PEG 3350 Powder Packets
It is used to treat constipation.
Drug Class
Osmotic Laxative
Pharmacologic Class
Osmotic Agent
Pregnancy Category
Not assigned (older system), generally considered low risk based on minimal systemic absorption
FDA Approved
Jan 1970
DEA Schedule
Not Controlled
Overview
What is this medicine?
PEG 3350 is a laxative that helps you have a bowel movement by bringing water into your stool, making it softer and easier to pass. It's often used for occasional constipation.
How to Use This Medicine
Taking Your Medication Correctly
To use this medication effectively, follow your doctor's instructions and read all accompanying information carefully. When preparing your dose, mix the powder with 1/2 to 1 cup (120 to 240 ml) of a liquid such as water, juice, soda, coffee, or tea. Stir well to ensure the powder is fully dissolved before consuming. It's essential to check for any clumps before drinking; if you notice any, do not consume the mixture. Additionally, avoid mixing this medication with starch-based thickeners.
Storing and Disposing of Your Medication
Store your medication at room temperature in a dry location, avoiding bathrooms and areas where children or pets may access it. Keep all medications in a secure place and out of reach of children and pets. When disposing of unused or expired medication, do not flush it down the toilet or pour it down the drain unless instructed to do so by your pharmacist. Instead, consult with your pharmacist for guidance on proper disposal methods, which may include participating in local drug take-back programs.
Managing Missed Doses
If you take this medication on a regular schedule and miss a dose, take it as soon as you remember. However, if it's close to the time for your next scheduled dose, skip the missed dose and resume your regular dosing schedule. Do not take two doses at the same time or take extra doses. If you take this medication as needed, follow your doctor's instructions and do not take it more frequently than recommended.
To use this medication effectively, follow your doctor's instructions and read all accompanying information carefully. When preparing your dose, mix the powder with 1/2 to 1 cup (120 to 240 ml) of a liquid such as water, juice, soda, coffee, or tea. Stir well to ensure the powder is fully dissolved before consuming. It's essential to check for any clumps before drinking; if you notice any, do not consume the mixture. Additionally, avoid mixing this medication with starch-based thickeners.
Storing and Disposing of Your Medication
Store your medication at room temperature in a dry location, avoiding bathrooms and areas where children or pets may access it. Keep all medications in a secure place and out of reach of children and pets. When disposing of unused or expired medication, do not flush it down the toilet or pour it down the drain unless instructed to do so by your pharmacist. Instead, consult with your pharmacist for guidance on proper disposal methods, which may include participating in local drug take-back programs.
Managing Missed Doses
If you take this medication on a regular schedule and miss a dose, take it as soon as you remember. However, if it's close to the time for your next scheduled dose, skip the missed dose and resume your regular dosing schedule. Do not take two doses at the same time or take extra doses. If you take this medication as needed, follow your doctor's instructions and do not take it more frequently than recommended.
Lifestyle & Tips
- Drink plenty of fluids (at least 6-8 glasses of water daily) while taking this medication to help it work effectively and prevent dehydration.
- Increase dietary fiber intake (fruits, vegetables, whole grains) if tolerated and not contraindicated.
- Engage in regular physical activity to promote bowel regularity.
Available Forms & Alternatives
Dosing & Administration
Adult Dosing
Standard Dose:
17 grams (one heaping tablespoon or one packet) of powder dissolved in 4 to 8 ounces of water, juice, soda, coffee, or tea once daily.
Dose Range:
17 - 17 mg
Condition-Specific Dosing:
chronic_constipation:
17 grams once daily for up to 7 days. For longer use, consult a healthcare professional.
Pediatric Dosing
Neonatal:
Not established (off-label use exists, typically 0.2-0.8 g/kg/day, adjusted for effect)
Infant:
Not established (off-label use exists, typically 0.2-0.8 g/kg/day, adjusted for effect)
Child:
Not established (off-label use for chronic constipation often 0.2-0.8 g/kg/day, max 17g/day, adjusted for effect)
Adolescent:
17 grams once daily (similar to adult dose for ages 17 and older, for younger adolescents, off-label use similar to child dosing)
Dose Adjustments
Renal Impairment:
Mild:
No adjustment needed
Moderate:
No adjustment needed
Severe:
No adjustment needed
Dialysis:
No adjustment needed; minimal systemic absorption
Hepatic Impairment:
Mild:
No adjustment needed
Moderate:
No adjustment needed
Severe:
No adjustment needed
Pharmacology
Mechanism of Action
Polyethylene Glycol 3350 is an osmotic laxative. It works by drawing water into the colon and retaining it in the stool, which increases stool volume and softens the stool, making it easier to pass. It is an inert, non-absorbable, osmotically active polymer.
