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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:
• 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.
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
• Monitor patient's bowel movements.
• Check for signs and symptoms of severe (but rare) allergic reactions, such as anaphylaxis and asthma.
• 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.
Modane Bulk(trade name),
Mylanta Natural Fiber Supplement(trade name),
Naturacil Caramels(trade name),
Natural Source Fibre Laxative(trade name),
Reguloid Natural(trade name),
Pharmacologic: bulk forming agents
Time/action profile (laxative effect)
|PO||12–24 hr||2–3 days||unknown|
Adverse Reactions/Side Effects
- intestinal or esophageal obstruction
Drug-Drug interactionMay ↓ absorption of warfarin, salicylates, or digoxin.
Availability (generic available)
- 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 DiagnosesConstipation (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.
- 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.
- A soft, formed bowel movement, usually within 12–24 hr. May require 3 days of therapy for results.