Fortrans Special Precautions

Diarrhea provoked by administration of this medication is likely to cause considerable disturbance in the absorption of simultaneously administered drugs (see Interactions).
This medicine contains macrogol (polyethylene glycol or PEG). Allergic-type reactions have been reported with preparations based on macrogol: anaphylactic shock, rash, urticaria, angioedema (see Adverse Reactions).
Although not expected due to the isotonic composition of this product, rare cases of water electrolyte disturbances have been reported in at-risk patients. Patients with pre-existing electrolyte abnormalities should have them corrected before the bowel cleansing solution is administered. This product should also be used with caution in patients with these conditions or in patients treated with medications that may increase the risk of water electrolyte disturbances, including hyponatremia and hypokalemia, or may increase the risk of potential complications (such as patients with altered renal function, cardiac insufficiency, or those being treated concomitantly with diuretics). In this case, patients should be appropriately monitored.
The product should be administered carefully and only under attentive supervision in patients with a tendency towards regurgitation, bedridden patients, or those with disturbances in neurological and/or motor function, due to the risk of inhalation. The product should be administered to these patients after first putting them in a sitting position, and possibly even via gastric tube.
In patients with cardiac or renal insufficiency, there is a risk of acute pulmonary edema due to fluid overload.
This medicine contains sodium. This medicine contains 2.890 g of sodium per sachet. This fact must be taken into account in patients on a strict low-sodium diet.
Ischemic colitis: Post-marketing surveillance has revealed that cases of ischemic colitis, some of them serious, have been reported in patients treated with macrogol as part of their bowel preparation. Macrogol should be used with caution in patients with known risk factors for ischemic colitis or if there is concomitant use of stimulant laxatives (such as bisacodyl or sodium picosulfate). Patients presenting with sudden abdominal pain, rectal bleeding, or other symptoms of ischemic colitis should be evaluated promptly.
Effects on ability to drive and use machines: There have been no studies conducted on what effects, if any, FORTRANS might have on the ability to drive and use machines.
Use in the Elderly: This product should be administered to elderly patients in a frail general condition only under medical supervision.