Pharmacokinetics
Absorption:
Bioavailability:
<0.2%
Tmax:
Not applicable (minimal systemic absorption)
FoodEffect:
Not significant
Distribution:
Vd:
Not applicable (minimal systemic absorption)
ProteinBinding:
Not applicable (minimal systemic absorption)
CnssPenetration:
No
Elimination:
HalfLife:
Not applicable (minimal systemic absorption)
Clearance:
Not applicable (minimal systemic absorption)
ExcretionRoute:
Fecal
Unchanged:
>99%
Pharmacodynamics
OnsetOfAction:
24 to 96 hours (1 to 4 days)
PeakEffect:
Not distinctly defined due to gradual onset
DurationOfAction:
As long as treatment continues and bowel movements are regular
Safety & Warnings
Side Effects
Urgent Side Effects: Seek Medical Help Right Away
While rare, some people may experience severe and potentially life-threatening side effects when taking this medication. If you notice any of the following symptoms, contact your doctor or seek immediate medical attention:
Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin (with or without fever)
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Severe dizziness or fainting
Diarrhea
Rectal bleeding or rectal pain
Other Possible Side Effects
Like all medications, this drug can cause side effects. Although many people may not experience any side effects or only minor ones, it's essential to discuss any concerns with your doctor. If you experience any of the following side effects or any other unusual symptoms that bother you or persist, contact your doctor for guidance:
Loose, watery, or more frequent stools
Stomach pain or cramps
Gas
Bloating
* Upset stomach
Reporting Side Effects
This list is not exhaustive, and you may experience other side effects. If you have questions or concerns about side effects, consult your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
While rare, some people may experience severe and potentially life-threatening side effects when taking this medication. If you notice any of the following symptoms, contact your doctor or seek immediate medical attention:
Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin (with or without fever)
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Severe dizziness or fainting
Diarrhea
Rectal bleeding or rectal pain
Other Possible Side Effects
Like all medications, this drug can cause side effects. Although many people may not experience any side effects or only minor ones, it's essential to discuss any concerns with your doctor. If you experience any of the following side effects or any other unusual symptoms that bother you or persist, contact your doctor for guidance:
Loose, watery, or more frequent stools
Stomach pain or cramps
Gas
Bloating
* Upset stomach
Reporting Side Effects
This list is not exhaustive, and you may experience other side effects. If you have questions or concerns about side effects, consult your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
Seek Immediate Medical Attention If You Experience:
- Severe abdominal pain, cramping, or bloating
- Rectal bleeding or blood in stool
- Nausea or vomiting that doesn't go away
- Diarrhea that is severe or lasts for more than a few days
- Signs of an allergic reaction (e.g., rash, itching, swelling, severe dizziness, trouble breathing)
- No bowel movement after 7 days of use (for occasional constipation)
Before Using This Medicine
Before Taking This Medication: Important Information to Share with Your Doctor
It is essential to inform your doctor about the following:
Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the allergic reaction and its symptoms.
Certain health conditions, including:
+ Bowel obstruction or blockage
+ Abdominal pain
+ Upset stomach
+ Rectal bleeding
+ Vomiting
+ Changes in bowel habits that last longer than 2 weeks
A diagnosis of irritable bowel syndrome
Kidney disease or any other health problems that may interact with this medication
Additionally, provide your doctor and pharmacist with a comprehensive list of:
All prescription and over-the-counter medications you are taking
Natural products and vitamins you are using
* Any health problems you have
This information will help your doctor determine if it is safe for you to take this medication with your other medications and health conditions. Never start, stop, or change the dose of any medication without first consulting your doctor.
It is essential to inform your doctor about the following:
Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the allergic reaction and its symptoms.
Certain health conditions, including:
+ Bowel obstruction or blockage
+ Abdominal pain
+ Upset stomach
+ Rectal bleeding
+ Vomiting
+ Changes in bowel habits that last longer than 2 weeks
A diagnosis of irritable bowel syndrome
Kidney disease or any other health problems that may interact with this medication
Additionally, provide your doctor and pharmacist with a comprehensive list of:
All prescription and over-the-counter medications you are taking
Natural products and vitamins you are using
* Any health problems you have
This information will help your doctor determine if it is safe for you to take this medication with your other medications and health conditions. Never start, stop, or change the dose of any medication without first consulting your doctor.
Precautions & Cautions
It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication. To avoid potential complications, do not use this drug for more than 7 days without explicit instructions from your doctor. Additionally, refrain from using other laxatives or stool softeners unless your doctor advises you to do so. Please note that it may take several days to experience the full effects of this medication. If you are pregnant, planning to become pregnant, or are currently breast-feeding, it is crucial to discuss your situation with your doctor to carefully weigh the benefits and risks of this medication to both you and your baby.
