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Related to Metamucil: psyllium


trademark for preparations of psyllium hydrophilic mucilloid, a bulk laxative.


Fiberall, Fibrelief (UK), Fibro-Lax, Fibro-XL, Fybogel (UK), Hydrocil Instant, Isogel (UK), Ispagel (UK), Karacil (CA), Konsyl, Metamucil, Metamucil Orange Flavor, Metamucil Sugar Free, Modane Bulk, Natural Fiber Therapy, Prodiem Plain (CA), Regulan (UK), Reguloid, Reguloid Sugar Free

Pharmacologic class: Psyllium colloid

Therapeutic class: Bulk-forming laxative

Pregnancy risk category B


Stimulates lining of colon, increasing peristalsis and water absorption of stool and promoting evacuation


Chewable pieces: 1.7 g/piece, 3.4 g/piece

Granules: 2.5 g/tsp, 4.03 g/tsp

Powder: 3.3 g/tsp, 3.4 g/tsp, 3.5 g/tsp, 4.94 g/tsp

Powder (effervescent): 3.4 g/packet, 3.7 g/packet

Wafers: 3.4 g/2 wafers

Indications and dosages

Chronic constipation; ulcerative colitis; irritable bowel syndrome

Adults and children ages 12 and older: 30 g daily in divided doses of 2.5 to 7.5 g/dose P.O. in 8 oz of water or juice


• Hypersensitivity to drug
• Intestinal obstruction
• Abdominal pain or other appendicitis symptoms
• Fecal impaction


Use cautiously in:
• phenylketonuria
• pregnant patients.


• Mix powder with 8 oz of cold liquid (such as orange juice) to mask taste.
• Give diluted drug immediately after mixing, before it congeals. Follow with another glass of fluid.

Adverse reactions

GI: nausea; vomiting; diarrhea (with excessive use); abdominal cramps with severe constipation; anorexia; esophageal, gastric, small-intestine, or rectal obstruction (with dry form)

Respiratory: asthma (rare)

Other: severe allergic reactions including anaphylaxis


None significant

Patient monitoring

• Monitor patient's bowel movements.
• Check for signs and symptoms of severe (but rare) allergic reactions, such as anaphylaxis and asthma.

Patient teaching

• Tell patient to dissolve in 8 oz of cold beverage and drink immediately, followed by another glass of liquid.
• Caution patient not to take without dissolving in liquid.
• Instruct patient to take after meals if drug decreases his appetite.
• Tell patient drug usually causes bowel movement within 12 to 24 hours but may take as long as 3 days.

Instruct patient to immediately stop taking drug and notify prescriber if signs and symptoms of allergic reaction occur.
• Advise diabetic patient to use sugar-free drug form.
• Instruct patient with phenylketonuria to avoid forms containing phenylalanine.
• As appropriate, review all other significant and life-threatening adverse reactions.


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Therapeutic: laxatives
Pharmacologic: bulk forming agents
Pregnancy Category: UK


Management of simple or chronic constipation, particularly if associated with a low-fiber diet.Useful in situations in which straining should be avoided (after MI, rectal surgery, prolonged bed rest).Used in the management of chronic watery diarrhea.


Combines with water in the intestinal contents to form an emollient gel or viscous solution that promotes peristalsis and reduces transit time.

Therapeutic effects

Relief and prevention of constipation.


Absorption: Not absorbed from the GI tract.
Distribution: No distribution occurs.
Metabolism and Excretion: Excreted in feces.
Half-life: Unknown.

Time/action profile (laxative effect)

PO12–24 hr2–3 daysunknown


Contraindicated in: Hypersensitivity;Abdominal pain, nausea, or vomiting (especially when associated with fever);Serious adhesions;Dysphagia.
Use Cautiously in: Some dosage forms contain sugar, aspartame, or excessive sodium and should be avoided in patients on restricted diets; Obstetric / Lactation: Has been used safely.

Adverse Reactions/Side Effects


  • bronchospasm


  • cramps
  • intestinal or esophageal obstruction
  • nausea
  • vomiting


Drug-Drug interaction

May ↓ absorption of warfarin, salicylates, or digoxin.


Oral (Adults) 1–2 tsp/packet/wafer (3–6 g psyllium) in or with a full glass of liquid 2–3 times daily. Up to 30 g daily in divided doses.
Oral (Children >6 yr) 1 tsp/packet/wafer (1.5–3 g psyllium) in or with 4–8 oz glass of liquid 2–3 times daily. Up to 15 g daily in divided doses.

Availability (generic available)

Powder: 3.3–3.5 g/dose or packetOTC
Effervescent powder: 3–3.5 g/dose or packetOTC
Granules: 2.5 g/doseOTC
Wafers: 3.4 g/doseOTC

Nursing implications

Nursing assessment

  • Assess patient for abdominal distention, presence of bowel sounds, and usual pattern of bowel function.
  • Assess color, consistency, and amount of stool produced.
  • Lab Test Considerations: May cause elevated blood glucose levels with prolonged use of preparations containing sugar.

Potential Nursing Diagnoses

Constipation (Indications)


  • Packets are not standardized for volume, but each contains 3–3.5 g of psyllium.
  • Oral: Administer with a full glass of water or juice, followed by an additional glass of liquid. Solution should be taken immediately after mixing; it will congeal. Do not administer without sufficient fluid and do not chew granules.

Patient/Family Teaching

  • Encourage patient to use other forms of bowel regulation, such as increasing bulk in the diet, increasing fluid intake, and increasing mobility. Normal bowel habits are individualized and may vary from 3 times/day to 3 times/wk.
  • May be used for long-term management of chronic constipation.
  • Instruct patients with cardiac disease to avoid straining during bowel movements (Valsalva maneuver).
  • Advise patient not to use laxatives when abdominal pain, nausea, vomiting, or fever is present.

Evaluation/Desired Outcomes

  • A soft, formed bowel movement, usually within 12–24 hr. May require 3 days of therapy for results.


A trademark for a therapeutic preparation containing psyllium.
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The young swan underwent a series of scopes over the course of the following days, and was also given Metamucil to help pass the fishing line in its system.
Business of Procter & Gamble s health care brands like Vicks, Pepto-Bismol, Metamucil and Prilosec will be boosted by the deal.
Metamucil is both a dietary fiber supplement as well as a laxative made from the soluble and insoluble fiber psyllium, which provides digestive and coronary health benefits and relieves constipation.
Certain foods and medications can do this, such as prunes, prune juice, Metamucil, light laxatives, fruit and vegetables, etc.
It turns out that a pear a day keeps both the doctor and the Metamucil away.