Forlax in the treatment of chronic constipation: features of therapy for elderly patients

Published 03/20/2020 · Comments: · Reading time: 8 min · Views: Post Views: 7,771

Not all laxatives are created equal. The reasons for stool retention may be different, and drugs must be used with appropriate specificity. Constipation can be situational, chronic, due to atony or spasm of the intestinal muscles, caused by a disease, etc.

For the treatment of chronic or systematic constipation, a course of treatment with mild osmotic laxatives in small doses is used. The drug "Forlax" is one of them. It combines European quality and affordable price.

Osmotic laxatives are better known to the consumer as a means for complete bowel cleansing, used before tests. "Forlax" is used for another purpose - to normalize digestion in a situation where stool retention has turned into a systematic malaise.

Two dosage forms of the drug are registered in Russia: 1. For adults and children over 8 years old. 2. For children from 6 months to 8 years. Both options are available in the form of powders for dilution in individual foil film bags. The product package includes 20 sachets. For adults and children over 8 years old - 10 g powders, for children from 6 months to 8 years old - 4 g each.

Taste qualities of the product with the help of citrus flavor. Allergic people should take into account its composition: • orange oil; • grapefruit oil; • orange juice concentrate; • acetaldehyde; • sorbitol; • sulfur dioxide; • acacia gum; • citral; • maltodextrin.

"Forlax" - instructions for use

The active substance of the drug is macrogol 4000. The molecules of this component have the ability to bind large amounts of water, preventing it from being absorbed in the intestines. The total volume of intestinal contents increases and dissolves. Due to this mechanism of action, the laxative effect of Forlax develops.

It has been clinically confirmed that macrogol, following the digestive tract, is not transformed in any way, is not absorbed into the systemic bloodstream, and therefore does not have any general effect on the body. When taken in recommended doses, the effect of the drug develops gradually and gently, and there are no unpleasant symptoms that often accompany taking stimulant-type laxatives.

Reviews

Reviews about the laxative are positive. Doctors recommend giving the product to young children to improve intestinal motility. If you follow the instructions for use, the drug will act within 12-48 hours.

Doctors

Anna Yurievna, gastroenterologist

The safest drug in childhood. The suspension has a pleasant taste and an excellent laxative effect. There is no habituation to this product. It can be safely taken during breastfeeding and pregnancy. I recommend.

Stanislav Mironovich, proctologist

An excellent stool softener. This drug is prescribed to cleanse the intestines. A laxative does not lead to dehydration and leaching of beneficial substances from the body. After 2 weeks of regular use, Forlax is able to train the intestines to have bowel movements regularly.

How to take Forlax for adults?

The dose should be selected depending on the clinical effect caused. According to the instructions, adults and children over 8 years old need to take 1 - 2 sachets once in the morning. If a person uses 2 sachets per day, the intake can be divided into morning and evening.

Therapy, especially in a child, should be started with a minimum dose of 1 sachet. If there is no significant effect within a few days, you can increase the dose to 2 sachets. If the desired result is achieved at a minimum dose, there is no need to increase it without reason.

Forlax therapy should be accompanied by sufficient fluid intake. It is due to the water not absorbed in the intestines that the laxative works. To achieve the full effect, you should increase the volume of water you drink relative to your usual one.

Many people do not have the habit of drinking water at all. You can put a 1.5 - 2 liter bottle of water in your room or workplace and make it a rule to drink 0.5 - 1 glass every half hour. You can also take advantage of progress - there are now many different mobile applications that remind you at set intervals to drink water or take medicine.

Before use, Forlax powder should be diluted in a glass of water. It is not recommended to use other drinks to dilute the drug. The resulting solution will be translucent white. The diluted drug cannot be stored; it must be drunk immediately.

To restore independent digestion, it is important to normalize your diet and lead an active lifestyle: • fill your daily diet with foods rich in fiber; • get into the habit of drinking at least 1.5 - 2 liters of drinking water daily; • reduce consumption of flour products and sweets; • regularly perform feasible physical activity, avoid physical inactivity; • walk as much as possible.

You cannot rely only on the effect of drugs. Without an adequate diet and exercise regimen, the problem of constipation will quickly return after completing the course of therapy.

special instructions

Before starting therapy, organic gastrointestinal diseases should be excluded.

Treatment of constipation with medications is recommended only as an addition to a healthy lifestyle and diet, for example: increasing fluid and fiber intake; adequate physical activity, which helps restore gastrointestinal motility.

If diarrhea develops, extreme caution should be taken in patients predisposed to fluid and electrolyte imbalances (for example, patients with impaired liver or kidney function, or patients receiving diuretics); in such cases, it is necessary to monitor the electrolyte content.

There have been reports of cases of aspiration when large volumes of polyethylene glycol with electrolytes are administered through a nasogastric tube. Children with neurological disorders involving swallowing problems are at risk for aspiration.

Very rare cases of hypersensitivity (including rash, hives, swelling) have been reported when taking drugs containing macrogol (polyethylene glycol). In exceptional cases, anaphylactic shock has been observed.

Forlax contains sorbitol, so the drug should not be used in patients with congenital fructose intolerance.

Forlax does not contain a large amount of sugar or polyol, so the drug can be prescribed to patients with diabetes mellitus, as well as to patients whose diet excludes galactose.

How long does it take for Forlax to work?

In most cases, comfortable defecation during drug therapy occurs 2–3 days after the first use. The course of treatment is 3 months.

Large-scale clinical studies have not been conducted in the pediatric consumer group, so the instructions do not recommend using Forlax in children for more than 3 months in a row.

