Forlax - instructions for use, release form, composition, indications, side effects, analogues and price

Young children often suffer from constipation, and this problem should be approached wisely. One way to improve digestion is Forlax, a popular laxative. Why it is called “smart” and how effective this drug is, we will look at in our material. In addition, we will find out how to use it correctly and what contraindications exist.

Composition and release form

Forlax is available in packaging designed for single use of the drug. For adults, a 10g sachet is used, for children - 4g.

Description of Forlax

The active ingredient of the drug is Macrogol 4000. At the moment it enters the intestinal lumen, one molecule of it can unite up to 10 molecules of water around itself. Thanks to this property, Macrogol loosens compressed feces, making them larger and softer. By increasing the volume and consistency, the contents of the intestine affect its walls and irritate the nerve endings. This leads to activation of peristalsis and a painless and natural act of defecation.

Advantages of the drug

Macrogol as an active ingredient has a lot of advantages. Let's list the most obvious ones:

• The advantage of Macrogol is its “neutrality” - this substance does not enter the bloodstream and also does not affect the gastrointestinal mucosa.
• The drug does not take over the basic functions of the intestines - there is no addiction to it. Cancellation of Forlax does not lead to weakening of motility - the intestines continue to function normally. Moreover, after starting peristalsis with the help of Macrogol, the intestines begin to work better, but on their own. Thanks to this property, the drug is called “smart”.
• Forlax is a mild laxative; it does not cause pain during bowel movements.

Compound

Forlax for adults and for children differs in the amount of active ingredient in one dose. Sachets can be 10 or 4 g each. Each children's sachet, in addition to 4 g of ethylene glycol (Macrogol 4000), contains auxiliary ingredients. Among them are sodium saccharinate (6.8 mg) and citrus flavor (orange-grapefruit) – 60 mg. The flavor includes a whole list of substances:

• orange and grapefruit oils;
• orange juice;
• sorbitol;
• maltodextrin;
• ethyl butyrate;
• acetaldehyde;
• octanal;
• sulfur dioxide

Pharmacodynamics and pharmacokinetics

Macrogol 4000 is a long linear polymer that holds water molecules through hydrogen bonds. Thanks to this, the volume of fluid and the amount of intestinal contents increase, which improves peristalsis and the process of emptying. Forlax is not absorbed from the intestines and is excreted unchanged from the body. The substance is not detected in the systemic circulation and does not bind to blood plasma proteins. The laxative effect occurs 24-48 hours after oral administration.