Overdose Information
Overdose Symptoms:
- Severe diarrhea
- Excessive fluid loss
- Electrolyte imbalances (e.g., low potassium, low sodium)
- Abdominal cramping
- Nausea
- Vomiting
What to Do:
Discontinue use. Rehydrate with fluids and electrolytes. Seek medical attention if symptoms are severe or persistent. Call 1-800-222-1222 (Poison Control).
Drug Interactions
Minor Interactions
- Other oral medications (potential for reduced absorption if taken concurrently, though generally not clinically significant due to PEG's minimal systemic effect)
Monitoring
Baseline Monitoring
Assessment of constipation cause
Rationale: To rule out underlying medical conditions requiring different treatment.
Timing: Prior to initiation of therapy
Fluid and electrolyte status
Rationale: Especially in patients with pre-existing electrolyte imbalances or those at risk for dehydration.
Timing: Prior to initiation, particularly for prolonged use or high doses
Routine Monitoring
Bowel movement frequency and consistency
Frequency: Daily or as needed
Target: Regular, soft, formed stools
Action Threshold: If no bowel movement after 7 days, or if severe abdominal pain/bloating occurs, discontinue and consult healthcare provider.
Hydration status
Frequency: Daily
Target: Adequate fluid intake
Action Threshold: Signs of dehydration (e.g., decreased urination, dry mouth) require increased fluid intake or medical attention.
Electrolytes (e.g., sodium, potassium)
Frequency: Rarely, only if prolonged use, excessive diarrhea, or pre-existing renal/cardiac conditions
Target: Within normal limits
Action Threshold: Abnormal levels require medical intervention.
Symptom Monitoring
- Abdominal pain
- Bloating
- Nausea
- Diarrhea
- Rectal bleeding
- Signs of electrolyte imbalance (e.g., muscle weakness, cramps, irregular heartbeat, excessive thirst, confusion)
Special Patient Groups
Pregnancy
Generally considered safe for use during pregnancy due to minimal systemic absorption. Consult a healthcare provider before use.
Trimester-Specific Risks:
First Trimester:
Low risk
Second Trimester:
Low risk
Third Trimester:
Low risk
Lactation
Considered safe for use during breastfeeding due to minimal systemic absorption by the mother and negligible excretion into breast milk.
Infant Risk:
Low risk (L1)
Pediatric Use
Widely used off-label for chronic constipation in children, often preferred over stimulant laxatives due to its safety profile and lack of systemic effects. Dosing must be individualized and guided by a healthcare professional.
Geriatric Use
Generally safe and well-tolerated in elderly patients. Often preferred due to minimal systemic absorption and lower risk of electrolyte disturbances compared to other laxatives, especially in patients with comorbidities or polypharmacy. Adequate hydration is crucial.
Clinical Information
Clinical Pearls
- PEG 3350 is often considered a first-line treatment for chronic constipation due to its efficacy and safety profile.
- It is important to emphasize adequate fluid intake when taking PEG 3350 to maximize its osmotic effect and prevent dehydration.
- Unlike stimulant laxatives, PEG 3350 is not associated with tolerance or 'lazy bowel' syndrome with long-term use.
- The powder should be fully dissolved in liquid before consumption.
- Onset of action can take 1-4 days, so patients should be advised not to expect immediate results.
Alternative Therapies
- Fiber supplements (e.g., psyllium, methylcellulose)
- Stool softeners (e.g., docusate sodium)
- Stimulant laxatives (e.g., bisacodyl, senna) - generally for short-term use
- Saline laxatives (e.g., magnesium hydroxide)
- Lubricant laxatives (e.g., mineral oil)
- Prosecretory agents (e.g., lubiprostone, linaclotide, plecanatide) - for chronic idiopathic constipation or IBS-C
- Peripherally acting mu-opioid receptor antagonists (PAMORAs) (e.g., methylnaltrexone, naloxegol) - for opioid-induced constipation
Cost & Coverage
Average Cost:
$15 - $30 per 17g x 30 packets/doses
Generic Available:
Yes
Insurance Coverage:
Often OTC, may be covered by some prescription plans with a prescription (Tier 1 or 2)
General Drug Facts
If your symptoms or health issues persist or worsen, it is essential to contact your doctor promptly. To ensure safe and effective treatment, never share your medication with others or take someone else's medication. Some medications may come with an additional patient information leaflet, so it's a good idea to check with your pharmacist for more information. If you have any questions or concerns about your medication, don't hesitate to reach out to your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately call your local poison control center or seek emergency medical attention. When seeking help, be prepared to provide details about the medication taken, the amount, and the time it happened.