the whole list
The presence of contraindications should be checked with a doctor.
If the preparation is carried out using the drug “Fortrans”, there is no need for cleansing enemas. 2 days before the colonoscopy, you need to switch to a special (slag-free) diet, excluding vegetables and fruits, potatoes, herbs, berries, mushrooms, legumes, and black bread from the diet. Allowed: broth, semolina porridge, egg, boiled meat, boiled sausage, fish, cheese, butter, fermented milk products, except cottage cheese.
It is advisable to start taking the Fortrans solution no earlier than 2 hours after eating. For effective preparation, you need to purchase 3 or 4 packages of the drug at the pharmacy. Four packages must be purchased for those patients who have a large body size, constipation, adhesive disease of the abdominal cavity, previously identified lengthening or prolapse of the colon (during the passage of barium through the intestines, irrigation or colonoscopy).
If the colonoscopy is planned from 8:00 to 14:00
On the eve of the study, you can have a light lunch, no later than 13:00, and it is better not to have dinner. Dissolve the contents of each Fortrans package in 1 liter of high-quality drinking water at room temperature. From 15:00 to 19:00 on the eve of the study, you need to drink 3-4 liters of Fortrans solution, no more than ¼ cup. If you try to drink it quickly, the cleansing of the intestines will be incomplete (the solution will come out quickly and will not have time to mix sufficiently with the contents of the intestines).
With rapid use, there is also a high probability of side effects in the form of nausea and vomiting. To make it easier to tolerate the taste of Fortrans, it is better to eat it with lemon, orange or any fruit (preferably sour), but without seeds, which may remain in the intestines. If necessary, lemon juice can be added to the solution to improve the taste. People who are sensitive to taking large volumes of liquid (nausea, belching, etc.) are recommended to take 1 tablet of Motilium 1 hour before the start of preparation.
Approximately 1.5–2 hours after taking the first liter of Fortrans solution, loose stools will appear, which is a natural consequence of taking this drug. Liquid stool will periodically appear several more times until approximately 21:00 - 22:00. After this, as a rule, the urge stops, and the preparation is considered complete.
You must appear for the examination on an empty stomach at the appointed time (as an exception, you can take 200–300 ml of water or tea in the morning, but no later than 2 hours before the examination, if anesthesia is not planned).
Fortrans 64 g (73.69 g) N4 powder for solution
Latin name
Fortrans
Release form
Powder for solution for oral administration
Compound
1 sachet contains:
Active substance: macrogol 4000;
Excipients: sodium chloride - 1.46 g; potassium chloride - 0.75 g; sodium bicarbonate - 1.68 g; sodium sulfate anhydrous - 5.7 g; sodium saccharinate - 0.1 g.
Package
4 bags of 64 g.
pharmachologic effect
Fortrans is a laxative.
Pharmacodynamics
The high-molecular compound macrogol 4000 is a linear polymer that holds water molecules through hydrogen bonds. Due to this, the osmotic pressure and the volume of intestinal contents increase.
The electrolytes contained in the drug prevent disruption of the water-electrolyte balance in the body.
Macrogol 4000 is not absorbed into the gastrointestinal tract and is not metabolized.
Indications
Cleansing the colon in preparation of the patient for the following procedures: endoscopic or x-ray examination of the colon; surgical interventions requiring the absence of contents in the colon.
Contraindications
- hypersensitivity to polyethylene glycol, since there are reports of very rare allergic reactions (rash, swelling, in isolated cases - anaphylactic shock) to taking drugs containing polyethylene glycol;
- the patient’s serious condition (for example, dehydration or severe heart failure);
- the presence of a malignant tumor or other disease of the colon, accompanied by extensive damage to the intestinal mucosa;
- complete or partial intestinal obstruction;
- age up to 15 years (due to lack of clinical data).
Use during pregnancy and breastfeeding
Currently, there is insufficient data to assess the effect of macrogol 4000 on the occurrence of fetal malformations when using the drug in pregnant women.
Therefore, Macrogol 4000 can be used in pregnant women only if necessary.