If after a three-month course the problem of constipation persists, you need to consult a gastroenterologist for additional examination. In this situation, it may be necessary to clarify the diagnosis, more detailed clarification of the causes of the condition, and adjustment of therapy.

"Forlax" - instructions for use for children

The dose of Forlax in pediatric form is 4 g per sachet. The number of sachets per dose is determined by age and severity of the condition: 1. Child 4 - 8 years old - 2 - 4 sachets per day. 2. From 1 year to 4 years - 1 - 2 sachets. 3. For babies from 6 months to one year - no more than 1 sachet per day.

As in the case of therapy for adult patients, dosing of children's Forlax should be based on the clinical response. If the effect is achieved with a minimum dose, there is no need to increase it. If the effect is insufficient, the dose is increased gradually.

Dissolve the contents of 1 sachet in 50 ml of water. They give the drug in the morning. If the child receives more than 1 sachet per day, then the dose is divided into morning/evening.

Unlike the adult form, the solution obtained by diluting the powder is transparent, like water.

The course of continuous therapy in children should not exceed 3 months. Repeated use, if necessary, should be agreed with your doctor.

To normalize independent digestion, you need to pay attention to the child’s diet. Possible causes of constipation are lack of fiber in the diet, low water consumption. It is important that the baby moves enough.

In the youngest, the restoration of regular bowel movements can be helped by massage, passive gymnastics, replacing the nutritional formula, eliminating unsuccessful complementary foods, or, conversely, introducing a new product into the diet that helps activate the intestinal muscles.

According to clinical recommendations, treatment of constipation in children of any age should be carried out under the supervision of a specialist and as prescribed.

Price of the drug in pharmacies in Moscow, St. Petersburg, regions

The price range of the medicine depending on the region and the number of sachets in the package (rub.).

Forlax has a mild effect in cleansing the intestines. To eliminate constipation in infants, also during pregnancy and in old age, specialist supervision is necessary. The effectiveness of the drug is proven by reviews from doctors and patients.

Author: Kotlyachkova Svetlana

Article design: Mila Friedan

"Forlax" during pregnancy and breastfeeding

The instructions allow pregnant and lactating women to take the Forlax laxative. Although there have been few clinical studies in these groups of consumers, the lack of systemic action of the drug allows us to conclude that it is safe for the body of the expectant mother and her baby.

Macrogol does not pass into breast milk, so the use of Forlax does not require temporary cessation of breastfeeding, like other drugs.

However, treatment of digestive disorders in pregnant and lactating women should be carried out under the supervision of a specialist. Although Forlax is safe, the very condition for which it is taken can cause complications. Stool retention leads to self-intoxication of the body, so constipation in a nursing mother can lead to harmful components getting into the milk.

Is Forlax taken to cleanse the intestines?

Before colonoscopy or abdominal surgery, complete cleansing of all parts of the intestines is required. In the current edition of the instructions, Forlax is not indicated for such a procedure.

The only indication according to the annotation is the symptomatic treatment of constipation in adults and children.

The dosage and regimen of use of the drug assume a smooth and gradual effect, rather than intense cleansing in a short time.

For these purposes, there are other macrogol preparations, for example, Fortrans or Lavacol. These drugs have corresponding dosage regimens and completely different dosages.

Are there any analogues for the drug Forlax?

The laxative is produced by the French. To manufacture the drug, the pharmaceutical substance macrogol from German or American factories is used.

This drug is an excellent balance of price and quality. The price of a Forlax package is about 300 rubles. Children's and adult's prices are approximately the same.

When looking for a suitable remedy, people wonder what is better? “Fitolax”, “Fitomucil”, “Forlax” - similar names. Only the box contains completely different contents.

“Fitolax” and “Fitomucil” are plant-based dietary supplements. In the first, the main laxative components are apricot and senna. It is a stimulant laxative. Although it has a natural composition, it is not suitable for long-term use.

“Fitomucil” is a very worthy dietary supplement based on the seed shells of a special type of plantain. It has no general effect on the body and is a source of large amounts of natural fiber. The effect develops gradually, the product is very gentle. Can be taken for a long time.

"Forlax" is a registered medicinal product. A priori, the effectiveness and safety indicators are better studied than those of dietary supplements. If a long course is necessary, for obvious reasons, preference should be given to medication.

Does Forlax have side effects?

If the instructions are followed, in the vast majority of cases the drug is well tolerated. Occasionally, negative reactions to taking it occur: • most often in the case of individual sensitivity, or due to exceeding the dosage, diarrhea occurs, there may be abdominal pain; • with the development of diarrhea, a feeling of pain and burning in the perianal area may additionally occur; • unpleasant phenomena such as nausea, vomiting, bloating occur even less frequently; • the rarest manifestation of a side effect is allergic reactions - skin rashes, possibly itchy, angioedema, and in rare cases - anaphylactic shock.

Allergic reactions can develop, in particular, to the citrus fragrance included in the drug. Although Forlax causes allergies extremely rarely, if the consumer knows about this possibility from his body, it is better to find a drug that does not contain potential food allergens.

To achieve the optimal effect and prevent possible side effects, Forlax must be taken strictly in accordance with the instructions.

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Contraindications

The drug is prohibited in the presence of the following pathologies:

• inflammatory processes in the intestines;
• intestinal obstruction in any form;
• an increase in the size of the colon;
• narrowing of the intestinal lumen;
• abdominal pain of unknown nature;
• intolerance or allergic reaction to the components of the drug;
• ruptures and other damage to the intestines, including ulcers;
• severe dehydration of the body;

  

• diseases of the digestive tract in an acute form.

The drug is not recommended for use by children under 6 months.