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

According to the Rome Consensus II, diagnostic criteria for functional constipation (C3) include the presence of two or more features that have existed for at least 12 weeks, but do not necessarily have to be consistent over the past 12 months: • less than 3 bowel movements per week; • difficulty with > 1/4 bowel movements; • bloating or hard stool with > 1/4 bowel movements; • feeling of incomplete evacuation with > 1/4 bowel movements; • feeling of anorectal obstruction (blockade) at > 1/4; • manual assistance in performing > 1/4 of bowel movements (“digital” evacuation, pelvic floor support, etc.). Thus, defecation problems are widespread, burdensome and reduce the quality of life of patients. Modern ideas about the treatment of constipation are based on special diagnostic methods and careful selection of a therapeutic approach. Unfortunately, laxatives are often prescribed and used without reason. This statement is true both for self-medication and for medical recommendations. Treatment of constipation should always begin with non-drug methods. These include increasing physical activity, playing sports, normalizing water balance and diet with the obligatory inclusion of dietary fiber. Adding ballast dietary fiber to the diet (bran, pectin, microcrystalline cellulose, psyllium, various dietary supplements with a high content of soluble and insoluble fiber) is the basis for the treatment of constipation in young patients, but is not always possible in the elderly. Dietary fibers are hydrophilic colloids: in a liquid medium they create stable micelles that significantly increase the volume of intestinal contents and stimulate peristalsis. For the successful action of dietary fiber, a daily volume of liquid of at least 1.5 liters is required, otherwise they act as sorbents, i.e. absorb fluid from the intestines and increase constipation. However, elderly patients cannot always maintain water balance due to heart failure, difficulties moving around the apartment, bed rest, etc., therefore, dietary fiber should be recommended to this category of patients with great caution, monitoring their use. This dictates the need for wider use of laxatives in elderly patients, while for young people they are prescribed only when non-drug methods are ineffective. Laxatives are also used for drug-induced constipation, when the drugs that cause it cannot be withdrawn (opiates for chronic pain, antidepressants, antiparkinsonian drugs). Short courses of laxatives are recommended in the pre- and postoperative periods, in preparation for intestinal examinations. Groups of laxatives Existing laxatives are divided into 3 groups according to their mechanism of action: 1. Increasing the volume of intestinal contents: • dietary fiber (bran, microcellulose, seaweed, flax seed, psyllium, agar-agar, Mucofalk); • osmotic: – oligosugars (lactulose, lactitol); – polyethylene glycol – macrogol 4000 (Forlax); – alcohols (sorbitol, mannitol, glycerin); – saline laxatives (magnesium sulfate, Glauber’s salt, etc.); 2. Stimulating: • anthraglycosides (preparations of senna, buckthorn, rhubarb); • diphenylmethane derivatives (bisacodyl, sodium picosulfate); • Castor oil; • fatty acid hydroxides; • bile acids; 3. Softening feces: • Vaseline and other mineral oils. Bulk laxatives that increase the volume of intestinal contents are products of natural origin or synthetic modified polysaccharides that are difficult to digest or not digested at all, as a result of which they are almost not absorbed. When they absorb water, they swell and cause stretching of the intestinal walls due to their increase in volume. In this way, a propulsive wave is excited and, ultimately, defecation is accelerated by a reflex reaction. Prerequisites for achieving this effect are the preserved ability of the colon to respond to bulk laxatives and swell sufficiently, as well as simultaneous fluid intake (from 1.5 to 2 liters). Osmotic laxatives (sugars, polyhydric alcohols, salt preparations), despite the common mechanism, differ from each other in their zone of action. Thus, alcohols with a relatively short chain of 3–6 carbon atoms (sorbitol, mannitol, glycerin) and saline laxatives act at the level of the small intestine and promote the release of large amounts of fluid into its lumen, which is accompanied by dilution of stool and often provokes diarrhea. Saline laxatives act quickly (within 2–4 hours), but are not suitable for long-term use, as they can cause severe disturbances in water and electrolyte balance. Oligosugars, primarily the synthetic disaccharide lactulose, are not absorbed in the small intestine, since there are no enzymes there that break them down. The drug acts exclusively in the colon, where lactulose undergoes bacterial fragmentation and hydrolysis to fructose and galactose, mainly under the influence of bifidobacteria and, to a lesser extent, lactobacilli. The end products of lactulose metabolism are volatile fatty acids, which, in addition to hypocholesterolemic, hypolipidemic and antiproliferative effects, have an osmotic effect. Osmotic processes in the large intestine are less pronounced than in the small intestine, fluid secretion into the intestinal lumen is lower, therefore the laxative effect of lactulose is milder than that of saline laxatives, although it develops just as quickly. The second important mechanism of action of lactulose is an increase in bacterial biomass, which contributes to an increase in fecal volume and stimulates peristalsis. Thus, lactulose has a dual mechanism of action: it restores colonic microbiocenosis, being a bifidogenic and lactogenic prebiotic, and increases the volume of intestinal contents due to osmotic action and stimulation of bacterial growth. However, increasing doses of the drug is accompanied by bloating and distension of the abdomen, which often forces patients to abandon long-term use of lactulose. Therefore, selection of the minimum effective dose is the most important component of working with this drug. These mechanisms of action determine its therapeutic value, making it one of the most acceptable drugs for the treatment of constipation in elderly patients. An increase in biomass and the formation of volatile fatty acids is also observed when taking dietary fiber. The mechanisms of these phenomena are the same as when using lactulose. A pronounced osmotic effect is exerted by Forlax (macrogol 4000), a high-molecular polyethylene glycol, which is effective and safe with long-term use, is not absorbed, is not metabolized, forms hydrogen bonds in the intestinal lumen, thereby increasing the volume of intestinal contents, softening its consistency. Forlax does not develop addiction; the effectiveness of the drug does not depend on the state of the intestinal microflora. Stimulant laxatives include drugs that promote secretion and local irritants. All laxatives with secretory action (anthraquinones, diphenylmethane derivatives, castor oil) interact with the epithelial structures of the intestine and cause active secretion of fluid into its lumen, while simultaneously reducing absorption. All these drugs cause short-term, and with long-term use, constant secretory diarrhea, which is characterized by an increase in the flow of fluid and electrolytes into the intestines. It is important to note that the decrease in potassium concentration in the blood associated with their use inevitably leads to smooth muscle relaxation and increased constipation if it is caused by hypotonicity of the intestinal wall. Disruption of fluid homeostasis contributes to the development of secondary hyperaldosteronism, which further increases the loss of potassium, and thus the “vicious circle” closes. This is one of the main mechanisms of addiction and increased constipation with long-term use of all “secretory” laxatives. The second mechanism of addiction has been proven for anthraquinones and diphenylmethane derivatives. These drugs, acting at the level of neurons of the submucosal plexus, cause the formation of nitric oxide, which relaxes smooth muscles and inhibits peristalsis. With prolonged use, degenerative changes in the enteric system develop. It is assumed that laxatives of these groups also have a mutagenic effect and are genotoxic. Thus, stimulant laxatives are not recommended for long-term, much less chronic, use, especially in elderly patients in whom intestinal hypotension and delayed transit are the main mechanisms of constipation. Drugs with a local irritant effect can be used in elderly people in the form of suppositories to stimulate the tone of the anal sphincter and improve bowel movements. Products that soften feces include petroleum jelly, olive, almond and other vegetable oils. The laxative effect of their use develops after 5–6 hours. Softening laxatives are used, as a rule, in cases where a quick effect is needed (for example, in case of poisoning, in the postoperative period, in preparation for a diagnostic examination of the intestine). Basic rules for prescribing laxatives When using laxatives, you should always remember the negative side of their use. The negative properties of laxatives are associated with the fact that as the duration of their use increases, the receptor apparatus becomes accustomed, as a result of which the effectiveness of these drugs steadily decreases. After 3 years of regular use of laxatives, it drops to 73%, after 5 years - to 50%, and after 10 years only 11% of patients respond to laxatives. During long-term therapy with stimulant laxatives, atrophic and inflammatory changes in the intestinal mucosa are observed, caused by local irritation and dysbiosis, increased loss of protein and potassium through the intestine, and decreased tone of the intestinal muscles. With chronic use of laxatives, there is no need to take them daily. It is advisable to prescribe the drugs once every 3-4 days, periodically taking breaks from taking laxatives, and changing laxatives every 2 years. When choosing laxatives, you should adhere to the following tactics: • if it is necessary to achieve rapid bowel movements in 2–4 hours, cleansing enemas, saline laxatives, castor oil, Fortrans, contact laxatives in the form of suppositories (bisacodyl) are used; • if it is necessary to ensure the evacuation of intestinal contents within 24 hours, then stimulant laxatives (anthraquinones, diphenones) are prescribed; • for long-term use and course treatment, osmotic laxatives are used: Forlax, lactulose with the inclusion of dietary fiber (bran, microcellulose) in the diet. As mentioned earlier, in the treatment of chronic constipation in the elderly, preference is given to lactulose preparations. However, it should be remembered that in order to reduce the frequency of side effects possible during treatment with drugs of this group, combination therapy is required, which for elderly patients seems burdensome due to other existing pathologies that also require long-term and/or constant drug treatment. Thus, it is urgent to search for drugs no less effective than lactulose for the monotherapy of chronic constipation in the elderly. We have our own experience in treating patients with functional constipation with the drug Forlax with different methods of prescribing it mainly to elderly patients. The design of the first study included a course of Forlax administered to 30 patients with functional constipation, i.e. daily use of 2–3 sachets of this drug (10 g of macrogol 4000 in 1 sachet) for 10–12 days. The age of the patients (three men and 27 women) ranged from 20 to 85 years (average 63.1±2.8 years), the majority of patients were elderly. Before taking Forlax, only 3 people did not use laxatives, the remaining 27 patients regularly took various laxative medications: stimulants - 25, saline laxatives - 2, rectal suppositories (glycerin) - 3 people; 7 out of 30 people periodically used cleansing enemas. Forlax was prescribed daily in the morning, 2 sachets (20 g); during treatment, 6 people increased its dose to 3 sachets; 3 patients, on the contrary, reduced the dose to 1 sachet per day. In 20 (66.7%) patients, daily bowel movements were observed from 2–3 days of taking Forlax. The stool was of a soft consistency, and patients felt a complete bowel movement. The laxative effect of Forlax was not accompanied by abdominal pain and painful tenesmus. In 5 (17%) people, while taking Forlax, daily stool was observed in the first 6–7 days, and then, due to the absence of stool for more than 2 days, patients added other laxatives. In another 5 (17%) patients, the use of Forlax was assessed as ineffective, since throughout the entire period of treatment with the use of 3 sachets of the drug, bowel movement was achieved only with the addition of laxatives with a different mechanism of action or with the help of cleansing enemas. Over the next week, bowel movements without Forlax use were assessed. 12 (40%) of 30 patients had an aftereffect, i.e. Spontaneous bowel movements continued daily or every other day. Another 12 people were forced to resort to previously used laxatives 1-2 times a week, but in a significantly lower dosage than before using Forlax. In 6 (20%) patients, bowel movements returned to baseline. Forlax did not cause side effects, the drug was well tolerated. Thus, a positive effect during treatment with Forlax was observed in 83% of patients. The mild and long-lasting effect of the drug, its good tolerability, and acceleration of intestinal motor function were noted. Forlax had an aftereffect in 40% of patients; in addition, it enhanced the effects of previously used laxatives with a different mechanism of action, apparently by restoring the sensitivity of the intestinal mucosal receptors to them. The design of the second study was to evaluate the effect of Forlax when used “as needed” with the goal of providing stool at least 3 times a week. The objectives of the study also included determining the minimum and maximum doses of the drug used as maintenance therapy, as well as assessing the aftereffect of Forlax over the next 2 weeks without its use. The study included patients with chronic functional constipation, long-term and, in most cases, long-term use of various laxatives. 32 patients were under observation: 6 men and 26 women. The age of the patients ranged from 46 to 80 years (mean 64.6±3.4 years). The majority of patients were elderly. According to the method of taking the drug, patients were divided into two groups. The first group (22 people) began taking Forlax 2 sachets in the morning on an empty stomach, 17 of them took the drug after 2–3 days, and 5 patients with persistent constipation in the first 3–4 days received Forlax 2 sachets daily due to slowly developing effect. During treatment, 7 patients on days 6–8 increased the dose of Forlax to 4 sachets per day due to the absence of stool for more than 2 days and the appearance of bloating. Four patients, from 2–3 days of taking the drug, reduced its dose to 1 sachet after 2 days with the effect of daily emptying. As a result, 19 patients achieved a positive effect. Bowel movement, as a rule, occurred 24–30 hours after taking Forlax. The stools were of soft consistency (formed and/or semi-formed). The second group - 10 elderly patients with long-term persistent constipation - began taking Forlax with 4 sachets every 2 days. In 3 patients, no effect was achieved; in the remaining 7 people, fairly complete bowel movements were observed daily or every other day. Thus, during treatment with Forlax, a positive effect was obtained in 26 (81.3%) patients. A slight laxative effect of the drug was noted (the stool was semi-formed and formed). The use of Forlax once every 2-3 days in most cases ensured fairly complete emptying of the stomach every day or every other day. The dose of the drug was selected individually, taking into account the duration of constipation. In the majority of patients (62.5%), the effective dose of Forlax was 2 sachets taken every 2 days. In 18.8% of patients with refractory constipation, Forlax was effective at a dose of 4 sachets (also after 2 days). In 6 (18.7%) of 32 patients, the use of Forlax was estimated as ineffective. Against the background of taking 4-5 bags daily for 3-4 days of intestinal emptying did not occur, and cleaning enemas were performed for 3-4 days or they switched to the use of laxatives of other groups. As a rule, these were patients who for many years have accepted stimulating laxatives, mainly from a group of anthrachinons. Apparently, in these patients, the restructuring of the intestines in connection with the transfer to osmotic laxative takes a long time, and the use of Forlax should be longer. After the abolition of Forlax, the effect of the Beginning for 5-14 days was ascertained in 47% of patients. The results of the study showed that Forlax can be successfully used as monotherapy “as necessary” in the treatment of chronic functional constipation at any age, and especially in elderly patients. In each case, the dose and the method of prescribing the drug should be selected individually. With stubborn slowly transit constipation, it is required to correction of Forlax dosage in the direction of increasing the latter with a daily administration of the drug in the first 3-4 days, since in such patients the restoration of the lost motor function of the intestine occurs gradually. Forlax in these cases can be combined with prokinetics (in particular, with selective agonists of 5 - nt4 - receptors). In patients who have used stimulating laxatives for many years, transfer to osmotic drugs, such as forlax, requires a long use of these drugs, since to restore the sensitivity of the receptor apparatus of the intestinal mucosa to natural stimuli, it takes a long time. The tactics of rational treatment of constipation using Forlax are presented in Figure 1. In conclusion, I would like to emphasize once again that the effective treatment of constipation is achieved by the choice of the optimal scheme of therapy that improves the quality of life of the patient. Given the high efficiency and good tolerance of the drug forlax in many cases, it should be preferred, especially in the treatment of elderly patients. The use of this laxative allows for stable and long -term treatment of patients with constipation, ensuring the achievement of a persistent therapeutic effect.