Since macrogol 4000 is not absorbed from the gastrointestinal tract, Fortrans® can be used during breastfeeding.
Directions for use and doses
Inside.
The drug can only be used in adult patients (over 15 years of age).
The contents of one sachet should be dissolved in 1 liter of water and stirred until completely dissolved.
The solution should be taken in a dosage equal to 1 liter per 15–20 kg of body weight, which approximately corresponds to 3–4 liters.
The solution can be taken once (4 liters in the evening, on the eve of the examination or operation) or divided into 2 doses (2 liters the night before and 2 liters in the morning); Taking the drug must be completed 3-4 hours before the procedure.
Side effects
Nausea and vomiting have been reported at the beginning of taking the drug, which ceased with continued use.
Possible bloating.
Very rare cases of allergic skin reactions such as rash and swelling have been reported. Isolated cases of anaphylactic shock have also been reported.
special instructions
Elderly people with poor health should use the drug only under medical supervision.
Drug interactions
Diarrhea caused by the use of Fortrans may impair the absorption of other medications taken at the same time.
Overdose
There is no data on an overdose of the drug Fortrans®.
Storage conditions
Store at a temperature no higher than 25oC, out of the reach of children!
Best before date
5 years.
If the colonoscopy is planned from 14:00 to 19:00
On the eve of the study, you can have breakfast, lunch and even a light dinner, but the last meal should be no later than 18:00. It is not recommended to drink carbonated drinks. Dissolve the contents of each Fortrans package in 1 liter of boiled water at room temperature. From 20:00 to 22:00 on the eve of the study, you need to drink 2 liters of solution; over 1 hour, gradually, no more than ¼ cup, drink 1 liter of solution. This is important because if you try to drink it quickly, the cleansing of the intestines will be incomplete (the solution will come out quickly and will not have time to mix sufficiently with the contents of the intestines).
Approximately 1.5–2 hours after taking the first liter of solution, loose stools will appear, which is a natural consequence of taking this drug. Loose stools will periodically repeat several more times until approximately 24:00. After this, as a rule, the urge to bottom stops, and the first stage of preparation is considered complete. Before going to bed the night before, as well as at 7:00 on the day of the study, you can drink up to 300–400 ml of still water or weak tea. On the day of the study, the second stage of preparation is carried out - taking two liters of Fortrans solution from 8:00 to 10:00. After this, there will be loose stools several times again, which, as a rule, stops by 13:00. If the drug is poorly tolerated the day before, it is permissible to replace the solution taken on the day of the study with two cleansing enemas with a volume of 1.5–2.0 liters each at 8:00 and 10:00. Appear for the examination on an empty stomach at the appointed time (as an exception, you can take 200–300 ml of water or tea, but no later than 2 hours before the examination, if anesthesia is not planned).
Important!
There is no need to fast the night before or the day of the test. You can drink broth, tea, still mineral water, juice. In the days of preparation for a colonoscopy, it is possible and even necessary to take the medications you need, with the exception of iron supplements and activated carbon. When preparing patients with diabetes, consultation with a doctor is necessary.
General rules for using Fortrans
The drug can be taken orally by adults and children over 15 years of age. Fortrans should be taken no earlier than two hours after meals.
The dosage of Fortrans is calculated individually depending on body weight, and is rounded up to the whole sachet. The dose is calculated based on the ratio of 1 sachet per 15–20 kg of weight.
For example, a person weighs 70 kg, which means that he will need 70 kg / 15 kg = 4.67 sachets or 70 kg / 20 kg = 3.5 sachets to perform intestinal lavage. In both cases, the result is a fractional number that must be rounded up to a whole number. That is, 4.67 is rounded up and you get 5 bags. And 3.5 is rounded up to whole numbers and you get 4 bags. This means that for a person weighing 70 kg, 4–5 sachets of Fortrans are needed to carry out the lavage procedure.
How many specific sachets should be used for the procedure is determined by the doctor who prescribed Fortrans. However, at present, most often the calculation is based on the ratio of 1 sachet for every 20 kg of body weight. Practitioners have found that the ratio of 1 sachet per 20 kg of weight is subjectively better tolerated, but provides the same effect as 1 sachet per 15 kg of weight. Therefore, the patient is offered the lowest effective dosage.
