Fortrans

Cleansing of colon as bowel prep for adult patients before endoscopic & radiological exam, & colonic surgery.

1 sachet dissolved in 1 L of water for 15-20 kg corresponding to ave dosage of 3-4 L. Single dose: Ingest 3-4 L on the evening before the procedure, possibly w/ a 1-hr break after the 1st 2 L. Divided doses: Ingest 2 L on the evening before the procedure & 1-2 L on the morning of the procedure (ingest last glass 3-4 hr before the procedure), or alternatively, ingest 3 L on the evening before the procedure & 1 L on the morning of the procedure (ingest last glass 3-4 hr before the procedure). Recommended ingestion rate: 1-1.5 L/hr.

Hypersensitivity. Severe heart failure. Serious deteriorations in general health eg, dehydration. Advanced carcinoma or any other colonic pathology causing excessive mucosal fragility. Acute phases of intestinal tract inflammation including Crohn's disease & ulcerative colitis. GI perforation or risk of perforation. Toxic colitis or toxic megacolon. Patients likely to have or who already have ileus; GI obstruction or stenosis. Gastric emptying disorders (eg, gastroparesis, gastric stasis). Childn & teenagers <18 yr.

Diarrhea provoked by administration of Fortrans is likely to cause considerable disturbance in the absorption of simultaneously administered drugs. Reports of allergic-type reactions (anaphylactic shock, rash, urticaria, angioedema) w/ prep based on macrogol. Correct electrolyte abnormalities before administration. Caution in patients w/ pre-existing electrolyte abnormalities or in patients treated w/ medications that may increase the risk of water electrolyte disturbances, including hyponatremia & hypokalemia, or may increase the risk of potential complications (eg, patients w/ altered renal function, cardiac insufficiency, or those being treated concomitantly w/ diuretics). Should be administered carefully & only under attentive supervision in patients w/ regurgitation tendencies, bedridden, or those w/ disturbances in neurological &/or motor function. Risk of acute pulmonary edema due to fluid overload in patients w/ cardiac or renal insufficiency. Patients w/ strict low Na diet. Macrogol should be used w/ caution in patients w/ known risk factors for ischemic colitis or if concomitantly using stimulant laxatives (eg, bisacodyl or Na picosulfate). Should only be used in pregnant & lactating women when necessary. Elderly.

Nausea, abdominal pain/distention. Vomiting.

Oral medicines may not be absorbed due to the bowel-emptying effect of Fortrans, should be administered over 2 hr before ingestion. Avoid taking oral treatments before & after ingestion, & until the medical exam has been completed. Efficacy of medicines w/ narrow therapeutic index or short t_½ (eg, digoxin, antiepileptics, coumarins, immunosuppressants) may be affected.

Laxatives, Purgatives

A06AD65 - macrogol, combinations ; Belongs to the class of osmotically acting laxatives.

NP