Peglec (Polyethylene Glycol (Macrogol 3350 / PEG))
Also sold as: Peglec, Forlax, Movicol, Lax-Eze, PEG 3350 (Cipla)
Pregnancy
Cat C
Lactation
Safe
Schedule
OTC
Forms
Powder sachet 10g (Forlax/Movicol individual sachets for 125–250 mL water) +2
Indications
- Chronic constipation (first-line osmotic laxative — safe for long-term use)
- Faecal impaction (higher dose treatment)
- Bowel preparation for colonoscopy/surgery (PEG-electrolyte solution)
- Hepatic encephalopathy (high dose — alternative to lactulose)
- Constipation in children (safe long-term use)
Adult Dosing
Chronic constipation
1–2 sachets (10g each) PO daily, dissolved in water
May take 2–3 days to work. Can adjust dose based on response. Once-daily dosing for maintenance. No habituation or dependence.
Faecal impaction
8 sachets dissolved in 1 litre water, consumed over 4–6 hours — repeat daily for 3 days if needed
High-dose regimen; ensure adequate fluid intake
Bowel prep (colonoscopy)
PEG-EL 2–4 litres over 2–4 hours (evening before or morning of procedure) — per colonoscopy protocol
Electrolyte versions (Peglec, Golytely) prevent electrolyte disturbance
Pediatric Dosing
PEG is first-line for childhood constipation (NICE guidelines) — safe for months-years of use
Renal Dose Adjustment
| CrCl / eGFR | Dose Adjustment |
|---|---|
| CrCl < 30 mL/min | Use with caution for high-dose bowel prep (electrolyte imbalance risk); low-dose constipation treatment is safe |
Hepatic Adjustment
No dose adjustment; large bowel prep: monitor electrolytes in severe liver disease (ascites may worsen with large volume)
Pregnancy & Lactation
Pregnancy: Category C
Generally considered safe — not systemically absorbed. Preferred osmotic laxative in pregnancy over stimulant laxatives. Limited controlled trials but mechanism suggests safety. Fibre and lactulose also acceptable in pregnancy.
Lactation: Safe
Not absorbed systemically — no transfer to breast milk. Safe during breastfeeding.
Top Drug Interactions
| Interacting Drug | Effect | Severity |
|---|---|---|
| Other medications (high-dose bowel prep) | High-volume PEG flush can reduce absorption of oral medications taken concurrently — take other drugs 2 hours before bowel prep | Moderate |
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Side Effects
Common
- Bloating and flatulence (first few days — usually improves)
- Nausea (if taken too quickly)
- Abdominal cramps (high doses)
- Excessive diarrhoea (reduce dose)
Serious / Discontinue If
- Electrolyte disturbances (high-dose bowel prep — hyponatraemia, hypokalaemia; use electrolyte-containing PEG for prep)
- Aspiration risk (elderly/dysphagia — never use high-volume prep without supervision)
- Severe vomiting (bowel prep — stop and reassess)
Contraindications
- Bowel obstruction
- Toxic megacolon
- Bowel perforation
- Phenylketonuria (some sachet flavours contain aspartame — check packaging)
- Swallowing disorders (high-volume bowel prep)
Available Indian Brands
| Brand | Manufacturer | Price (approx) |
|---|---|---|
| Peglec (PEG-EL 70g/L for prep) | Cipla | 1 litre prep ₹285 |
| Forlax 10g sachet | Ipsen India | 20 sachets ₹345 |
| Lax-Eze sachets | Sun Pharma | 20 sachets ₹255 |
| Movicol sachets | Norgine/Sanofi India | 20 sachets ₹425 |
Monitoring Required
- Stool frequency and consistency (adjust dose)
- Serum electrolytes (bowel prep or high-dose use)
- Renal function (high-dose in elderly or renal impairment)
- Weight (paediatric constipation — long-term treatment)
- Nutritional status if long-term in children
Patient Counseling Points
- Dissolve sachet completely in a full glass of water (150–250 mL) and drink promptly
- Drink extra water throughout the day — PEG works by keeping water in the stool
- It may take 1–3 days to work initially — do not double up doses impatiently
- Unlike bisacodyl (stimulant), PEG is safe for long-term daily use — no dependency
- Children: PEG is the preferred treatment for long-term constipation — it is safe for months to years
- For colonoscopy prep: drink the full volume — split dose (half evening, half morning) is better tolerated
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Clinically reviewed by: Dr. Pradeep Nair, DM (Gastroenterology), Consultant Gastroenterologist
Last reviewed: 2026-04-01
References
- NICE Constipation in Children CG99
- ACG Chronic Constipation Guidelines 2021
- ESGE Bowel Preparation Guidelines 2023
- BNF — Macrogol
- Indian Society of Gastroenterology — Constipation Guidelines