POLYCARBOPHIL

POLYCARBOPHIL
(pol-i-kar'boe-fil)
Equalactin, FiberNorm
Classifications: bulk laxative; antidiarrheal;
Therapeutic: bulk laxative; antidiarrheal
Prototype: Psyllium
Pregnancy Category: C

Availability

500 mg, 625 mg tablets; 500 mg, 625 mg chewable tablets

Action

Hydrophilic agent which absorbs free water in intestinal tract and opposes dehydrating forces of bowel by forming a gelatinous mass.

Therapeutic Effect

Restores more normal moisture level and motility in the lower GI tract; produces well-formed stool and reduces diarrhea.

Uses

Constipation or diarrhea associated with acute bowel syndrome, diverticulosis, irritable bowel and in patients who should not strain during defecation. Also choleretic diarrhea, diarrhea caused by small-bowel surgery or vagotomy, and disease of terminal ileum.

Contraindications

Partial or complete GI obstruction; fecal impaction; dysphagia; acute abdominal pain; rectal bleeding; undiagnosed abdominal pain, or other symptoms symptomatic of appendicitis; poisonings; before radiologic bowel examination; bowel surgery; pregnancy (category C). Safety in children <3 y is not established.

Cautious Use

Renal failure, renal impairment.

Route & Dosage

Constipation or Diarrhea
Adult: PO 1 g q.i.d. prn (max: 6 g/d)
Child: PO 3–6 y, 500 mg b.i.d. prn (max: 1.5 g/d); 6–12 y, 500 mg t.i.d. prn (max: 3 g/d)

Administration

Oral

Chewable tablets should be chewed well before swallowing.
Give each dose with a full glass [240 mL (8 oz)] of water or other liquid.
Repeat dose every 30 min up to the maximum dose in 24 h with severe diarrhea.
Store at 15°–30° C (59°–86° F) in tightly closed container unless otherwise directed.

Adverse Effects (≥1%)

GI: Esophageal blockage, intestinal impaction, abdominal fullness. Metabolic: Low serum potassium, elevated blood glucose levels (with extended use). Respiratory: Asthma. Skin: Skin rash.

Interactions

Drug: May decrease absorption and clinical effects of antibiotics, warfarin, digoxin, nitrofurantoin, salicylates.

Pharmacokinetics

Absorption: Not absorbed from GI tract. Onset: 12–24 h. Peak: 1–3 d.

Nursing Implications

Assessment & Drug Effects

Determine duration and severity of diarrhea in order to anticipate signs of fluid-electrolyte losses.
Monitor and record number and consistency of stools per day, presence and location of abdominal discomfort (i.e., tenderness, distention), and bowel sounds.
Monitor and record I&O ratio and pattern. Dehydration is indicated if output is <30 mL/h.
Inspect oral cavity for dryness, and be alert to systemic signs of dehydration (e.g., thirst and fever). Dehydration from an episode of diarrhea appears rapidly in young children and older adults.

Patient & Family Education

Consult physician if sudden changes in bowel habit persist more than 1 wk, action is minimal or ineffective for 1 wk, or if there is no antidiarrheal action within 2 d.
Be aware that extended use of this drug may cause dependence for normal bowel function.
Do not discontinue polycarbophil unless physician advises if also taking an oral anticoagulant, digoxin, salicylates, or nitrofurantoin.

Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; Canadian drug name; Prototype drug

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