D-Forject por. d/prig. r-ra d/pr. inside in the pack. in pack No. 4 (macro goal)

Instructions for use

Instructions for use of the drug should be studied in detail before starting therapy. this will help avoid the negative consequences of taking a laxative in the form of side effects and overdose.

This rule also applies to Macrogol. It must be taken exclusively according to indications and strictly in recommended dosages.

Indications for use

The use of Macrogol helps to get rid of isolated and chronic constipation in adult patients. Also, this osmotic laxative is often used for lavage - forced bowel movement for medical reasons.

It is recommended to use the drug in the following situations:

• 
  for periodic constipation that occurs due to the presence of certain intestinal diseases, including dysbiosis;

• if necessary, conduct a diagnostic examination of the intestinal lumen using special medical instruments (colonoscopy, gastroscopy);
• if necessary, examine the intestines using X-rays or ultrasound;
• before performing surgery (including minimally invasive) on the intestines or adjacent organs.

Other cases involving difficulties with bowel movements do not fall under direct indications. Before using the product, you should discuss the feasibility of this decision with your doctor.

Mode of application

Macrogol is taken in the form of a solution prepared from 10-20 g of powder and a glass of water . This dosage is designed for one dose, but in general, for total bowel movement you need to drink at least 3 liters of solution (about 15 glasses). This should be done gradually, keeping a break of 15-20 minutes between taking each portion of the product.

It is recommended to take the drug at least 18 hours before diagnosis or surgery. To eliminate constipation, the time of administration can be any, but it should be remembered that food after using a laxative should enter the stomach only in liquid form.

Experts do not recommend using Macrogol for a long time. The maximum period for course admission is 7-10 days. In parallel with the use of the product, it is recommended to adhere to a diet enriched with fiber and liquid (up to 2 liters per day).

Release form, composition

The drug Maclogol contains a synthetic compound of the same name, which is a powder of PET microspheres, which, when entering the digestive tract, cause swelling of its contents and the release of bound liquid from the feces. This is what contributes to the rapid and painless removal of intestinal contents from the body.

The main feature of macrogol is inertia . This chemical changes the structure of chyme and feces, but does not affect its chemical parameters at all. Thanks to this effect, there is no formation of gases in the intestines or spasms of certain areas of the small and large intestines.

Each Macrogol sachet contains 10 g of white powder. One package of laxative can consist of 4, 12 or 24 sachets.

Interaction with other drugs

Macrogol does not react with other chemical compounds, however, due to stimulation of the onset of stool, a decrease in the effectiveness of the latter may occur.
To eliminate this effect, it is recommended to maintain an interval of 1.5-2 hours between taking Macrogol and other medications, and if you need to constantly take a laxative, reconsider the dosage (only in consultation with your doctor!).

Macrogol

Macrogol

(lat.
Macrogol
) - a laxative drug.
Another common name is macrogol
. From a chemistry perspective, the names “macrogol” and “polyethylene glycol” are synonyms. Polyethylene glycol, a polymer of ethylene glycol, is a high molecular weight substance that is a long linear polymer with the empirical formula C2nH4n+2On+1. Polyhydric alcohol. A number is sometimes added to the name of this polymer indicating its molecular weight. Thus, macrogol-4000, widespread in medicine, has a molecular weight of 4000.

Macrogol is the international nonproprietary name (INN) of the drug. According to the pharmacological index, macrogol belongs to the group “Laxatives”. According to ATC, it belongs to the group “Osmotic laxatives” and has code A06AD15. Macrogol forms hydrogen bonds with water molecules in the intestinal lumen, increases the fluid content in the chyme, stimulates mechanoreceptors, and improves intestinal motility. Macrogol increases the volume of chyme and prevents the loss of electrolytes in feces. As a result, the evacuation reflex is restored and defecation is normalized. Macrogol is not absorbed, not metabolized, and does not change the acidity of chyme.

Indications for use of macrolog

• symptomatic treatment of constipation in adults
• for bowel cleansing before colonoscopy, x-ray examinations or surgery

Method of administration of macrogol and dose

Macrogol is taken orally in a dose of 10-20 g once a day, in the morning, before or during meals.
Before use, dissolve the powder at the rate of 10 g per glass of water. The effect of macrogol begins a day or two after taking the drug. Unlike most laxative drugs, when taking laxatives with an osmotic effect: macrogol and lactulose, there is no irritation of the chemoreceptors of the mucous membrane and no damage to it, even with prolonged use of the drugs. The high effectiveness of macrogol and lactulose and the absence of serious adverse reactions make these drugs the most preferred laxatives,

used in the treatment of chronic constipation. Several randomized placebo-controlled studies have shown that macrogol is practically free of toxic and side effects and is highly effective in the treatment of constipation (Roitberg G.E., Strutynsky A.V. Internal diseases. Digestive system. M.: MEDpress- inform, 2007).

Osmotic laxatives based on macrogol and lactulose are considered second-line drugs for the treatment of constipation of any type. Macrogol and lactulose are recommended when non-medicinal methods and dietary fiber are ineffective (Shulpekova Yu.O.).