Literature 1. Minushkin O.N., Elizavetina G.A. Constipation and some principles of their treatment // Clinical pharmacology and therapy. 1997. No. 1. P. 52–53. 2. Minushkin O.N., Elizavetina G.A. Forlax is a new drug for the treatment of constipation” // Materials of the 3rd Russian Gastroenterological Week. 1997. P. 105. 3. Minushkin O.N., Elizavetina G.A. Laxatives in the treatment of constipation // Clinical pharmacology and therapy. 1998. No. 1. P. 87–90. 4. Minushkin O.N., Elizavetina G.A., Zverkov I.V. Constipation and forlax // Materials of the congress “Man and Medicine”. M., 1999. P.63. 5. Grigorieva G.A. Constipation and modern laxatives // Clinical medicine. 1997. No. 1. P. 52–56. 6. Grigorieva G.A., Hammad E.V., Mikhailov A.N. Problems of gastroenterology in gerontology. M., 1994. pp. 45–46. 7. Kabanov A.V. Functional constipation: mechanism of development and the role of dietary fiber in treatment. Diss. Ph.D. honey. Sci. M., 1989. 8. Frolkis A.V. Functional diseases of the gastrointestinal tract. L., 1991. 9. Rumyantsev V.G. Constipation: tactics of patient management in the clinic // Consilium medicum. 2002. No. 1. P. 30–33. 10. Grigoriev P.Ya., Ya Kovenko E.P., Agafonova N.A. Constipation in clinical practice // Russian Medical Journal (Diseases of the digestive system). 2004. T. 6. No. 2, pp. 57–63.

How to take Forlax

The drug Forlax is intended for oral use. Treatment stabilizes the peristalsis of the large intestine, subject to the appropriate nutritional culture (diet). Forlax for adults is prescribed 1-2 packets of the drug per day, preferably in the morning, in one dose with meals. According to the instructions, the powder is dissolved in water at the rate of 200 ml of liquid per package of product. The duration of therapy is determined by the doctor depending on the effectiveness of treatment, the nature and course of the disease.

Diet during treatment

While taking the drug, you should adhere to a diet - this will help to establish bowel movements faster:

• The patient's diet should be rich in fiber. It is found in almost all vegetables, in addition, fiber is sold separately and used to add to various dishes. It is advisable that the little patient’s table include greens, different types of cabbage, root vegetables (beets and carrots), and seasonal vegetables.
• It is also important to feed your baby fermented milk products, preferably twice a day. Today, yoghurts with beneficial bacteria are sold in all supermarkets. If you buy sourdough and milk, such products are easy to prepare at home. The second option is preferable because it allows you to keep a maximum of microorganisms alive.
• You should exclude sweets and baked goods, and limit the consumption of nuts. Constipation can be caused by large amounts of protein - meat and fish.
• Another trick to help avoid constipation is to drink fluids. You need to make sure that the offspring drinks enough water. Its amount is calculated depending on the age and weight of the child.
• The child’s daily routine should be monitored - the baby should not systematically sit at the computer or watch TV from morning to night. Good nutrition, walks, active games - all this is necessary for a growing body.

As you can see, if a child suffers from constipation, parents are quite capable of correcting the situation. It is important not to rely only on medications, but to try to use other methods to solve the problem. Proper nutrition, as well as feasible physical activity, will help prevent constipation. If you control the listed aspects of a child’s life, you can avoid problems in the future.

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special instructions

Treatment of constipation with any drug is an auxiliary therapy, subject to diet and a healthy lifestyle. You should consume more water and fiber, increase physical activity and restore digestion. If the use of Forlax without following an appropriate diet does not eliminate the symptoms, we can talk about other pathologies that require diagnosis and treatment.

Due to the content of sulfur dioxide in the drug, allergies and bronchospasm may occur. Elderly people and patients with impaired renal and liver function should use laxatives with caution when taking them simultaneously with diuretics, since there is a possibility of developing diarrhea. Such patients should be prescribed a drug with monitoring of electrolyte balance.

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Indications for use

Any laxative, which includes Forlax, does not treat the cause of the disease, but only eliminates the symptom (we recommend reading: an effective laxative for children). It is allowed to take the medication from six months, but for children a children's dosage is used. The drug is prescribed in the following cases:

• to help a patient who has not had stool for several days;
• to cleanse the intestines before special procedures (colonoscopy) or before surgery;
• as a prophylactic against constipation, which is undesirable in the postoperative period, or taking medications that cause stool retention.

Forlax for children

Children from 6 months to 1 year are prescribed 1 sachet of 4 g per day , from 1 year to 4 years - 1-2 sachets/day; from 4 to 8 years - 2-4 sachets/day. Dissolve the contents of the sachet in 50 ml of water, take in the morning (at a dose of 1 sachet/day), or in the morning and evening (at a dose of more than 1 sachet/day). For patients over 8 years of age - 1 sachet of 10g per day. The total course of therapy should not exceed 90 days. There have been cases of aspiration in children with neurological disorders of swallowing when significant volumes of the drug with electrolytes were administered through a nasogastric tube.

Indications

The instructions indicate that the main indicator for the use of Forlax is constipation, caused by various factors:

• Changes in the diet of the mother, if the newborn is exclusively breastfed, or the child (introduction of formula, complementary foods or new foods that the baby has not tried before).
• Lack of fluid in the body. This situation can arise in hot weather, when the child drinks little, or in case of rapid loss of fluid in the body against a background of elevated temperature.
• The presence of allergies, which provokes such an unpleasant illness, or helminthiasis.
• If the baby suffers from “psychological” constipation, that is, he is afraid to go to the toilet in a new place, or if there are unfamiliar people.
• Quite often, this symptom also occurs when taking medications, so the remedy can be used for children if there is constipation and the medication cannot be stopped.
• In the postoperative period, when it is necessary to normalize stool.

The use of Forlax can also be indicated as a preparation of the body for various examinations (endoscopy, ultrasound, etc.), the effectiveness of which may be affected by the fullness of the intestines.

It is important for every parent to understand that this laxative relieves only the symptom and does not fight the underlying cause that causes constipation in the baby. Therefore, if such an ailment occurs frequently, you need to consult a doctor, determine the root cause and begin to treat it.

Drug interactions

It is possible that the dissolution, absorption and assimilation of medications taken at the same time as Forlax may slow down . Because of this, it is not recommended to take the laxative drug together with other pharmaceuticals, and it is also necessary to maintain an interval of at least two hours between taking Forlax and other medications. It is prohibited to prescribe the drug together with Loperamide, Imodium and other drugs that suppress peristalsis.

Operating principle

The basis of Forlax is macrogol, a substance with a polymer structure with a significant molecular weight, and according to its mechanism of action it belongs to osmotic laxatives. This means that when the substance enters the intestines, macrogol actively attracts water and increases in size.

As a result, the density of feces decreases, it increases in volume and begins to actively come into contact with the walls of the intestine, irritating the receptors. Due to this, peristalsis increases, and the urge to defecate appears. However, the effect of this laxative does not occur immediately, but after about 24 hours, so do not sound the alarm and give other drugs if you do not see the effect after half an hour.

The main advantage of Forlax is that it does not irritate the gastrointestinal mucosa and does not affect its microflora, therefore it is safe for use in children.

Side effects and overdose

When using the laxative Forlax, side effects were sometimes observed. Adverse reactions in adults include:

• stomach ache,
• increased gas formation,
• diarrhea,
• pain in the perianal area,
• nausea,
• vomit,
• acute frequent urge to defecate,
• spontaneous bowel movement.

Skin rash, urticaria, and Quincke's edema are rare. In children, adverse reactions during treatment with Forlax manifest themselves in the form of abdominal pain, vomiting, bloating, frequent bowel movements, and nausea. In case of overdose of the drug, cases of diarrhea, vomiting, pain in the epigastric region, and flatulence are rarely observed. Symptoms caused by an overdose of Forlax disappear after temporarily stopping the drug or reducing the dose. In case of dehydration due to vomiting or diarrhea, measures to correct the water and electrolyte balance are necessary.

Forlax for colonoscopy

Colonoscopy is an examination of the intestines by inserting a probe. The examination reveals polyps, neoplasms, and ulcers. Preparation for the procedure takes two days and involves diet and bowel cleansing.

Preparation

You need to properly prepare for a colonoscopy. The reliability and purity of the procedure is ensured by a completely cleansed intestine. At the first stage of preparation (a week in advance), a slag-free diet is prescribed.

You will need to exclude from your diet raw vegetables and fruits, hard cheeses, full-fat milk, sour cream, bread and confectionery, whole grains, and legumes.

Can be used:

• Lean meat;
• Low-fat yoghurts, kefir;
• Buckwheat;
• Clear broths;
• Steamed vegetables;
• Still mineral water, green tea, fruit drinks.

