Comparison of three drugs for intestinal colonoscopy: Fortrans, Lavacol and Moviprep

Lavacol, Moviprep, Fortrans - common features and differences

Lavacol is an osmotic laxative used for intestinal lavage, produced in powder form, packaged in sachets. Company-. Price for 15 bags - 215 rubles. The drug contains macrogol 4000 in an amount of 12 g. Additional components are also present:

• sodium bicarbonate (soda);
• potassium chloride;
• sodium sulfate;
• sodium chloride.

The composition of Lavacol is almost completely duplicated by the drug Fortrans. Its main active ingredient is macrogol 4000, but its amount is much higher - 64 g / one dose. The dosages of auxiliary components are also proportionally increased; the composition additionally includes sodium saccharin in a volume of 100 mg. The price difference between the drugs is significant - Fortrans costs 550 rubles/4 sachets, this medicine is produced in France.

Moviprep has much greater differences with the medications described above. It is sold by prescription (Fortrans and Lavacol - without a prescription). The active ingredient is macrogol 3350, a new product in the pharmaceutical industry. To compensate for the loss of electrolytes, the following was added to the composition:

• sodium sulfate, ascorbate and chloride;
• potassium chloride and acesulfame.

To give a pleasant taste, the composition contains flavorings, vitamin C, and aspartame, a sweetener, is present for sweetening. The package, priced at 690 rubles, contains 2 sachets of one type and 2 sachets of the second type. , England. So which is better - Moviprep or Fortrans, Lavacol? According to experts, Moviprep cleanses the intestines much better, since macrogol 3350 retains more moisture. The procedure requires less liquid, which is more convenient for the patient.

How are preparatory activities carried out?

All preparation for a colonoscopy is divided into three stages. The most detailed information should be obtained from a specialist who will take into account all the individual characteristics of the body.

In two days

First of all, two days before the test you should completely avoid eating foods that are rich in fiber. This:

• fresh vegetables,
• fruits,
• food made from legumes,
• mushrooms,
• berries,
• bakery products based on durum wheat.

It is recommended to include chicken or vegetable broths, fish dishes, white bread, low-fat cheese, and boiled lean meat in the diet. When a patient suffers from constipation, then he should start taking previously used laxatives. This approach will not only help to carry out intestinal cleansing at a physiological level for the upcoming colonoscopy, but also make it easier.

Important! Only with the use of preliminary preparation can you completely cleanse the intestines by taking Fleet Phosphosoda, otherwise the effectiveness of this medication will be low.

The day before

The day before the scheduled diagnosis, you should begin preparing using Fleet Phosphosoda. The patient should not have a heavy meal for breakfast. Usually it is recommended to only take 1 glass of unboiled water. Then take one dose of the medicine. To prepare it, you need to dilute the contents of one bottle in 150 ml of unboiled water. Next, you need to drink the prepared solution completely. It is not recommended to eat a full lunch before the study. You are only allowed to eat light broth.

Preparation with Flit Phosphosoda allows you to avoid such an unpleasant procedure as an enema

If the procedure is carried out in the morning, then in the evening the patient needs to take the next dosage of the drug. For this purpose, you need to dilute the contents of the next bottle in 150 ml of fresh water. Then immediately drink the solution. If necessary, it is recommended to take the medicine with warm water. This medicine lasts from 1 to 6 hours.

Important! During preparatory measures, the patient is prohibited from using an enema. Cleaning should only be carried out by exposure to Fleet Phosphosoda.

On the day of the procedure, you are allowed to take only a light and clear broth in the morning. It will not have a negative impact on the procedure and obtaining good results. The patient will have more strength for examination. This will improve his well-being.

Effect of drugs

Macrogol is a linear polymer. Due to the presence of special hydrogen bonds, it retains water molecules, increases osmotic pressure, and increases the volume of intestinal contents. The product only works in the large intestine. After administration, an increase in intestinal motility occurs, and moderate or severe diarrhea is observed.

Macrogol is not absorbed into the gastrointestinal tract and does not participate in metabolic reactions.

The presence of electrolytes in the composition helps maintain natural balance without disturbing the electrolyte balance.

The drug Moviprep contains ascorbic acid, which helps to compensate for its loss (occurs against the background of diarrhea). A certain amount of additional substances is absorbed and excreted in the form of metabolites by the kidneys.

Indications for use and contraindications

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Any drug has the same indications. Taking a certain amount of powders is recommended before conducting bowel examinations:

• colonoscopy;
• rectoscopy;
• sigmoidoscopy;
• irrigoscopy (radiography).

The drugs are also prescribed as an alternative to an enema or in parallel with it before colon surgery. Among them are any procedures that require a cleansed intestine (removal of polyps, cysts, tumors, intestinal resection, etc.).

There are a number of contraindications to taking medications. You should not drink powders if you are intolerant to the components or have allergic reactions. It is also prohibited to carry out cleansing in case of intestinal obstruction, especially if it occurs for an unknown reason. During pregnancy and lactation, take medications only for important indications!

Gastroparesis - failure of the motor function of the stomach - also serves as a ban on therapy.

Other contraindications are the risk of intestinal perforation or existing perforation of the walls of any part of the gastrointestinal tract. Due to the presence of aspartame, Moviprep is prohibited for phenylketonuria, and due to the presence of vitamin C, it is prohibited for a lack of glucose-phospho-dihydrogenase.

Prohibitions on treatment with any of the drugs apply to Crohn's disease, acute ulcerative colitis, and toxic megacolon. Fortrans and Lavacol are used from the age of 15, Moviprep - from the age of 18. The drugs are used with caution in cases of tendency to vomiting, dehydration, heart failure, renal failure, and abdominal pain of unknown cause.