In the treatment of chronic constipation in elderly and senile patients, lactitol has higher clinical efficacy, fewer side effects and a faster response to therapy compared to macrogol. This is due to the more pronounced effect of the latter on the motor activity of the colon, which is confirmed by electrogastroenterography data, as well as the normalization of the disturbed intestinal ecosystem, which was expressed by more significant changes in the concentration and qualitative composition of short-chain fatty acids, which are metabolites of the obligate microflora of the colon (Minushkin O.N. . and etc.).

The use of macrogol before colonoscopy, X-ray examinations and surgical interventions on the intestine

Macrogol 4000, due to its high molecular weight, is not absorbed from the gastrointestinal tract and is not metabolized, prevents the absorption of water from the stomach and intestines and promotes accelerated evacuation of intestinal contents.
The use of a solution with macrogol 4000 is much more effective than using the standard method: the descending colon, sigmoid and rectum are cleansed significantly better. Examination of the mucous membrane of the entire colon using macrogol 4000 was possible in 75% of patients, and with preparation using the standard method only in 20%. The average time required for a physician to examine the bowel was 24 minutes when using macrogol 4000 solution, and 35 minutes when preparing using the standard method. Although patients generally tolerated Macrogol 4000 well, the salty taste of the solution caused some to limit their fluid intake. To eliminate this drawback, the drug Fortrans was developed, the active ingredient of which is also macrogol. One sachet of Fortrans (containing 64 g of macrogol) is dissolved in 1 liter of water. The dose of the drug is set at the rate of 1 liter of solution per 15–20 kg of the patient’s body weight. The solution is taken 200 ml every 20 minutes in the evening before the procedure. Or 2 liters in the afternoon the day before and 1 liter in the morning on the day of the study. To prepare patients with severe heart failure and erosive and ulcerative lesions of the intestines, for whom the intake of such volumes of liquid is unacceptable, Forlax is used, containing in one sachet 10 g of macrogol 4000, which is dissolved in 250 ml of water and taken either 2 sachets per day in the morning at meal times during the three days preceding the procedure, or 2 sachets in the morning and evening. During this time, the proximal parts of the intestine are gradually released. To cleanse the distal sections, one small cleansing enema is given in the morning on the day of the study (Golysheva S.V., Grigorieva G.A. Macrogol preparations in preparing patients for colonoscopy and surgical interventions. Diseases of the digestive organs No. 2, 2004). See also the article: “Preparation of the colon for instrumental studies.”

Professional medical publications addressing the effects of macrogol (polyethylene glycol) on the gastrointestinal tract and its use in clinical practice

• Matsukatova B.O., Erdes S.I. Experience with the use of osmotic laxatives in the treatment of constipation in children // Questions of Dietetics. 2015. T. 5. No. 2. pp. 5–20.
• Erdes S.I., Matsukatova B.O., Revyakina S.A., Kasanave E.V. The effectiveness of osmotic laxative polyethylene glycol 4000 in the treatment of constipation in children // RZHGGK. - 2011. - T.21. — No. 6. — P.23-32.
• Samedov B.Kh. Recommendations for the use of espumizan during endoscopic examinations of the gastrointestinal tract and transendoscopic manipulations // North-West Bulletin of Endoscopy. – 2003.
• Pasechnikov V.D. Functional constipation caused by slow transit of intestinal contents // Farmateka. – 2003. – No. 10. – p. 16–23.
• Minushkin O.N., Ardatskaya M.D., Voskoboynikova I.V., Kolkhir V.K. Analysis of the clinical effectiveness of the drugs Exportal and Forlax // RZHGGK. - 2010. - T.20. - No. 5. - Adj. No. 36. — P.118.
• Shulpekova Yu.O. Constipation and methods of its treatment // Breast cancer. Diseases of the digestive system. – 2006. – Volume 8. – No. 2. – pp. 90–96.
• Description of the drug for patients (UK, pdf): “Macrogol Grapefruit Flavor, 10 g powder for oral solution. Macrogol Lemon Flavor, 10 g powder for oral solution. Package Leafleat. Information for the User"

On the website gastroscan.ru in the literature catalog there is a section “Laxatives”, containing medical articles relating to laxatives and their use.

Contraindications to the use of macrogol

• inflammatory diseases and ulcerative lesions of the colon mucosa, ulcerative colitis, Crohn's disease
• partial or complete intestinal obstruction
• abdominal pain of unknown origin
• hypersensitivity to polyethylene glycol

Long-term use of macrogol is not recommended without consulting a doctor.

Macrogol during pregnancy and breastfeeding.

Macrogol can be prescribed during pregnancy and breastfeeding.

Macrogol overdose

Due to the lack of systemic absorption, overdose is unlikely.

Interaction of macrolog with other drugs

The absorption of drugs taken simultaneously with macrogol may slow down, so macrogol is taken no earlier than 2 hours after taking other drugs.

Brand names of drugs containing macrogol

Medicines with the only active substance macrogol:
Lavacol, Osmogol, Realaxan, Tranzipeg, Forlax, Forteza Rompharm, Fortrans.