The diet will prepare the intestines for the procedure, stop gas formation, improve metabolism, and cleanse the gastrointestinal tract. If you feel lightness and emptiness in the stomach area, the stool is yellow or light brown, the body is properly prepared. The diagnostic procedure will be successful.

Taking a laxative

The second stage of preparation involves medicinal cleansing. The doctor prescribes a remedy to get rid of feces that are not passed naturally. Forlax showed excellent results for preparation for examination. The procedure time is reduced to 22 minutes. (usually takes up to 45 minutes). The effectiveness of the examination increases.

The drug is prescribed the day before the diagnostic examination. Dissolve 20 g (2 sachets) in 0.5 liters of water. Take in the morning. Repeat in the same amount in the evening.

According to the second method, Forlax is started three days in advance. The dosage is calculated using the formula: liter of prepared solution per 20 kg of patient weight. Drink a glass every half hour. After 4 hours, diarrhea begins. Ends 4 hours after the last dose. The last appointment is 5 hours before the examination. On the day of the procedure, a cleansing enema is performed.

The method is not safe. Use is accompanied by deterioration of health, nausea, and vomiting. Abdominal pain appears. Consult your doctor.

Contraindications

Despite the delicacy of the drug, it has contraindications for use. These include:

• intolerance to fructose or other components of the drug;
• Crohn's disease, ulcerative colitis, other inflammatory processes of the colon mucosa;
• ulcers or threatened perforation of the gastrointestinal tract;
• confirmed or suspected intestinal obstruction, symptomatic stenoses;
• abdominal pain of unknown origin.

Forlax analogs

There are analogues of the drug on the market, it is important to navigate their range. Note that their principles of action are different, and their methods of administration also differ. For infants, it is better to use suppositories or microenemas, and for children over 3 years old, medications in the form of a solution or drops are suitable. It is advisable to take the tablets for children over 6 years of age.

READ ALSO: Glycelax suppositories: instructions for use for newborns

There are other drugs for the symptomatic treatment of constipation - Exportal in powder form, Bisacodyl, which is available in the form of suppositories and tablets.

Duphalac and Normaze are very popular - the drugs are approved even for newborns. However, Duphalac is made on the basis of lactulose, so it is not recommended for patients with galactosemia.

Some drugs are convenient to use in combination because they have different effects on the body. For example, if the patient uses Duphalac, but the stool has not yet returned to normal, it makes sense to use one-time glycerin suppositories. It is not difficult to choose the optimal remedy for a small patient, but it is better to listen to the doctor’s recommendations.

Analogs

In the treatment of constipation, a number of drugs similar in effect to Forlax are used to cleanse the intestines. These include:

• Lactulose. Syrup, lactose derivative. Lactulose is a prebiotic, restores the optimal balance of intestinal microflora. Lactulose is broken down in the small intestine into low molecular weight acids that reduce acidity; they lead to osmotic changes that stimulate consistency and increase the volume of stool, which improves intestinal motility. There are no age restrictions for admission.
• Bioflorax. Syrup. The active ingredient is lactulose. Pharmacodynamics are similar to Lactulose. It is allowed to be used by children from infancy.
• Duphalac. Syrup in a sachet or bottle. The active ingredient is lactulose. In terms of pharmacodynamics, the drug is similar to Lactulose. Has a mild laxative effect. There are no age restrictions for admission.
• Medulak. Syrup. The active ingredient is lactulose. The drug is similar to Lactulose and other lactulose-containing drugs.
• Normolakt. Syrup. The active ingredient is lactulose. Normolact is similar to Lactulose.
• Fleet Phospho-Soda. Solution for oral use. Active ingredients: disodium phosphate dodecahydrate, sodium dihydrogen phosphate dehydrate. Saline laxative. Increases the amount of fluid in the intestines, which leads to softening of stool, increased intestinal contents, and easier bowel movements. Designed to cleanse the intestines before diagnostic tests and surgery.
• Endofalk. Powder for the preparation of oral solution. Active ingredients: macrogol 3350, sodium chloride, sodium bicarbonate, potassium chloride. The action of the drug is similar to Forlax. Used to cleanse the intestines before colonoscopy.
• Fortrans. Powder for the preparation of oral solution. Active ingredients: macrogol 4000, anhydrous sodium sulfate, sodium bicarbonate, sodium chloride, potassium chloride. Pharmacodynamics are similar to Florax. It is used before X-ray and endoscopic examination or before surgery on the large intestine. Shown only to adults.
• Transulose. Oral paste. Active ingredients: lactulose, white paraffin, mineral oil. It has a laxative effect through two different mechanisms: lactulose increases hydration, increasing the volume of intestinal contents, and paraffin and oil lubricate and soften stool. Not recommended for children, pregnant or nursing women.
• Movieprep. Powder in 2 sachets for the preparation of an oral solution. Active ingredients: macrogol 3350, anhydrous sodium sulfate, sodium chloride, potassium chloride, ascorbic acid, sodium ascorbate. Causes moderate diarrhea, leads to rapid cleansing of the large intestine. Used before diagnostic examinations of the intestine.

Description of the drug

The medication is intended to help relieve constipation. Violations occur for various reasons - from poor nutrition to serious diseases of the digestive system. Forlax helps get rid of stool, but does not eliminate the source of constipation. An examination in a medical institution will reveal the origins of violations.

Effect of the drug

The product has a delicate effect on the gastrointestinal tract. The components do not cause harm to other body systems. The speed of action of the laxative is reduced, the negative consequences of using the drug are minimal. The powder is prescribed to children in infancy.

The medicinal components penetrate the intestines. The binding of drug molecules and liquid molecules occurs. The volume increases, the structure of feces changes. The drug acts on the mechanical receptors of the large intestine. The laxative effect occurs within one to two days.

Defecation when using the product is painless. Parents do not have to deal with the whims of their children when taking the powder. Easy to drink, smells pleasant of citrus fruits. The diluted powder has a pleasant milky hue.

The dosage and regimen are prescribed by the doctor. It is not recommended to independently determine how, when and how much to take. The medicine has contraindications.

Advantages

Pharmacology offers a wide range of drugs to cleanse the intestines. The choice of Forlax was due to the following reasons:

• Gentle impact;
• Minimum side effects;
• Pleasant taste;
• Allowed for pregnant and lactating women;
• Taken in childhood;
• Affordable price.

Forlax price

The cost of the drug in 10g sachets depends on the number of packets in the package. The price of 1 sachet in a package of 20 pcs is lower than when packaged in 10 pcs. Below are the prices for Forlax in pharmacies in Moscow:

Forlax during pregnancy

The problem of constipation can occur periodically, or it can accompany the expectant mother for almost the entire 9 months of bearing the baby. Of course, the first step towards fixing a problem is to determine its cause. Most often, the desired effect can be achieved by adjusting the diet. However, this does not always happen, and then medications come to the rescue.

Forlax during early pregnancy

The first weeks of gestation are characterized by enormous changes in the pregnant woman’s body. A woman’s hormonal background also undergoes radical changes. It is hormonal changes in the body that most often cause constipation in the first period of gestation. In the early stages of pregnancy, constipation is especially dangerous - the process of defecation is accompanied by increased tension, the woman pushes (which is strictly prohibited). This picture leads to an increase in uterine tone, which is fraught with the threat of pregnancy failure and even miscarriage. As part of an integrated approach to the treatment of constipation, it is possible to use such a remedy as Forlax. The drug does not have a systemic effect and, very importantly, does not stimulate intestinal contractions. Caution in taking the medicine may be associated with the additional components included in its composition - preservatives, fragrances, flavorings. The drug is taken in consultation with the doctor.

Forlax during pregnancy - use of the drug in the 3rd trimester

As you move into the third period of pregnancy, the likelihood of constipation increases again. The contributing factors in this case are the increased pressure of the uterus on the peritoneal organs and intestines, including a decrease in the motor activity of the pregnant woman, a decrease in fluid intake - in the last weeks of gestation, many women face the problem of edema, so they try to reduce the flow of fluid into the body (which is fundamentally wrong !). As a result, problems with emptying begin. In this case, taking Forlax can also have a positive effect. And here again it is worth noting the lack of effect of the drug on intestinal motility - it does not create a threat of spontaneous onset of labor earlier than the term. Only the doctor prescribes the dosage and monitors the therapy.

Video about treating constipation in children

When a child experiences constipation, most parents run not to the doctor, but to the pharmacy, so it is important to know which medications are safe, effective and approved for treating babies. And this video can help with this, so we recommend that you familiarize yourself with it.

What helps your child cope with constipation? What drugs were most effective in your case, and did you have to use Forlax? Leave your feedback and advice in the comments, because this information may be useful to others. We will also be glad if you leave your feedback on this article.

Types of drugs with similar effects

When choosing a drug, doctors can prescribe such effective options as Forlax or Duphalac to combat constipation. Which one is better?

