First-lineMovicol / Laxido
Macrogol (PEG)
Osmotic polyethylene glycol laxative
Alternative osmotic laxative — better tolerated than lactulose.
Oral (sachet in 125 mL water)
First-line for
- Pregnancy constipation intolerant to lactulose
- Faecal impaction
Mechanism
Non-absorbed PEG binds water molecules → increased stool water content and volume without electrolyte flux.
"Movicol moves stool with minimal wind"
- Less flatulence than lactulose
- One sachet in 125 mL water
- Impaction: up to 8 sachets/day for 3 days
Dosing
- Chronic constipation
- 1–3 sachets/day
- Impaction
- 8 sachets/day × up to 3 days
Contraindications
- AbsoluteIntestinal obstruction/perforation
- AbsoluteToxic megacolon
Side effects
- Bloating, cramps
- Nausea
- Electrolyte disturbance with high-dose disimpaction
Fetal & maternal notes
- • Not absorbed — safe throughout pregnancy and lactation
Key interactions
Other oral drugs
CautionMay ↓ absorption during disimpaction dosing
Clinical pearls
- 💡 Preferred over stimulants in pregnancy
- 💡 Adequate hydration is essential
Content last reviewed: REPLACE_ME (e.g. 2026-07)
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