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Drug overview for METAMUCIL SUGAR-FREE (psyllium husk/aspartame):
Generic name: PSYLLIUM HUSK/ASPARTAME
Drug class: Bulk Laxatives
Therapeutic class: Gastrointestinal Therapy Agents
Cellulose derivatives (methylcellulose), malt soup extract, and psyllium preparations are bulk-forming laxatives.
No enhanced Uses information available for this drug.
Generic name: PSYLLIUM HUSK/ASPARTAME
Drug class: Bulk Laxatives
Therapeutic class: Gastrointestinal Therapy Agents
Cellulose derivatives (methylcellulose), malt soup extract, and psyllium preparations are bulk-forming laxatives.
No enhanced Uses information available for this drug.
DRUG IMAGES
METAMUCIL SUGAR-FREE POWDER
The following indications for METAMUCIL SUGAR-FREE (psyllium husk/aspartame) have been approved by the FDA:
Indications:
Constipation
Professional Synonyms:
None.
Indications:
Constipation
Professional Synonyms:
None.
The following dosing information is available for METAMUCIL SUGAR-FREE (psyllium husk/aspartame):
Bulk-forming laxatives are usually administered 1-3 times daily. To reduce the risk of esophageal obstruction in patients receiving large (e.g., the maximum daily dosage recommended by the manufacturer) dosages of bulk-forming laxatives, these laxatives should be administered in divided doses instead of a single daily dose. The usual dosages for the individual bulk-forming laxatives are below; for dosages in children younger than the ages listed, a physician should be consulted.
Bulk-forming laxatives are administered orally. Commercially available powders, flakes, granules, tablets, and liquids should be dissolved and/or diluted according to the instructions of the manufacturer. In the treatment of constipation, at least one full glass (250 mL) of liquid should be administered with each laxative dose. When used to increase the bulk of stools in patients with chronic, watery diarrhea, one manufacturer suggests that one-third of a glass (80 mL) of liquid be administered with each dose.
No dosing information available.
No generic dosing information available.
The following drug interaction information is available for METAMUCIL SUGAR-FREE (psyllium husk/aspartame):
There are 0 contraindications.
There are 3 severe interactions.
These drug interactions can produce serious consequences in most patients. Actions required for severe interactions include, but are not limited to, discontinuing one or both agents, adjusting dosage, altering administration scheduling, and providing additional patient monitoring. Review the full interaction monograph for more information.
| Drug Interaction | Drug Names |
|---|---|
| Aspartame; Phenylalanine; Tyrosine/Nitisinone SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction. MECHANISM OF ACTION: Aspartame contains phenylalanine, which is metabolized into tyrosine. Nitisinone prevents the breakdown of tyrosine.(1) CLINICAL EFFECTS: Elevated levels of tyrosine can cause vision changes (cornea ulcers, corneal opacities, keratitis, conjunctivitis, eye pain, and photophobia), skin problems (painful hyperkeratotic plaques on the soles and palms), and nervous system toxicity (variable degrees of mental retardation and developmental delay). PREDISPOSING FACTORS: None determined. PATIENT MANAGEMENT: Patients receiving nitisinone should following dietary restrictions concerning the consumption of aspartame, phenylalanine, and tyrosine, including medications that contain these ingredients.(1) DISCUSSION: In most patients, eye symptoms resulting from elevated tyrosine levels were transient, lasting less than one week; however, six patients had prolonged episodes lasting up to almost 2 years.(1) |
NITISINONE, NITYR, ORFADIN |
| Trofinetide/Laxatives SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction. MECHANISM OF ACTION: Trofinetide commonly causes diarrhea of mild to moderate severity. Laxatives may increase the incidence or severity of diarrhea.(1) CLINICAL EFFECTS: Concurrent use of laxatives with trofinetide may increase the risk of severe diarrhea.(1) PREDISPOSING FACTORS: None determined. PATIENT MANAGEMENT: Patients should stop laxatives before starting trofinetide. If diarrhea occurs, consider anti-diarrheal treatment and monitor hydration status. If severe diarrhea or dehydration occurs, interrupt, reduce dose, or discontinue trofinetide.(1) DISCUSSION: In clinical trials, 85% of patients on trofinetide developed diarrhea. Concurrent use of laxatives may increase this risk.(1) |
DAYBUE |
| Tenapanor/Laxatives; Stool Softeners SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction. MECHANISM OF ACTION: Tenapanor commonly causes diarrhea of mild to moderate severity. Laxatives and stool softeners may increase the incidence or severity of diarrhea.(1) CLINICAL EFFECTS: Concurrent use of laxatives or stool softeners with tenapanor may increase the risk of severe diarrhea.(1) PREDISPOSING FACTORS: None determined. PATIENT MANAGEMENT: The US manufacturer of tenapanor states that patients should be instructed to avoid stool softeners and laxatives with tenapanor. If severe diarrhea occurs, tenapanor should be discontinued.(1) DISCUSSION: In clinical trials, 43-53% of CKD patients on dialysis treated with tenapanor developed diarrhea. Diarrhea usually occurred soon after treatment initiation and was severe in 5% of patients.(1) |
XPHOZAH |
There are 1 moderate interactions.
