Description

Simple

A chemical used in various types of medications to help pass stool and prepare the intestine for medical tests like colonoscopies.

Clinical

A laxative used to treat constipation and used for bowel preparation before colonoscopies and other procedures.

Overview

Polyethylene glycol (PEG) is a synthetic polymer produced via polymerization of ethylene oxide molecules to make joining units of ethylene glycol by an ether linkage.[2,3] PEGs are water-soluble polymers that can form hydrogen bonds in a ratio of 100 water molecules per one PEG molecule.[2] Molecular weights of PEGs vary by time of the polymerization process and the molecular weight represents the weighted average of the individual PEG molecules. PEGs differ in their physical and chemical properties depending on their molecular weight: PEGs are liquids when molecular weights are <1000 and the molecule turns to waxy solids with i... Read more

Pharmacology

Indication

Polyethylene glycol is indicated for use as an over-the-counter osmotic laxative to relieve occasional constipation.[8] When used in combination with sodium ascorbate... Read more

Pharmacodynamic

The osmotic effect of PEG produces a copious watery diarrhea. The onset of action of PEG 3350 is about 1 to 2 hours after oral ingestion.[ Read more

Mechanism of action

Osmotic laxatives contain substances that are poorly absorbable and draw water into the lumen of the bowel.[9] Polyethylene glycol functions is an osmotic laxative that causes increased water retent... Read more

Absorption

Following a two-day split-dosing regimen of an oral suspension containing 140 grams of PEG 3350 in healthy subjects, the mean Cmax was 2.7 mcg/mL and the mean Tmax was 3 hours.[ Read more

Protein binding

There is limited information on the protein binding profile of polyethylene glycols.

Volume of distribution

Following a two-day split-dosing regimen of an oral suspension containing 140 grams of PEG 3350 in healthy subjects, the mean volume of distribution was 48,481 L.[ Read more

Clearance

There is limited information on the clearance rate of polyethylene glycols.

Half life

Following a two-day split-dosing regimen of an oral suspension containing 140 grams of PEG 3350 in healthy subjects, the mean half life was 4.1 hours.[ Read more

Route of elimination

Following administration of an oral suspension containing 140 grams of PEG 3350 in healthy subjects, up to 85% to 99% of the compound was excreted in the feces.[ Read more

Toxicity

The oral LD50 of PEG 3350 in rats is 22000 mg/kg.[10]

There is limited clinical information on the overdose of polyethylene glycols. Based on the pharmacological... Read more

Adverse Effects

Contraindications

  • Route:
    • Nasogastric
    • Oral
  • Regions: US
  • Patient Conditions:
      • Name: Gastric Retention
      • Drugbank Id: DBCOND0088112
  • Route:
    • Nasogastric
    • Oral
  • Regions: US
  • Patient Conditions:
      • Name: Toxic colitis
      • Drugbank Id: DBCOND0108606
  • Route:
    • Nasogastric
    • Oral
  • Regions: US
  • Patient Conditions:
      • Name: Toxic megacolon
      • Drugbank Id: DBCOND0096768
  • Route:
    • Nasogastric
    • Oral
  • Regions: US
  • Patient Conditions:
      • Name: Bowel Perforation
      • Drugbank Id: DBCOND0062437
  • Route:
    • Nasogastric
    • Oral
  • Regions: US
  • Patient Conditions:
      • Name: Gastrointestinal obstruction
      • Drugbank Id: DBCOND0010786
  • Route:
    • Nasogastric
    • Oral
  • Regions: US
  • Patient Conditions:
      • Name: Ileus
      • Drugbank Id: DBCOND0010794

Food Interactions

  • Avoid alcohol. Withdrawing from alcohol increases the risk of seizures, which is also caused by the drug.
  • Avoid milk and dairy products.
  • Avoid solid foods. Consume only clear liquids from the start of drug treatment until after the colonoscopy.