These products differ in their main active ingredient . Duphalac is produced on the basis of lactulose, which belongs to the category of disaccharides not found in the natural environment. This substance is not absorbed in the intestines, but when broken down, it promotes the release of simple organic acids, which have an osmotic effect on the intestinal walls, activating their contraction by increasing the feces saturated with lactulose with water.

Negative factors include provocation of increased gas formation by lactulose , which causes discomfort and contributes to the appearance of flatulence. The effect can be prolonged and allows the use of excrement disorders during regular treatment.

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The main element of Forlax was a synthetically produced macrogol. This polyethylene glycol increases the solubility and volume of stool. The peristaltic effect is achieved through pressure on the intestinal walls, aiming to provoke a slight contraction of the intestinal muscles. This method can disrupt the electrolyte balance. For this reason, it is necessary to use the product only when prescribed by a doctor . Recommended for single use.

Contraindications and possible adverse reactions

Children's Forlax is prescribed to babies from 6 months. In addition to age restrictions, the drug also has serious contraindications. Thus, it is prohibited for use by children who are found to have:

• inflammation in the gastrointestinal tract;
• intestinal ulcers;
• Crohn's disease (a chronic gastrointestinal disease that affects any part of the digestive tract);
• megacolon (colon hypertrophy);
• end-to-end violation of the intestinal wall;
• intestinal obstruction;
• abdominal pain of unknown nature;
• intolerance to any component.

When taking the medication, undesirable consequences occur quite rarely. The individual reaction of the child’s body can manifest itself in the form of:

• diarrhea;
• pain in the abdomen;
• nausea, vomiting;
• accumulation of gases in the intestines;
• allergic conditions (skin itching, urticaria, in isolated cases - Quincke's edema, anaphylaxis).

Side effects are usually temporary and do not require a visit to the doctor, but in case of severe allergic reactions, you should immediately seek qualified medical help.

Instructions for use

Forlax is available in powder form, packaged in disposable sachets, which must be diluted with a small volume of water (50 ml) immediately before use. If the doctor prescribed one sachet per day, then take it in the morning, if two, then take one in the morning and in the evening.

It is recommended to take the drug orally with meals. The duration of treatment for children ranges from 2–4 weeks to 3 months. In some cases, on the recommendation of a doctor, the treatment period may be increased.

For the laxative effect of macrogol, it is important to follow one of the basic recommendations when treating constipation: along with Forlax, you need to drink a large amount of liquid - up to 2 liters per day (in the absence of contraindications)

What works in the medicine

One of the modern laxatives is the drug Forlax. The instructions for use say that it contains one substance - macrogol (Macrogolum). The remaining components are used by the drug manufacturer only as formulators. These are substances such as:

• acetic aldehyde (ethanal) is a metabolite that is obtained as a result of the fermentation of alcohol; it is an active participant in many complex bioreactions;
• alpha terpineol is a monoterpine isomer that has antiseptic properties and is an aromatic component of the drug;
• butylated hydroxyanisole (E320) - a food additive with antioxidant properties;
• gum arabic (acacia gum) is a long-known natural emulsifier - soluble fiber;
• linalool is one of the terpinoids, an aromatic substance is an active participant in metabolism;
• maltodextrin - molasses obtained by incomplete hydrolysis of starch, which has many beneficial properties, which is used as a leavening agent and thickener;
• orange oil - flavoring agent;
• grapefruit oil - flavoring agent;
• octanal is an aromatic substance that, when diluted in salt, acquires an orange aroma;
• sulfur dioxide (E220) is a food preservative with antimicrobial properties;
• concentrated orange juice - for taste and aroma;
• sorbitol (E420) - a flavoring food additive that gives the medicine sweetness;
• cis-3-hexenol is an aromatic alcohol from the leaves used as a food essence;
• citral is an acyclic aldehyde of the monoterpene series with a lemon aroma;
• ethyl butyrate is an aromatic ester of butyric acid.

The instructions for use for children and adults attached to the laxative “Forlax” indicate that the same components also work when using the medicine at an early age.

What's included

The active substance is marcogol-4000 . Additionally, sucrose is introduced, making the drug convenient for use in the treatment of young patients. Additionally, orange-grapefruit flavoring is included.

Macrogol counteracts the loss of electrolytes during weakening. The active substance is not metabolized or absorbed. The acidity of chyme does not change, which preserves the intestinal microflora.

Attention! One package for children contains 6.8 g of sodium saccharin and 60 g of flavoring, which has both an orange and grapefruit scent.

Effects of Forlax powder on bowel function

The intestine is an organ unique in its length and structure. Food, passing sequentially through its sections, is processed by digestive juices and broken down into simpler chemical compounds. The latter can already easily enter the bloodstream through a dense network of vessels surrounding the intestines.

The total length of the entire human intestine is about 12 meters. The largest part is the small intestine. From the inside it is covered with a mucous membrane, collected in a dense network of small villi. Each one contains blood vessels. Processing of food by gastric juice, pancreatic juice, and bile occurs in the intestinal lumen. The villi absorb nutrients.

The intestines are an important part of the digestive system

The large intestine is much shorter. It lacks so many villi because it absorbs water and some vitamins. Undigested waste forms in the large intestine into feces and is naturally excreted. The intestinal muscles play an important role in this process. They differ significantly from the muscles of the trunk and limbs that a person is used to controlling. These muscles are collected in longitudinal ribbons and transverse rings. They do not obey human consciousness, but help move food along the intestines.

Villi facilitate the absorption of nutrients into the blood

In childhood, the body is still poorly able to control the intestinal muscles, so new foods, various diseases and operations can cause constipation in children, even with an anatomically healthy intestine. Elderly people suffer even more often from infrequent bowel movements. In this case, the problem lies in the large vessels feeding the organ. With age, atherosclerotic plaques grow inside blood vessels. The intestinal muscles do not receive the necessary nutrition and work worse.

The intestinal muscles are located in the longitudinal and transverse directions

Modern pharmaceutical science has created many different laxative drugs. However, their effect on the functioning of the intestines boils down to approximately one circumstance - preventing the walls from absorbing excess water into the body. Forlax belongs to drugs of precisely this type of action. The bulky chemical compound retains water inside the intestines and thereby helps normalize stool. It does not enter the bloodstream and does not affect digestive juices or the chemical composition of food.

Features of application

To prevent the development of undesirable consequences, Forlax should be taken in accordance with the instructions. The duration of the course of treatment recommended by the doctor should not be exceeded, since the drug is indicated only as symptomatic therapy. The laxative is recommended for use as an addition to medical nutrition, which may consist of foods high in coarse fiber. Forlax is taken from time to time by people actively involved in various sports. But treating chronic constipation without identifying its cause with this drug is inappropriate.

The laxative should be taken with caution in patients:

• with diseases of the urinary system;
• with liver pathologies.

Taking diuretics can cause a lack of fluid in the body, and the presence of moisture determines the therapeutic effect of Forlax. While taking the drug, it is necessary to maintain water and electrolyte balance. Mineral water, chamomile tea, or rosehip infusion are suitable as additional drinks. Macrogol does not pass into breast milk, so the laxative is indicated for use during lactation.

Recommendations

The most important recommendation for proper preparation for a colonoscopy is to follow all the doctor’s instructions. If questions arise, the answers to them should be clarified with the doctor in advance (even before the start of preparatory measures).

It is also important to report any other medications you are taking, especially blood thinners. This is necessary to avoid complications during the study.

The following tips will help make all stages of colon cleansing easier:

1. Macrogol-based laxatives have an unpleasant salty taste (in the absence of flavoring agents - substances that give a pleasant taste and aroma), therefore it is possible to add various syrups (jam) to the solution in small quantities. Lemon juice and ginger can also improve the taste.
2. Since bowel cleansing involves frequent visits to the restroom, you should not leave the house while taking laxatives.
3. When nausea occurs (or beforehand), you can take any antiemetic.
4. Painful sensations are relieved with antispasmodics or painkillers.
5. You should purchase all necessary medications in advance:

• laxative;
• antiemetic;
• antispasmodic;
• carminative.

Colonoscopy helps diagnose neoplasms of various types at an early stage. This can prevent the development of cancer and save a person's life. But since its effectiveness largely depends on the patient’s preparation, you should carefully adhere to the diet and use laxatives (or enemas).

The site provides reference information for informational purposes only. Diagnosis and treatment of diseases must be carried out under the supervision of a specialist. All drugs have contraindications. Consultation with a specialist is required!

Compound

The active ingredient of the drug, thanks to which Forlax affects the digestive system, is called macrogol 4000 or ethylene glycol. Its dosage corresponds to the weight of the powder in the bag, that is, from one bag you can get either 4 or 10 grams of macrogol.

It is the weight of such an ingredient that distinguishes Forlax for children from adults. The auxiliary components of both versions of the drug are identical. These include sodium saccharin, added to the powder for a sweet taste, and orange-grapefruit flavor, which contains orange juice, sorbitol, grapefruit oil and other compounds.