The clinician should assess the patient’s characteristics and take action as needed. Actions required for moderate interactions include, but are not limited to, discontinuing one or both agents, adjusting dosage, altering administration.
| Drug Interaction | Drug Names |
|---|---|
| Clozapine/Bulk Forming Laxatives SEVERITY LEVEL: 3-Moderate Interaction: Assess the risk to the patient and take action as needed. MECHANISM OF ACTION: Clozapine has potent anticholinergic properties and inhibits serotonin receptors, including 5-HT3.(1-4) Both of these properties may cause inhibition of gastrointestinal (GI) smooth muscle contraction, resulting in decreased peristalsis.(3,4) If fluid intake is inadequate, bulk forming laxatives can increase the risk of gastrointestinal obstruction.(1-6) CLINICAL EFFECTS: Concurrent use of clozapine and bulk forming laxatives with inadequate fluid intake may increase the risk of constipation (common) and serious bowel complications (uncommon), including complete bowel obstruction, fecal impaction, paralytic ileus and intestinal ischemia or infarction.(1-6) PREDISPOSING FACTORS: The risk for serious bowel complications is higher with increasing age, higher frequency of constipation, and in patients on higher doses of clozapine or multiple anticholinergic agents.(1,5) PATIENT MANAGEMENT: Concurrent use of bulk forming laxatives with clozapine may be used with caution in patients who can maintain adequate fluid intake. Evaluate the patient's bowel function regularly. If patient is unable to maintain adequate fluid intake and use bulk forming laxatives as prescribed, avoid the use of bulk forming laxatives with clozapine.(1-6) Monitor for symptoms of constipation and GI hypomotility, including having bowel movements less than three times weekly or less than usual, difficulty having a bowel movement or passing gas, nausea, vomiting, and abdominal pain or distention.(2) Consider a prophylactic laxative in those with a history of constipation or bowel obstruction.(2) Review patient medication list for anticholinergic agents which may have additive effects on decreased GI motility. When possible, decrease the dosage or number of prescribed anticholinergic agents, particularly in the elderly. Counsel the patient about the importance of maintaining adequate hydration. Encourage regular exercise and eating a high-fiber diet.(2) DISCUSSION: The concurrent use of clozapine and bulk forming laxatives has not been studied. Use of bulk forming laxatives with inadequate fluid intake has been associated with gastrointestinal obstruction. |
CLOZAPINE, CLOZAPINE ODT, CLOZARIL, VERSACLOZ |
The following contraindication information is available for METAMUCIL SUGAR-FREE (psyllium husk/aspartame):
Drug contraindication overview.
No enhanced Contraindications information available for this drug.
No enhanced Contraindications information available for this drug.
There are 3 contraindications.
Absolute contraindication.
| Contraindication List |
|---|
| Gastrointestinal obstruction |
| Ileus |
| Phenylketonuria |
There are 0 severe contraindications.
There are 0 moderate contraindications.
The following adverse reaction information is available for METAMUCIL SUGAR-FREE (psyllium husk/aspartame):
Adverse reaction overview.
No enhanced Common Adverse Effects information available for this drug.
No enhanced Common Adverse Effects information available for this drug.
There are 11 severe adverse reactions.
| More Frequent | Less Frequent |
|---|---|
| None. | None. |
| Rare/Very Rare |
|---|
|
Allergic dermatitis Anaphylaxis Bronchospastic pulmonary disease Conjunctivitis Esophageal obstruction Gastrointestinal obstruction Intestinal impaction Pruritus of skin Rhinitis Skin rash Urticaria |
There are 0 less severe adverse reactions.
The following precautions are available for METAMUCIL SUGAR-FREE (psyllium husk/aspartame):
No enhanced Pediatric Use information available for this drug.
Contraindicated
Severe Precaution
Management or Monitoring Precaution
Contraindicated
| None |
Severe Precaution
| None |
Management or Monitoring Precaution
| Psyllium | 1 Day – 6 Years | Consult with clinician for children age under 6 years. |
No enhanced Pregnancy information available for this drug.
No enhanced Lactation information available for this drug.
No Known Risk
No known risk. This drug has no known risks to nursing infants and does not adversely affect lactation.
No Known Risk
No known risk. This drug has no known risks to nursing infants and does not adversely affect lactation.
| Drug Name | Excretion Potential | Effect on Infant | Notes |
|---|---|---|---|
| Psyllium | Unknown. It is unknown whether the drug is excreted in human breast milk. | This drug has been shown not to have an adverse effect on the nursing infant. | Breastfeeding can continue during treatment |
No enhanced Geriatric Use information available for this drug.
The following prioritized warning is available for METAMUCIL SUGAR-FREE (psyllium husk/aspartame):
No warning message for this drug.
No warning message for this drug.
The following icd codes are available for METAMUCIL SUGAR-FREE (psyllium husk/aspartame)'s list of indications:
| Constipation | |
| K59.0 | Constipation |
| K59.00 | Constipation, unspecified |
| K59.01 | Slow transit constipation |
| K59.03 | Drug induced constipation |
| K59.04 | Chronic idiopathic constipation |
| K59.09 | Other constipation |
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