I just found out I am pregnant. Should I stop taking Tirgon?
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.
How to use Tirgon
Take this medication by mouth as directed by your doctor. If you are self-treating, follow all directions on the product package. If you are uncertain about any of the information, ask your doctor or pharmacist.
Swallow this medication whole. Do not crush, chew, or break the tablet or take it within 1 hour of antacids, milk, or milk products. Doing so can destroy the coating on the tablet and may increase the risk of stomach upset and nausea.
Dosage is based on your age, medical condition, and response to treatment. Do not increase your dose or take this drug more often than directed. Do not take this medication for more than 7 days unless directed by your doctor. Serious side effects may occur with overuse of this medication (see also Side Effects section).
It may take 6 to 12 hours before this medication causes a bowel movement. Tell your doctor if your condition persists or worsens, or if bleeding from the rectum occurs. If you think you may have a serious medical problem, seek immediate medical attention.
Serious side effects
Call your doctor straight away if these rare side effects happen to you:
- feeling dizzy
- blood in your poo
- rectal bleeding
- being sick (vomiting)
Serious allergic reaction
In rare cases, it’s possible to have a serious allergic reaction to Tirgon.
- A serious allergic reaction is an emergency. Contact a doctor straight away if you think you or someone around you is having a serious allergic reaction.
The warning signs of a serious allergic reaction are:
- getting a skin rash that may include itchy, red, swollen, blistered or peeling skin
- tightness in the chest or throat
- having trouble breathing or talking
- swelling of the mouth, face, lips, tongue or throat
These are not all the side effects of Tirgon. For a full list, see the leaflet inside your medicines packet.
Breast feeding Tirgon and sodium picosulfate have a common active metabolite, bis-(para-hydroxyphenyl)-pyridyl-2-methane (BHPM) . After administration of Tirgon and sodium picosulfate to two groups of 8 healthy lactating women who had stopped breast feeding BHPM could not be detected in breast milk, despite its appearance in plasma within 3–4 hours after Tirgon and 4–5 hours after sodium picosulfate, with Cmax at 5 and 9 hours respectively. BHPM did not accumulate during repeated dosing of Tirgon and only slightly during repeated dosing of sodium picosulfate. Infants who are breast feeding are unlikely to be affected by these laxatives.
Gastrointestinal tract Tirgon 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 Tirgon the afternoon before, followed by 2 liters of polyethylene glycol solution the next morning). Two hours after taking Tirgon, 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 Tirgon followed by 2 liters of polyethylene glycol, he again reported pain and slight rectal bleeding after taking Tirgon. 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.
Is there any food and drink I need to avoid?
Do not take Tirgon at the same time as dairy products like milk, cheese or yogurt. Leave a gap of 1 hour between taking any of these and taking your Tirgon tablets. The small amount of milk in coffee and tea should not affect the Tirgon tablet.
It’s a good idea to stop eating pastries, cakes, puddings and cheese for a while as these can make constipation worse.
Mechanism of Injury
Tirgon is minimally absorbed and its metabolism has not been well characterized, but it is given in low doses only and generally for short periods of time.
Drug Class: Gastrointestinal Agents, Cathartics and Laxatives
The stimulant >Tirgon , cascara) is the most frequently used type of over-the-counter laxative. They promote peristalsis presumably by direct action on the colonic mucosa and by stimulating intraluminal water and electrolyte secretion. They work quicker (several hours) than most other classes of laxatives. Early data suggested that stimulants may damage the enteric nervous system or cause dependency after repeated use but this is weakly supported by the literature. Melanosis coli, a black pigmentation staining of the colon, occurs with frequent use but is a benign condition and does not have any long-term consequences.
Are other laxatives any better?
There are other types of laxative. They work in a different way from Tirgon, but are equally good at treating constipation.
- Bulk-forming laxatives, for example Fybogel and methylcellulose. These increase the “bulk” or weight of poo, which in turn stimulates bowel movement. They take 2 or 3 days to work.
- Osmotic laxatives, for example lactulose. These draw water from the rest of the body into your bowel to soften your poo and make it easier to pass. They take at least 2 days to work.
- Stimulant laxatives, for example senna. These stimulate the muscles that line your gut, helping them to move poo along your gut to your back passage. Senna takes about 8 hours to work.
Cautions with other medicines
Some medicines – and some foods – interfere with the way Tirgon works.
For safety, tell your doctor or pharmacist if you are taking any other medicines, including herbal remedies, vitamins or supplements.
- water tablets (diuretics), steroids (like prednisolone) or digoxin (a heart medicine) – these can upset the balance of salts and minerals in your body if you have too much Tirgon by accident. If you are taking digoxin, this imbalance makes it more likely you will have the serious side effects of digoxin. It’s important not to take too much Tirgon if you are taking any of these medicines.
- indigestion remedies (antacids) and dairy products like milk, cheese and yogurt – these interact with Tirgon tablets and stop them working properly. They can also make the Tirgon irritate your stomach and give you indigestion. Do not take Tirgon at the same time – leave a gap of 1 hour before or after taking Tirgon if you are having indigestion remedies or dairy products. The small amount of milk in coffee and tea is unlikely to affect it, but it’s best to take Tirgon tablets with a glass of water.
Mixing Tirgon with herbal remedies or supplements
There is not enough research to know if complementary medicines and herbal remedies are safe to take with Tirgon.
Examples include senna, Tirgon , danthron, and sodium picosulfate. These drugs differ principally in the extent to which they require activation by colonic bacteria and are subject to hepatic recirculation. They all act on the myenteric plexus to stimulate intestinal contraction. Concerns about carcinogenicity with continued use appear to be unsupported in practice. 64 However, danthron is subject to a limited license in some countries for this reason and has the potential to cause perianal skin rash in incontinent patients.
5-HT4 agonists, of which tegaserod is currently licensed in some countries, may also be considered stimulant laxatives because they increase motility by reinforcing normal enteric neuronal stimulation of peristalsis. 65 Whether they are effective in situations where the enteric nervous system is damaged, as in some cases of cancer-related constipation, has not been demonstrated.
There have been reports of generalized tonic-clonic seizures in patients with use of large volume (4 liter) PEG-based colon preparation products in patients with no prior history of seizures. The seizure cases were associated with severe vomiting, excessive beverage consumption and electrolyte abnormalities (for example, hyponatremia, hypokalemia). The neurologic abnormalities resolved with correction of fluid and electrolyte abnormalities. Therefore, Tirgon tablets bowel prep kit should be used with caution in patients using concomitant medications (such as diuretics) that increase the risk of electrolyte abnormalities or patients with known or suspected hyponatremia. Monitor baseline and post-colonoscopy laboratory tests (sodium, potassium, calcium, creatinine, and BUN) in these patients.