Having calculated the required number of bags, it is necessary to prepare clean, boiled water in sufficient quantity. For 1 sachet of Fortrans powder you will need 1 liter of water. All powder should be dissolved in the required amount of water, for example, 2 sachets in two liters of water, 3 sachets in 3 liters, etc. To avoid confusion, it is recommended to dissolve each packet of powder in a separate jar or any other container.
The entire prepared solution should be taken at one time. However, this does not mean that you need to drink all 3 - 4 liters of solution in one go. It is recommended to pour the solution into a glass and drink it in small sips. Drink the next glass in 5 – 10 minutes, etc. Thus, taking breaks between glasses of the solution for 10 - 20 minutes, you need to drink the entire prepared volume of Fortrans. On average, this can take from 2 to 4 hours. The intake rate of Fortrans should be approximately 1 liter per hour.
If it is not possible to drink the entire solution at one time, then you can divide it into two equal portions, one taken in the evening and the second in the morning. For example, drink 2 liters in the evening, and another 2 liters in the morning of the next day.
Since the solution can cause a gag reflex due to a subjectively unpleasant taste, it is recommended to drink it in quick small sips without holding it in the mouth. And immediately after the last sip from the next glass, it is recommended to put a piece of lemon in your mouth or take a sip of lemon juice, which will immediately relieve the gag reflex and eliminate nausea.
Since after the last dose of Fortrans, defecation may continue for another 2 to 3 hours, it is recommended to calculate the time of use of the drug. It is best to take Fortrans in the evening, on the eve of the upcoming examination in the morning. If the study will be carried out in the afternoon or evening, then you can drink Fortrans in the morning, but the last glass should be taken 3 - 4 hours before the procedure.
Stool begins to be released approximately 1.5 - 2 hours after the first glass of Fortrans. At this point, the entire volume of the solution may not have been drunk yet. In this case, you should continue to drink the Fortrans solution in glasses until the entire prepared volume has been taken. Doctors usually recommend taking another glass of Fortrans after each bowel movement.
An overdose of Fortrans is impossible, since the drug is not absorbed into the bloodstream and is excreted unchanged. When Fortrans is taken simultaneously with other medicinal substances, their effect is significantly weakened.
Fortrans – preparation for colonoscopy or irrigoscopy
Proctologists, radiologists and endoscopists believe that it is better to cleanse the intestines with Fortrans not on the eve of the upcoming procedure, but directly on the day on which it is planned. However, to do this you will have to get up early in the morning, at about 5:00, if the procedure is scheduled for 10:00. So, the evening before irrigoscopy and colonoscopy, you should prepare the required amount of water, bags of Fortrans powder and lemons. In the morning, you need to dilute the powder in water and drink the solution within 2 - 3 hours - from approximately 5-00 to 8-00 am. It is recommended to drink one glass of the solution every 5 to 15 minutes.
The first portion of stool will be released 1 - 2 hours after starting to take Fortrans, and will end 2 - 3 hours after taking the last glass of the laxative drug. 4 hours after taking the last glass of Fortrans, you can perform irrigoscopy or colonoscopy.
However, if the irrigoscopy or colonoscopy procedure is scheduled for earlier hours, for example, at 7-00, 8-00 or 9-00 in the morning, then it is recommended to cleanse the intestines with Fortrans the night before. In this case, it is optimal to start taking Fortrans at 17:00 or 18:00 in the evening and finish by 20:00 or 21:00.
How long does it take for Fortrans to work?
The first portion of stool is released 1 to 2 hours after taking the first glass of Fortrans solution. That is, we can say that the drug begins to act 1 – 2 hours after administration.
Duration of action of Fortrans
After taking the last glass of Fortrans solution, stool excretion may continue for 2 to 4 hours, depending on the individual characteristics of the human body. This means that in total Fortrans lasts approximately 6 – 8 hours, depending on the amount of solution drunk.