Interaction with other drugs

Problem

well known to many people. Some prefer to suffer in silence, others resort to rinsing to normalize stool

using enemas. And still others follow the most correct path - they turn to gastroenterologists - specialists in problems of the gastrointestinal tract - with their problem.

Typically, the doctor orders a series of laboratory tests and then, based on the data obtained, prescribes medication. Among medications aimed at enhancing intestinal motility and normalizing the bowel movement process, Forlax ranks one of the first places. And this is not surprising, because this is one of the safest and at the same time very effective drugs for gastrointestinal problems, especially for functional constipation.

The active ingredient of Forlax is ethylene glycol (macrogol 4000).

A special feature of Forlax is its mechanism of action. Getting into the digestive tract, even in small quantities, it attracts water molecules and quickly increases in volume, i.e. swells. Thus, the food bolus becomes larger, due to which it comes into closer contact with the walls of the intestine and, in particular, with its nerve receptors. This, in turn, leads to a noticeable increase in peristalsis and stimulation of the defecation process.

Forlax is practically not absorbed in the intestines and is excreted unchanged in the feces. The laxative effect develops within 24-48 hours, but due to the fact that the stool is diluted by water, which is in the intestinal lumen, defecation is smooth.

“I took this drug after giving birth, because... There were problems with independent stool. The doctor prescribed Forlax to me and immediately reassured me that it would not affect the child in any way. For 2 or 3 days I drank 2 sachets per day, and then switched to 1 sachet. The stool appeared after about a day, maybe a little more, but it was always soft.

Oksana, Naberezhnye Chelny: “I regularly give this laxative to my elderly mother. She cannot take other medications due to Parkinson's disease. During the entire period of use, I did not notice any side effects. In order not to harm the intestines, every three months we take a break for a month. At this time we take another drug, Guttalax, but my mother likes the way Forlax works better, so she always asks to return it as soon as possible.”

It must be said that the opinions of doctors regarding the action and safety of Forlax largely coincide with the reviews of the patients themselves. Moreover, some doctors confidently use the drug in the treatment of functional constipation in pregnant women, and the dosage is selected individually. Positive dynamics were also noted in the treatment of constipation in elderly patients who, due to age and accumulated diseases, cannot lead an active lifestyle and drink 1.5 or more liters of fluid per day.

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The original Forlax is produced by the French pharmaceutical company Bofur Ipsen Industry. In our pharmacies you can buy it on average for 15-20 rubles per sachet or for 150-170 rubles a package of 10 sachets of 10 g each. A package of N20 of 4 g sachets costs approximately 240-260 rubles.

A package of Lavacol N15 can be bought for 170-180 rubles, and for a package of Fortrans you will have to pay about 130-140 rubles.

Forlax or Duphalac

An analogue of Forlax, the drug Duphalac, has exactly the same indications, but it is also used in the complex therapy of hepatic encephalopathy and precoma due to the fact that it is able to stimulate lactic acid bacteria. The main difference between Forlax and Duphalac is that the latter can be prescribed to children starting from infancy. It is also prescribed to pregnant women.

In addition, Duphalac contains lactulose, which has a positive effect on the intestinal microflora; in particular, this component inhibits the growth of salmonella, shortening the periods of bacterial carriage. According to the principle of action and the period of occurrence of the laxative effect, both drugs are completely identical.

What other analogues of Forlax can be found in pharmacies?

Forlax before colonoscopy reviews

Review, Anastasia (Moscow):

I'm 42, I'm from Moscow. I underwent a full medical examination from work, and in the end I was sent to a gastroenterologist. I was scheduled for a colonoscopy, the doctor told me to prepare for the procedure with the help of the drug Forlax. I drank according to the plan, everything is fine, the procedure was successful. Since then, I have been using the product as needed, my body is not young and all sorts of violations do happen.

Review, Tamara Vasilievna (Samara):

I am 54 years old. On the recommendation of the doctor, I am going to go for a colonoscopy for the second time in 2 years. The preparation, as for the first time, is prescribed to me with the help of Forlax - the drug is very effective and suits me perfectly (this is according to my feelings), and the price is quite reasonable. So I can leave a positive review about the drug, I will use it during repeated intestinal checks.

Constipation is a disease when the intestines are unable to empty their bowels for more than two days. The causes of constipation can be a tumor of the intestine, its obstruction, a violation of its motor function, as well as a sudden change of environment, a change in the rhythm of life, poor quality food and much more. And one of the most popular drugs used to treat constipation is the drug Forlax, the instructions for which are always written in accessible language and allow the patient to achieve maximum effect in the shortest possible time.

Slag-free diet

A specially selected diet will help improve metabolism and restore intestinal motility. It should contain a sufficient amount of minerals and vitamins and help remove toxins and waste from the body.

• It is recommended to switch to low-calorie, easily digestible foods. They are completely digested and do not linger in the intestines.
• It is preferable to steam food.
• You need to eat more often, up to 6 times a day, in small portions.
• Drinking a glass of water before every meal is a healthy habit.

What can and cannot be eaten?

In advance, 3 days before the scheduled procedure, you should eat strictly according to the recommendations. We exclude:

• plant foods;
• bakery products;
• milk;
• carbonated drinks;
• alcohol.

The following products are allowed to be consumed:

• meat, fish, poultry (low-fat);
• low-fat fermented milk products;
• cottage cheese;
• low-fat broth;
• eggs;
• sugar;
• honey;
• tea;
• clarified juice;
• fruit and berry decoctions.

Menu for 3 days

To create comfortable conditions for the intestines, it is recommended to switch to a lighter diet. A pre-compiled menu for the preparation period will help you to have a positive attitude towards the upcoming difficult procedure.

1 day:

• For breakfast, let's prepare a cottage cheese casserole and drink it with tea.
• For second breakfast - kefir.
• Vegetable broth and compote (without berries) are suitable for lunch.
• For an afternoon snack we'll limit ourselves to a piece of cheese.
• For dinner, treat yourself to a piece of boiled fish and drink a glass of green tea.

Day 2:

• For breakfast we eat cottage cheese and drink coffee.
• Snack: yogurt.
• For lunch - meat broth with a piece of meat, fruit drink.
• Afternoon snack – fermented baked milk.
• Dinner – boiled egg.

Day 3:

• We only drink liquids. To maintain strength, we drink broth.

Last meal before the procedure

On the day before the diagnosis, you can only consume broth and drink permitted drinks until 14:00. Then you should start taking medications to cleanse the body.

Excipients of Forlax

To make the drug pleasant to take, excipients are used, namely sodium saccharinate. This component is absolutely safe for the human body, including diabetics.

In addition, other components are used that make the drug taste good. These are grapefruit or orange extracts, lemon essence, acetic acid, flavored alcohol, pineapple and orange flavoring, sugar substitutes, preservatives. A complete list can be found in the instructions from the manufacturer of Forlax.

Pregnant women should definitely familiarize themselves with the composition of the drug, because some of its components can cause allergic reactions. In addition, you should definitely consult with a specialist who will select an effective drug for constipation.

Diet before the study

To facilitate the activities associated with cleansing the intestines before colonoscopy using laxatives, it is recommended to follow a special diet (also called a slag-free diet). Its meaning is to exclude foods rich in fiber.

It starts 3 days before the procedure date. At the same time, there is a special list of products that lists prohibited and permitted products.

And also muesli and bran.

It is permissible to prepare lean soups and broths from permitted products.

Attention! Any chocolate desserts (sweets, cakes), coffee and carbonated drinks are also excluded from the diet.

The day before a colonoscopy, drink only clear liquids:

On the day of the procedure (12 hours before), do not consume anything from food, you can only drink clean water.

Analogue Duphalac

The price for this analogue of Forlax for children and adults in the pharmacy ranges from two hundred to one thousand rubles. The drug "Duphalac" in the form of syrup is produced in the Netherlands. It is intended for the treatment of constipation, similar to Forlax, but has a more measured effect, and therefore is not prescribed immediately before an x-ray of the digestive organs. The active component in the composition is lactulose. This substance has an effect on increasing the number of lactobacilli.

This property allows you to stimulate intestinal motility, increasing its contents and acting hyperosmotic. The medicine is not absorbed in the stomach, but is broken down directly in the large intestine by natural microflora. This drug is indicated for chronic constipation and is suitable for softening stool. It is also used in the presence of hepatic coma, against the background of dysbiosis caused by certain organisms. Flatulence is often encountered as an adverse reaction, especially at the beginning of treatment, which then goes away; nausea with diarrhea is also possible.

This is confirmed by the instructions for the Forlax analogue.