Macrogol in combination with other active ingredients:

• macrogol + potassium iodide + sodium chloride, brand Polyoxidin (belongs to the ATC group B05AA “Plasma replacement drugs and plasma protein fractions”)
• macrogol + sodium chloride + sodium bicarbonate, potassium chloride, trademark Endofalk (ATC code A06AD65 “Macrogol in combination with other drugs”)

Macrogol
is also used
in the pharmaceutical industry
in the production of various drugs as an excipient (the most commonly used is Macrogol 6000). For example, it is found in the enteric and film-coated preparations Ganaton, Bifiform, Festal, Omez, Sanpraz, Lanzoptol, Itomed, Emanera, Livodex, Festal N, Razo, in Gaviscon, De-Nol tablets, as well as in the vitamin and mineral complexes Complivit and others.

By order of the Government of the Russian Federation of December 30, 2009 No. 2135-r, macrogol (powder for the preparation of solution for oral administration) is included in the List of vital and essential medicines.

Macrogol has contraindications, application features and side effects. Before using macrogol, you should consult your doctor.

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Side effects

Among the side effects that occur while taking Macrogol, the official instructions mention:

• slight discomfort in the abdomen in the form of a feeling of intestinal fullness and mild aching pain;
• the occurrence of diarrhea;
• allergic reactions in the form of skin rashes (only in case of individual intolerance to the components of the drug).

In most cases, if adverse events develop, discontinuation of the drug is not required.

The only exception is allergies. In case of diarrhea, it is recommended to stop taking it for 1 or 2 days, after which you can resume it, but in smaller doses.

Contraindications

Contraindications to the use of the Macrogol laxative are:

• severe abdominal pain of unknown origin;
• intestinal obstruction (complete or partial);
• ulcerative lesions of the mucous membranes of the gastrointestinal tract.

It is not recommended to take Macrogol for children under 15 years of age, as well as for persons suffering from severe dehydration.

During pregnancy

When pregnant, Macrogol is prescribed if necessary. During breastfeeding, laxatives are also taken according to the indications of the attending physician.

In general, the drug is safe for the fetus , as it is not absorbed into the bloodstream. It does not pass into breast milk either.

pharmachologic effect

The presence of several active substances provides several therapeutic effects at once:

• anti-inflammatory;
• antiallergic;
• antipruritic;
• antibacterial.

In addition, when applied topically, betamethasone dipropionate constricts blood vessels. The cream also has a softening and cooling effect, which helps soothe affected skin and reduce inflammation.

Gentamicin is bactericidal. This aminoglycoside antibiotic is active against many gram-negative bacteria and gram-positive microorganisms, including those resistant to other antibiotics. It provides topical treatment for primary and secondary bacterial skin infections.

Price

The cost of Macrogol depends on which pharmacy chain sells the medicine.

On average, the minimum and maximum prices for a package of 4 bags may differ by 90-100 rubles in Russia and 50-65 hryvnia in Ukraine.

Average price in Russia

The average price of Macrogol in Russia is about 280 rubles per pack of 10 sachets.

Average price in Ukraine

In Ukraine, the laxative Macrogol can be purchased for 178-190 hryvnia per package containing 12 packets of the drug.

Directions for use and dosage

The treatment regimen and dose are selected by a specialist individually for each patient, taking into account the severity of the disease, clinical picture and physiological characteristics. The instructions provide the standard procedure and application mode. Adults should apply a small amount of the product to the affected areas of the skin in a circular motion, rubbing lightly. The recommended frequency of application is 2 times a day - morning and evening. In mild cases, single use is possible. The duration of treatment depends on the effectiveness and tolerability of therapy and is usually no more than 2-4 weeks.

Analogs

Pharmacy chains sell many structural analogues of Macrogol, which contain the same active ingredient:

• Lavacol;
• Realaxan;
• Transipeg;
• Forlax;
• Fortrans;
• Osmogol.

Unlike Macrogol, they add flavorings and sweeteners, which make taking laxatives more pleasant.

However, such additives in most cases affect the cost of drugs, making them inaccessible to some segments of the population.

Video on the topic: Examination of the large intestine

Composition of the drug

A long-lasting therapeutic effect from the use of the cream was achieved due to the unique combined composition of Akriderm GENTA. The drug delivers a powerful blow to the source of inflammation with two active substances at once - betamethasone dipropionate (0.064 g) and gentamicin sulfate (0.1 g). The first component is a glucocorticosteroid, the second is an antibiotic of the aminoglycoside group. It is thanks to them that the product can significantly improve the condition of the skin.

Akriderm GENTA cream is most effective in the fight against acute inflammation, as it is quickly absorbed due to the increased concentration of purified water in the composition of the drug. It also contains excipients:

• methyl parahydroxybenzoate;
• propylene glycol;
• liquid paraffin;
• macrogol cetostearate;
• cetostearyl alcohol;
• disodium edetate;
• sodium hydrogen phosphate dodecahydrate;
• potassium dihydrogen phosphate.

Thanks to its thoughtful composition, Akriderm GENTA is easy to use and suitable for wet and thin areas of the skin.