Interactions

Type in a drug name to check for interaction with Polyethylene glycol
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  • Paracetamol(acetaminophen)
  • Paxil(paroxetine)
  • Pamelor(nortriptyline)
  • Panadol(acetaminophen)
  • Patanol(olopatadine ophthalmic)
  • Pataday(olopatadine ophthalmic)
  • Parnate(tranylcypromine)
  • Pazeo(olopatadine ophthalmic)
Abicipar Pegol
The therapeutic efficacy of Abicipar Pegol can be decreased when used in combination with Polyethylene glycol.
Acetazolamide
The risk or severity of adverse effects can be increased when Acetazolamide is combined with Polyethylene glycol.
Acetyldigoxin
The serum concentration of Acetyldigoxin can be decreased when it is combined with Polyethylene glycol.
Aclidinium
The therapeutic efficacy of Polyethylene glycol can be decreased when used in combination with Aclidinium.
Agmatine
The therapeutic efficacy of Polyethylene glycol can be decreased when used in combination with Agmatine.
Alcuronium
The therapeutic efficacy of Polyethylene glycol can be decreased when used in combination with Alcuronium.
Alfentanil
The therapeutic efficacy of Polyethylene glycol can be decreased when used in combination with Alfentanil.
Alloin
The risk or severity of adverse effects can be increased when Polyethylene glycol is combined with Alloin.
Almasilate
The therapeutic efficacy of Polyethylene glycol can be decreased when used in combination with Almasilate.
Aloglutamol
The therapeutic efficacy of Polyethylene glycol can be decreased when used in combination with Aloglutamol.
Alphacetylmethadol
The therapeutic efficacy of Polyethylene glycol can be decreased when used in combination with Alphacetylmethadol.
Alphaprodine
The therapeutic efficacy of Polyethylene glycol can be decreased when used in combination with Alphaprodine.
Aluminium
The therapeutic efficacy of Polyethylene glycol can be decreased when used in combination with Aluminium.
Aluminium acetoacetate
The therapeutic efficacy of Polyethylene glycol can be decreased when used in combination with Aluminium acetoacetate.
Aluminium glycinate
The therapeutic efficacy of Polyethylene glycol can be decreased when used in combination with Aluminium glycinate.
Aluminium phosphate
The therapeutic efficacy of Polyethylene glycol can be decreased when used in combination with Aluminium phosphate.
Aluminum hydroxide
The therapeutic efficacy of Polyethylene glycol can be decreased when used in combination with Aluminum hydroxide.
Amantadine
The therapeutic efficacy of Polyethylene glycol can be decreased when used in combination with Amantadine.
Amiloride
The risk or severity of adverse effects can be increased when Amiloride is combined with Polyethylene glycol.
Amiodarone
The therapeutic efficacy of Polyethylene glycol can be decreased when used in combination with Amiodarone.
10 References
  1. 1 . Hammer HF, Hammer J, Gasche C: [Polyethylene glycol (Macrogol)--an overview of its use in diagnosis and therapy of gastrointestinal diseases]. Wien Klin Wochenschr. 2000 Jan 28;112(2):53-60.PubMed: 10703152
  2. 2 . Minguez M, Lopez Higueras A, Judez J: Use of polyethylene glycol in functional constipation and fecal impaction. Rev Esp Enferm Dig. 2016 Dec;108(12):790-806. doi: 10.17235/reed.2016.4571/2016.PubMed: 27871178
  3. 3 . Fordtran JS, Hofmann AF: Seventy Years of Polyethylene Glycols in Gastroenterology: The Journey of PEG 4000 and 3350 From Nonabsorbable Marker to Colonoscopy Preparation to Osmotic Laxative. Gastroenterology. 2017 Mar;152(4):675-680. doi: 10.1053/j.gastro.2017.01.027. Epub 2017 Jan 29.PubMed: 28147222
  4. 4 . Portalatin M, Winstead N: Medical management of constipation. Clin Colon Rectal Surg. 2012 Mar;25(1):12-9. doi: 10.1055/s-0032-1301754.PubMed: 23449608
  5. 5 . PLENVU (polyethylene glycol 3350, sodium sulfate, ascorbic acid, sodium chloride and potassium chloride for oral solution) US FDA 2018 Label Link
  6. 6 . PegaLAX (polyethylene glycol 3350) 2017 Canadian Prescribing Information Link
  7. 7 . NCBI StatPearls [Internet]: Bowel Preparation Link
  8. 8 . DailyMed Label: GAVILAX (Polyethylene glycol 3350) powder, for solution Link
  9. 9 . Laxatives - StatPearls - NCBI Bookshelf Link
  10. 10 . Spectrum Chemical: POLYETHYLENE GLYCOL 3350 Safety Data Sheet Link