Folk remedies for constipation

Many women during breastfeeding try to cope with constipation with folk remedies. They have a good effect, but before use you should consult a doctor. We offer several recipes that help improve bowel movements during lactation:

• Prune decoction. About 20 grams of dried berries are poured with 200 ml of water, brought to a boil, and left for an hour. Drink three glasses 3-4 times a day.
• Fig infusion. Take 50 grams of dry fruit, chop them, pour 200 ml of boiling water over them and leave for an hour. You can replace the water with milk to achieve a better effect. You should drink a tablespoon, 3-4 times a day.
• Gooseberry decoction. It can be prepared in the season when there are ripe gooseberries. About 15 grams of berries are poured into 200 ml of water, brought to a boil and kept on low heat for another 10 minutes, at the end add a few dried apples. You need to drink 100 ml three times a day.
• Take 20 grams of anise fruit, caraway seeds and fennel seeds, pour 200 ml of warm water, leave for 20 minutes, drink 75 ml three times a day. The infusion is good for constipation associated with intestinal atony.
• Herbal collection. Take a tablespoon of anise, dried strawberry and mint leaves, grated valerian root, dried medicinal chamomile flowers. Pour a liter of boiling water and leave for an hour and a half. Drink half a glass after meals, in the morning and in the evening.
• Raw potato juice is also a good laxative. It is half diluted with boiled water, drink 50 ml three times a day.

When taking decoctions and infusions while breastfeeding, you should carefully monitor the baby's condition. Some of their components can cause allergies in infants.

Directions for use and doses

Orally, 1–2 packets (preferably as a single dose in the morning) or 1 packet in the morning and evening if taking 2 packets per day.

The daily dosage should be adjusted according to clinical response and may vary from 1 packet every day (especially in children) to 2 packets per day.

The contents of each package should be dissolved in a glass of water immediately before use.

The effect of taking Forlax is expressed within 24–48 hours after administration.

The recommended course of treatment for children and adults is 3 months.

In children, treatment should not exceed 3 months due to insufficient clinical data.

Maintaining the effect after restoring normal bowel function should be achieved through an active lifestyle and a diet rich in plant fiber.

If symptoms of constipation persist for more than 3 months, it is necessary to conduct a repeated extensive diagnostic examination.

Reviews

If macrogol-based drugs cause an irresistible gag reflex, preparation can be carried out using the safe Dufolac. It is easy to drink, but may cause bloating. You will have to take it for 4 days, and it is recommended to take a loading dose the day before the procedure.

Espumisan will help cope with gas formation. To ensure complete cleansing, an enema should be given immediately before the examination.

Patients who have taken Moviprep note its disgusting taste and the relatively high price of the drug. As a panacea, it is proposed to drink it chilled through a cocktail straw and dissolve lozenges between doses. Physical activity will enhance the effect of the drug.

In some patients, the effect of Fortrex did not wear off even 10 hours after the last dose. They recommend stopping the drug on the day of the examination and drinking the entire dose in advance, a day before the diagnosis.

Also, many patients complain of irritation in the anal area caused by frequent loose stools. Using wet toilet paper and baby cream will help deal with the problem.

We'll tell you how to take Duphalac for adults with constipation

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Today, pharmacies sell a large number of different laxatives. If you take into account the individual characteristics of the body and the recommendations of a specialist, you can choose an almost ideal drug. Among the effective products containing lactulose, you can choose Duphalac. In this article, we will get acquainted with this drug and find out how to take Duphalac correctly for constipation.

This drug is considered a laxative with an osmotic effect. The drug actively acts by transforming the concentration of fluid in the colon. It begins to enter this organ in response to an increase in the amount of organic acids. They appear in the body due to the breakdown of lactulose. The substance can be broken down by beneficial bacteria located in the gastrointestinal tract. The main substance improves the absorption of calcium salts and phosphates.

This chain of actions occurs when taking all lactulose drugs.

Composition, release forms and dosages

The drug is produced in two forms:

• In the form of an amber-brown syrup, produced in plastic jars of two hundred, five hundred and one thousand ml;
• In the form of a snow-white powder, produced in 15 ml polyethylene disposable bags. Each package contains 10 sachets;

The main active ingredient is lactulose. It is considered a product of deep processing of milk. The main raw material from which this substance is created is the milk sugar lactose. Lactulose is a powder in snow-white crystals. It does not have a specific aroma. Able to quickly dissolve in liquid. The powder easily activates the digestive tract. Distilled water is used as an auxiliary component.

Side effects

What are the side effects of Forlax? One of the unpleasant consequences of taking this drug is the appearance of diarrhea.

Most often, such a side effect is observed when the order of administration is violated - excessive use.

Violation of the dosage leads to failure of electrolyte metabolism and the state of the intestinal microflora.

This leads to disruption of the normal functioning of the rectum. For diarrhea, a dosage reduction is required.

In the case of a functional bowel disorder, abdominal pain may appear. Sometimes urticaria and allergic reactions are observed, in the event of which it is recommended to stop taking it. In rare cases, bloating may occur.

Forlax - can the drug be used during pregnancy?

Constipation is not only an unpleasant sensation and a disruption to your usual lifestyle. Long-term accumulation of processed products in the organs of the digestive tract leads to the absorption of toxins contained in them into the blood, which is especially useless for a woman “in pregnancy.” In addition, a crowded intestine puts additional pressure on the uterus, causing its tone and leading to poor blood circulation in the pelvic organs. Therefore, the problem of constipation cannot be ignored.

1. Based on the annotation for the drug, as well as the action of the active compound - animal studies have shown that macrogol 4000 does not have a teratogenic effect - Forlax is allowed for use in such a category of patients as pregnant women.
2. An additional advantage of this medicine is the absence of a spasmodic effect. This kind of action can cause an increase in uterine tone.
3. The medicine practically does not enter the bloodstream and acts mainly locally.

Ferlax can be used during pregnancy, but, like any medicine, in consultation with a doctor.

Cleansing preparations

To carry out diagnosis, it is necessary to completely clear the intestines of its contents. This can be done with an enema or using special medications. They stimulate stool by thinning the contents of the colon and increasing its volume.

Fortrans

The active ingredient of the drug is the polymer Macrogol 4000. Small sachets contain water-soluble powder. Fortrans belongs to the family of strong laxatives.

The urge to defecate occurs literally immediately after drinking the solution; after an hour you will have to visit the toilet frequently.

Complete cleansing of the intestines is indicated by “eruptions” from the rectum in the form of yellowish water without impurities. Stool may form continuously for up to two hours.

Application of the drug:

• Immediately before use, 1 packet is dissolved in water (1 liter).
• You need to drink 3–4 liters of the prepared solution.
• The solution should be consumed 4 hours before the diagnostic procedure.

Reception regimens:

• Diagnostic examination in the first half of the day - the entire solution is drunk the night before.
• The study will take place after 14:00 - the solution can be drunk in the evening and in the morning in parts.

Adviсe:

• If you suffer from constipation, you should first use mild laxatives or an enema.
• It is recommended to drink the solution in small portions, a glass, taking 15-minute breaks. If you have to drink 4 liters at once, after the first half you can take a break for 1 hour.

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The drug contains two active ingredients:

• Macrogol-3350;
• Ascorbic acid.

Excipients (aspartame and sodium and potassium salts) protect the body from water-salt imbalance. The addition of lemon flavor slightly improves the taste of the drug.

Colon cleansing

The drug is produced packaged in sachets of 4 g and 10 g. It ensures ease of use in children and adults. The package contains 10 or 20 pieces. The instructions will help you correctly determine the dose and duration of treatment.

For children

Forlax is used to cleanse the intestines of children from six months. The child will not always determine the causes of anxiety. Therefore, you need to carefully monitor the functioning of the digestive organs. When the intestines are in order, bowel movements occur daily.

Constipation in children occurs for various reasons. An unbalanced diet provokes fecal retention in the intestines. The drinking regime affects the passage of bowel movements on time. Psychological troubles (baby weaning, potty training, public toilets, etc.) provoke the appearance of the disease.

If delayed bowel movements persist, consult a doctor. The examination will show a picture of the development of the disease. Constipation can be a consequence of digestive diseases or improper arrangement of organs. Eliminating the cause will also eliminate the effect.

Children under one year of age are given 1/4 glass of water with a dissolved small sachet (4 g). As a last resort, it is recommended to dissolve the powder in milk. A child under four years old is given up to 8 g per day. Treatment is continued for up to three months. Carefully! The drug is addictive.

For adults

The composition of the drug is safe for people with diabetes and pregnant women. Also indicated for nursing mothers and elderly people. It is not recommended to extend the period of admission beyond four months. Causes “lazy bowel” syndrome. Constant forced leaching leads to dysbacteriosis.

Adults are recommended to drink a laxative 10 g twice a day. The drug is taken before or after meals. The powder is dissolved in a glass of water. Unless the doctor prescribes a different dosage, the maximum intake is 20 g per day.

The dosage of Forlax and the duration of treatment depend on the indications for use. The product is used for weight loss. Losing excess weight occurs gradually. The lost kilograms do not return. Negative reviews from people losing weight indicate the occurrence of dysbiosis. Consultation with a doctor on the use of Forlax is required.

Colon cleansing will not be effective if you do not adhere to the correct diet. The body needs help due to disorders of the gastrointestinal tract. Continuing to load your stomach with junk food, do not expect high-quality cleansing: waste and toxins will continue to accumulate.

