Psyllium (Laxative)

(sill-ee-yum)

Trade/other name(s): Fiberall, Hydrocil, Metamucil, PerDiem Fiber, Konsyl, Effer-syllium, ispaghula, isphaghula Metamucil Wafers, plantago ovata, platago seed, and others

Why would this drug be used?

Psyllium is used to prevent and treat constipation. In some cases, doctors recommend higher doses to help reduce cholesterol, or to help with diarrhea. You can buy it over the counter, without a prescription.

How does this drug work?

Psyllium is actually a hydrophilic muciloid compound made of plant fiber. It absorbs water and expands in the intestines. This stimulates the normal forward movement of the intestines (peristalsis), usually resulting in a bowel movement within 12 to 24 hours. In some people, it may take 2 to 3 days.

Before taking this medicine

Tell your doctor…

• If you are allergic to anything, including medicines, dyes, additives, or foods.
• If you have nausea, vomiting, rectal bleeding, unexplained abdominal pain, blocked intestine, or any disease of the stomach or intestine. Something other than constipation may be causing your problem, and laxatives may worsen it.
• About any other prescription or over-the-counter medicines you are taking, including vitamins and herbs. In fact, keeping a written list of each of these medicines (including the doses of each and when you take them) with you in case of emergency may help prevent complications if you get sick.

Interactions with other drugs

Bulk-forming laxatives can keep tetracycline (an antibiotic) from working.

Do not take digoxin (heart medicine), nitrofurantoin (an antibiotic), or aspirin products within 3 hours of taking psyllium.

Several other medicines may not work as well if taken at the same time as laxatives. Do not take psyllium within 2 hours of other medicines.

Check with your doctor, nurse, or pharmacist about other medicines, vitamins, herbs, and supplements, and whether alcohol can cause problems with this medicine.

Interactions with foods

No serious interactions with food are known at this time. Check with your doctor, nurse, or pharmacist about whether foods may be a problem.

Tell all the doctors, dentists, nurses, and pharmacists you visit that you are taking this drug.

How is this drug taken or given?

Psyllium is given by mouth. Mix the powder in 8 oz of juice or water and drink it right away. Otherwise it will get too thick to drink. Take psyllium wafers in small bites, chew thoroughly, and drink at least 8 ounces of liquid along with them. The dose is the same for all adults, but the number of doses you take depends on how well it works for you.

Take this drug exactly as directed by your doctor, or follow the directions on the label. If you do not understand the instructions, ask your doctor or nurse to explain them to you. Keep the medicine in a tightly closed container away from heat and moisture and out of the reach of children and pets.

Precautions

Very little psyllium is absorbed by the body, so there are few side effects. However, some forms of psyllium may contain sugar. If you have diabetes, check with your pharmacist to be sure you get the powder without sugar.

If you are on a low-sodium diet, check the sodium content or ask your pharmacist before you buy psyllium.

Never try to swallow psyllium powder or granules in dry form. Always mix powdered forms with liquid and take as directed on the package. Take wafers with plenty of water or juice. Drinking extra fluids will help psyllium work better and reduce the chance of blocking the esophagus or intestine. Call your doctor if you have vomiting, abdominal pain, bleeding, or no bowel movement after 3 days.

Call your doctor right away if you have a skin rash or welts (hives), itching, or trouble breathing or swallowing (lump in the throat).

Avoid inhaling the powder when mixing a dose. It can raise your risk of allergic reactions.

To help avoid constipation, try to drink 2 to 3 quarts of fluid a day. Increase the amount of fiber you eat in foods by eating fruits, vegetables, beans, peas, and whole-grain breads and cereal. Talk to your doctor about what kind of exercise may help you.

Possible side effects

You will probably not have most of the following side effects, but if you have any talk to your doctor or nurse. They can help you understand the side effects and cope with them.

Common

• nausea
• gas or bloating

Less common

• vomiting
• blockage of esophagus, stomach, or intestines if this medicine is not properly diluted or drunk immediately after mixing, or if you are dehydrated*

Rare

• allergic reaction with itching, skin rash, hives (welts on skin), trouble breathing or swallowing*

*See the "Precautions" section for more detailed information.

There are other side effects not listed above that can also occur in some patients. Tell your doctor or nurse if you develop these or any other problems.

FDA approval

This drug appears to pre-date the FDA approval process, which would mean it was not required to get formal FDA approval.

Disclaimer: This information does not cover all possible uses, actions, precautions, side effects, or interactions. It is not intended as medical advice, and should not be relied upon as a substitute for talking with your doctor, who is familiar with your medical needs.