polyethylene glycol and electrolytes (GoLytely, MiraLax, Glycolax, GoEvac, CoLav, CoLyte, NuLYTELY, polyethylene glycol electrolyte soln, polyethylene glycol powder, TriLyte)
Classes: Laxatives, Osmotic
Dosing and uses of GoLytely, MiraLax (polyethylene glycol)
Adult dosage forms and strengths
Polyethylene glycol (PEG) content
powder for oral solution
- 17g/packet
- 119g
- 238g
- 255g
- 510g
- 527g
- 850g
Bowel Preparation
17 g (~1 heaping tbsp) in 8 oz of clear liquid PO q10min until 2 L has been consumed or rectal effluent is clear
NG: 20-30 mL/min
Constipation
17 g in 4-8 oz water PO once daily for ≤1 week
Administration
Refrigerate before administering to improve palatability
Have patient fast 3-4 hr before administering PEg
Encourage rapid drinking of each portion
MiraLax: Bottle top is measuring cup marked to contain 17 g
Advise patients to hydrate adequately before, during, and after use
Pediatric dosage forms and strengths
PEG content
powder for oral solution
- 17g/packet
- 119g
- 238g
- 255g
- 510g
- 527g
- 850g
Bowel Preparation
25-40 mL/kg/hr PO for 4-10 hr until rectal effluent is clear; total dose not to exceed 2 L
Constipation
<6 months: Safety and efficacy not established
≥6 months: 0.5-1.5 g/kg PO once daily for no longer than 2 weeks; adjusted to effect; not to exceed 17 g/day
GoLytely, MiraLax (polyethylene glycol) adverse (side) effects
Frequency not defined
Abdominal bloating
Abdominal cramping
Abdominal distention
Colonic mucosal aphthous ulcerations
Diarrhea
Flatulence
Ischemic colitis
Nausea
Warnings
Contraindications
Hypersensitivity
Cautions
Osmotic laxative products may produce colonic mucosal aphthous ulcerations, including reports of more serious cases of ischemic colitis necessitating hospitalization
Avoid use in patients with bowel obstruction, megacolon, perforated bowel, ulcerative colitis, toxic colitis, gastric retention
Not indicated for children <2 years because of risk of hypoglycemia, dehydration, and hypokalemia
When using PEG as laxative, do not give for >1 week
Electrolyte imbalance reported with prolonged use
Risk of fluid and electrolyte abnormalities, arrhythmias, seizures, and renal impairment
Use with caution in renal insufficiency; ensure adequate hydration, and consider laboratory testing
Directly observe administration to patients at risk for aspiration
Products are not for direct ingestion but require dilution with water
Pregnancy and lactation
Pregnancy category: C
Lactation: No data available
Pregnancy categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA: Information not available.
Pharmacology of GoLytely, MiraLax (polyethylene glycol)
Mechanism of action
Osmotic laxative; causes water retention in stool, causing increase in stool frequency
Absorption
Not absorbed
Bioavailability: 0.2%
Onset: 24-96 hr
Elimination
Excretion: Feces (93%), urine (0.2%)
