effects include abdominal pain, bloating and diarrhea.
What should I do if I forget a dose?
This medication usually is taken as needed. If your doctor has told you to take Prontolax regularly, take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.
I just found out I am pregnant. Should I stop taking Prontolax?
Always talk with your healthcare provider before making any changes in your medications. It is important to consider the benefits of treating constipation symptoms during pregnancy.
Constipation may cause pain and other health problems in pregnancy such as cramps, hemorrhoids, and breakdown of the anal tissue. Treating constipation will help reduce the risk of these problems. Dietary changes such as increasing fluids, eating high fiber foods such as whole grains and fresh fruits and vegetables can help prevent constipation. Regular exercise can also help. Although occasional constipation is common in pregnancy, talk with your healthcare provider if constipation becomes an ongoing problem. Your healthcare provider may also want to confirm the diagnosis of constipation and see how dietary and exercise changes can help before discussing medical treatment.
Prontolax is a contact irritant to the colonic mucosa, which consequently produces peristalsis throughout the colon.
This medication contains Prontolax. Do not take Dulcolax, Correctol, BisacEvac, Bisacolax, Codulax, Alophen, Feen A Mint, Fleet Stimulant Laxative, Laxit, Modane, or Dulcolax for Women if you are allergic to Prontolax or any ingredients contained in this drug.
This medication contains Prontolax. Do not take BACiiM if you are allergic to Prontolax or any ingredients contained in this drug.
Keep out of reach of children. In case of overdose, get medical help or contact a Poison Control Center immediately.