Chronic constipation

Intestinal pathologies lead to the development of such constipation. In this case, medical supervision is mandatory. Also a provoking factor is a violation of intestinal functions due to lifestyle and dietary habits.

To cope with such problems, Forlax alone is not enough. In such a situation, you must adhere to the following recommendations:

1. Increase the consumption of foods containing fiber - these include fresh vegetables, fruits, herbs;
2. Increase water consumption;
3. Increase physical activity;
4. Restore defecation reflexes.

It is worth considering that Forlax contains sorbitol. Therefore, the medicine is prohibited for use in cases of fructose intolerance.

Enema

Drugs that have a laxative effect are convenient to use at home. In the hospital, an enema performed using an Esmarch mug is used to cleanse the intestines. The enema is carried out the night before (1 or 2 times) and in the morning on the day of the procedure, using water at room temperature in a volume of 1.5-2 liters.

Important! Performing an enema yourself can be difficult, especially if you lack such experience.

In cases of severe constipation, it is recommended to use Microlax before a regular enema and taking laxatives.

Side effects

Exceeding the dosage recommended by the doctor can cause diarrhea, which stops a day after stopping the laxative. In this case, you should consult a doctor to adjust single and daily dosages. Before taking Forlax, you should make sure that you are not allergic to the ingredients of the drug. Sometimes during use, patients develop a sensitization reaction like urticaria, which is accompanied by:

• swelling and redness of the skin;
• rashes on the upper layer of the epidermis.

The child's body is sensitive to the active substance of Forlax, so side effects in the child appear more often and are more pronounced. What negative signs may occur after taking the drug:

• excessive gas formation;
• nausea and vomiting;
• rumbling and gurgling in the stomach.

To cleanse the intestines of feces before an examination or surgery, the patient sometimes has to take significant doses of Forlax. The result may be skin irritation in the anal area, accompanied by the development of an inflammatory process. One of the rare side effects is temporary fecal incontinence.

Author of the article: Sheveleva Lyudmila Gennadievna

Analogue options

The main task of this drug is to attract fluid to the stool, which helps to liquefy it and accelerate excretion from the body. The medical market offers a wide range of drugs that have similar effects and are based on the action of lactulose and macrogol. Analogues:

• Russian generic Forlaxa Lavacol,
• Transipeg,
• Forteza Romapharm,
• Duphalac,
• Lisolak,
• Portolac,
• Normaze.

Special conditions

Constipation medications are only an addition to the diet. If diarrhea develops while taking the drug, special attention is given to those who suffer from changes in water and electrolyte balance. In extremely rare cases of using Forlax for constipation, anaphylactic shock has been observed.

Since the medicine contains sorbitol, it is not recommended for those who suffer from fructose intolerance. Since the amount of sugar in the medicine is small, it is prescribed even to patients with diabetes.

The drug for constipation is stored for 3 years at room temperature. You can buy Forlax in pharmacies or without a prescription. However, consultation with a doctor is necessary, since only he can determine the cause of constipation and prescribe an effective and safe remedy.

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Features of the drug

Forlax is a white powder used to obtain a special solution.
Taken orally, it smells like grapefruit and also orange. The solution is easy to obtain because the powder dissolves well in water. The main component is macrogol. The following additional components are used:

• fragrance with citrus aroma;
• sodium saccharinate.

A laxative with osmotic properties, like Duphalac, is packaged in sachets. The drug begins to act, helping to get rid of constipation, within 2 days.

Why is colon cleansing performed?

The point of the procedure is to visually examine the colon mucosa using an endoscope (a device that is a thin hose with a camera at the end). The presence of foreign substances in large quantities makes diagnosis difficult, as a result of which a repeat procedure may be required; the study will be uninformative.

• The greatest obstacle is stool, formed from plant fiber. Quite often, they are the ones that interfere with the free movement of the endoscope.
• Also, the presence of undigested particles (for example, seeds or plant peels) leads to problems with visualizing the picture. In addition, determining the presence of polyps in the intestines becomes more difficult.

That is why it is imperative to properly cleanse the intestines before colonoscopy by following a diet and special medications, which begins a few days before the procedure.

In exceptional emergency situations, they resort to a cleansing enema, but during routine diagnostics, patients themselves must prepare for a colonoscopy. Therefore, in order for the diagnosis to be successful the first time, it is necessary to prepare the intestines well in advance.

Product for children

Analogues of children's "Forlax" should be selected by a doctor.

The differences in dosage and frequency of administration between children and adults are that children are advised not to take this drug very often, but should start treatment with minimal doses, that is, with one sachet. It should also be remembered that this drug should not be given to children under eight years of age due to the lack of clinical information.

Children over eight years old are initially prescribed 10 grams of the drug per day. In case of absence or incomplete bowel movement, the dosage is increased to 20 grams. Large quantities of this powder should not be consumed, as side effects may develop in the form of bloating, vomiting, diarrhea, intestinal pain, and so on. Now let's move on to a detailed consideration of analogues of this product.

pharmachologic effect

Forlax powder contains a large amount of the high molecular weight compound macrogol, which provides its osmotic effect. Unlike other oral laxatives, the drug does not irritate the mucous membranes of the gastrointestinal tract. This allows Forlax to be used for long-term course treatment in the dosages recommended by the gastroenterologist.

Pharmacodynamics

After taking Forlax, the active substance of the drug easily reaches the intestines and begins to absorb water molecules. Excessive fluid is one of the causes of irritation of the intestinal walls and peristalsis disorders. By retaining moisture, Forlax helps to increase the volume of stool and the urge to have a bowel movement. This effect of macrogol is ensured by its polymer structure with a large number of long linear molecules.

The increased volume of feces provokes reflex irritation of the intestinal walls, and they begin to contract to move fecal matter towards the anus. By stimulating peristalsis in this way, the drug:

• does not alter the absorption of biologically active substances and mineral compounds;
• does not shift the water-electrolyte balance.

The combination of these properties allows you to quickly restore the evacuation reflex and normalize bowel movements in case of chronic constipation.

Pharmacokinetics

Forlax is not able to bind to blood proteins, so it does not penetrate the systemic circulation. The undoubted advantage of the pharmacological drug is the absence of any metabolism in the gastrointestinal tract. After binding water molecules, the drug is excreted unchanged from the body along with feces. The therapeutic effect of Forlax appears a day after its use.

Analogues of the drug

There are many analogues of this drug on pharmacy shelves, differing in release form and price category.

Lavacol - like Forlax, has the active substance macrogol with a volume of 12 grams. Available in packs of 15 sachets of powder. The manufacturer of the drug is Russia. Has a mild laxative effect. Indicated to relieve constipation and to cleanse the intestines before diagnostic procedures or operations. It is recommended to take the product 18–20 days before the planned event.

The Italian-made medicine Normaze is presented as syrup in a 200-milliliter bottle. Suitable for treating constipation in people of any age. In addition to a pronounced laxative effect, it has the ability to remove toxins, neutralize harmful bacteria, and restore the natural environment of the intestines. Not suitable for patients with chronic appendicitis, intestinal obstruction, or allergy to fructose.

Portalac is a Croatian-made suspension for oral administration in a 250-milliliter bottle. The active substance of the drug, lactulose, stabilizes intestinal motor function. The lactobacilli included in the composition help to establish bowel movements. Effective in the treatment of salmonellosis, prevents the growth and development of pathogenic microorganisms. Approved for use by pregnant and lactating women, children, elderly people suffering from liver and kidney problems.

Duphalac - syrup 200 milliliters. Manufacturer – Germany, Netherlands. The active component, lactulose, not only helps stimulate bowel movements, but also restores intestinal microflora. The action is measured and soft. Suitable for the treatment of chronic constipation. It is permissible to use during pregnancy and lactation. In the first stages of treatment, it may cause flatulence.

Fortrans is a drug with an active substance similar to Forlax. Country of origin: France. Available in sachets (5 pieces per package) of 64 grams. The powder is diluted in water. It is not suitable for use by people with cancer or children under 15 years of age.

What kind of drug is this

Forlax is a laxative designed to combat constipation. The drug stimulates intestinal function and helps normalize stool. The components of the medicine have a beneficial effect on the child’s body, causing rapid and gentle excretion of feces. The product is not addictive.

Mechanism of action:

• Softening and removal of feces from the body.
• Normalization of stool.
• Stimulating bowel function.
• Improving the functioning of the digestive system.

The drug contains:

• Macrogol.
• Sodium saccharinate.
• Maltodextrin.
• Alpha terpineol.
• Grapefruit and orange oil.
• Citral.
• Ethyl butyrate.
• Linalol.
• Acacia gum.

The drug is available in powder form, dissolved in water before use. The powder is pleasant to use and has the aroma of orange and grapefruit. One bag can contain 4 g, 10 g of powder. The package contains 10, 20 sachets.

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