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Celevac (UK), Citrucel, Entrocel (CA)
Pharmacologic class: Semisynthetic cellulose derivative
Therapeutic class: Bulk laxative
Pregnancy risk category NR
Stimulates peristalsis by promoting water absorption into fecal matter and increasing bulk, resulting in bowel evacuation
Powder: 105 mg/g, 196 mg/g
⊘Indications and dosages
➣ Chronic constipation
Adults and children ages 12 and older: Up to 6 g P.O. daily in divided doses of 0.45 to 3 g
Children ages 6 to 11: Up to 3 g P.O. daily in divided doses of 0.45 to 1.5 g
• Signs or symptoms of appendicitis or undiagnosed abdominal pain
• Partial bowel obstruction
Use cautiously in:
• intestinal ulcers
• laxative-dependent patients.
• Give with 8 oz of fluid.
• If patient is receiving maximum daily dosage, give in divided doses to reduce risk of esophageal obstruction.
GI: nausea; vomiting; diarrhea; severe constipation; abdominal distention; cramps; esophageal, gastric, small-intestine, or colonic strictures (with dry form); GI obstruction
Other: laxative dependence (with long-term use)
Drug-drug.Antibiotics, digitalis, nitrofurantoin, oral anticoagulants, salicylates, tetracyclines: decreased absorption and action of these drugs
• Assess patient's dietary habits. Consider factors that promote constipation, such as certain diseases and medications.
• Monitor patient for signs and symptoms of esophageal obstruction.
• Evaluate fluid and electrolyte balance in patients using laxatives excessively.
• Instruct patient to take with a full glass (8 oz) of water.
• Advise patient to prevent or minimize constipation through adequate fluid intake (four to six glasses of water daily), proper diet, increased fiber intake, daily exercise, and prompt response to urge to defecate.
☞ Instruct patient to report chest pain or pressure, vomiting, and difficulty breathing (possible symptoms of GI obstruction).
• Caution patient not to use drug for more than 1 week without prescriber's approval.
• Inform patient that chronic laxative use may lead to dependence.
• Tell patient to contact prescriber if constipation persists or if rectal bleeding or symptoms of electrolyte imbalance (muscle cramps, weakness, dizziness) occur.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs mentioned above.