Preparation with Lavacol, if the procedure is under anesthesia

Given the pain and discomfort during colonoscopy, diagnosis can be performed under anesthesia. The following types of anesthesia are known: sedation, local or general anesthesia.

If pain relief is necessary, Lavacol is taken according to the same regimen. The product does not reduce the effectiveness of anesthesia, since the last dose is taken 4-5 hours before. Failure to do so may reduce the effect of the sedative. Also, unwanted vomiting develops during the manipulation.

Attention ! During the morning procedure under anesthesia, patients should not eat any food. Food can trigger severe vomiting and an allergic reaction.

Patients with diabetes should discuss management tactics with their doctor.

Side effects

Usually, unpleasant effects occur after a short period of time from the start of taking the drugs, after which they subside. Most often there is heaviness in the abdomen, a feeling of bloating and fullness. Diarrhea is a characteristic and expected symptom; it occurs as a consequence of the therapeutic effect of macrogol. As a result of frequent bowel movements, pain in the anal area is often noted.

In some people, taking medications is accompanied by nausea; in severe cases or in cases of impaired gag reflex, vomiting.

Allergic reactions more often develop when taking the drug Moviprep, since it contains fragrances and a sweetener. Allergies to Fortrans or Lavacol develop less frequently, but are quite possible. Hypersensitivity reactions include:

• rash on the body;
• redness, spots;
• itching;
• hives;
• rarely - severe systemic reactions.

The manufacturer of the drug Moviprep indicates that taking the drug may cause such phenomena as insomnia and other types of sleep disorders. In rare cases, headaches, dizziness, transient increases in blood pressure, and convulsions occurred. Changes in liver tests and significant changes in electrolyte levels were very rarely recorded. Typically, electrolyte balance is disturbed in patients who simultaneously use medications with nephrotoxic effects.

Conclusion

Consult your doctor. A safer drug is Moviprep. It is easier to tolerate and can be washed down with plenty of tasty liquid (sweet tea, juice). Moviprep should be chosen if there are indications of renal failure and high levels of creatinine and urea in blood tests, confirmation of gastric and duodenal ulcers, inflammation of the intestinal and rectal mucosa. If you plan to drive a car after the study or work with moving mechanisms, then Moviprep is better suited.

Choose Fortrans if it is difficult for you to induce nausea and vomiting, if you suffer from sleep disturbances, dizziness, and headaches. If you know that you suffer from phenylketonuria or glucose-6-phosphate dehydrogenase deficiency, then Fortrans is the drug of choice.

And in conclusion - consult an endoscopist!

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Instructions for use

The procedure for using medications is similar. It is advisable to take them 18-20 hours before surgery or intestinal examination. Lavacol is used in this way:

• the drug must be taken orally;
• one sachet should be diluted with boiled water at room temperature;
• amount of water per sachet - 1 glass (200 ml);
• the indicated portion is drunk every 20 minutes, a total of 3 liters of the drug is taken (this amount can be reduced on the recommendation of a doctor);
• During the reception you should eat only liquid food in small quantities;
• Usually the period for taking the medicine is from 14 to 19 hours, after 21 hours therapy is not carried out.

Fortrans is diluted in a different way - a bag goes to 1 liter of water. The dose of the required solution is determined as a liter per 20 kg of body weight. Typically, 3 to 4 liters of solution are consumed. Reception is carried out in the same way as indicated for Lavacol. The instructions for the drug Moviprep are as follows:

• take one sachet of type 1 and type 2;
• dilute both sachets in a small volume of water;
• add water to 1 liter;
• proceed in the same way with the second pair of sachets;
• the total dose for one bowel cleansing procedure is 2 liters;
• It is permissible to take 2 liters once (if possible, 1-2 hours before) in the morning or evening, you can also divide the intake into 2 parts - one liter in the morning and in the evening;
• Usually before operations, cleansing is done in the evening, before examination - in the morning;
• additionally drink at least a liter of other liquid - juice, broth, water, do not consume milk or alcohol;
• 2 hours before the examination, the drug should be stopped;
• You can’t eat from the beginning of bowel cleansing.

Overdose usually results in severe diarrhea, which can cause electrolyte imbalances.

Are there other analogues?

Structural analogues include the drugs Forlax and Endofalk based on macrogol. Among the analogues there are products with a laxative effect that can be used to cleanse the intestines. But most of them do not give such a powerful effect as these medications:

Elderly patients or those with impaired consciousness are given this type of medication through a tube in a hospital setting. During the course, you should stop driving and operating machinery.

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Patient reviews

Fortrans is mainly criticized for its disgusting taste, which some could not bear and canceled the preparation. Based on the results, there are almost no complaints about the drug. Many people experience persistent nausea.

Some also call Lavacol disgusting, but most consider it absolutely normal in taste in comparison with Fortrans. The urge does not begin for a long time, so a person has to put up with a stomach full of fluid for hours. When the effect is achieved, defecation continues almost until the morning. Both doctors and patients are satisfied with the results.

Moviprep is highly praised for its taste and high-quality cleansing. However, the effect takes longer than from Fortrans. Complaints about the cost being too high. Some had their preparations disrupted due to severe sudden vomiting.

Colon cleansing medications before colonoscopy only work after a 3-day diet. Even the most powerful remedy is not able to prepare the intestines in a hurry. Those who suffer from chronic constipation need to maintain a special diet for 5 or even 7 days, and additionally drink mild laxatives based on lactulose or plant extracts.