BNF for Children (BNFC) 2018-2019

Sterculia 19-Feb-2016

lDRUG ACTIONSterculia is a bulk-forming laxative. It
relieves constipation by increasing faecal mass which
stimulates peristalsis.

lINDICATIONS AND DOSE

Constipation

▶BY MOUTH

▶Child 6–11 years: 0. 5 – 1 sachet 1 – 2 times a day,

alternatively, half to one heaped 5 -mL spoonful once

or twice a day; washed down without chewing with

plenty of liquid after meals

▶Child 12–17 years: 1 – 2 sachets 1 – 2 times a day,

alternatively, one to two heaped 5 -mL spoonfuls once

or twice a day; washed down without chewing with

plenty of liquid after meals

lCONTRA-INDICATIONSColonic atony.difficulty in
swallowing.faecal impaction.intestinal obstruction
lCAUTIONSAdequatefluid intake should be maintained to
avoid intestinal obstruction

lSIDE-EFFECTSDiarrhoea.gastrointestinal discomfort.
gastrointestinal disorders.nausea

lDIRECTIONS FOR ADMINISTRATIONMay be mixed with soft
food (e.g. yoghurt) before swallowing, followed by plenty
of liquid.

lPATIENT AND CARER ADVICEPatients and their carers
should be advised that the full effect may take some days
to develop. Preparations that swell in contact with liquid
should always be carefully swallowed with water and
should not be taken immediately before going to bed.

lMEDICINAL FORMS
There can be variation in the licensing of different medicines
containing the same drug.
Granules
CAUTIONARY AND ADVISORY LABELS25, 27
▶Normacol(Norgine Pharmaceuticals Ltd)
Sterculia 620 mg per 1 gramNormacol granules 7 g sachets|
60 sachetG£ 6. 67 DT = £ 6. 67
Normacol granules| 500 gramG£ 7. 92 DT = £ 7. 92

Sterculia with frangula

The properties listed below are those particular to the
combination only. For the properties of the components
please consider, sterculia above.

lINDICATIONS AND DOSE

Constipation

▶BY MOUTH

▶Child 6–11 years: 0. 5 – 1 sachet 1 – 2 times a day,

alternatively, 0. 5 – 1 heaped 5 -mL spoonful once or

twice a day; washed down without chewing with plenty

of liquid after meals

▶Child 12–17 years: 1 – 2 sachets 1 – 2 times a day,

alternatively, 1 – 2 heaped 5 mL spoonfuls once or twice

a day; washed down without chewing with plenty of

liquid after meals

lPREGNANCYManufacturer advises avoid.

lBREAST FEEDINGManufacturer advises avoid.

lPATIENT AND CARER ADVICEPatients and their carers
should be advised that the full effect may take some days
to develop. Preparations that swell in contact with liquid
should always be carefully swallowed with water and
should not be taken immediately before going to bed.

lMEDICINAL FORMS

There can be variation in the licensing of different medicines

containing the same drug.

Granules

▶Normacol Plus(Norgine Pharmaceuticals Ltd)

Frangula 80 mg per 1 gram, Sterculia 620 mg per

1 gramNormacol Plus granules 7 g sachets| 60 sachetG£ 7. 12

DT = £ 7. 12

Normacol Plus granules| 500 gramG£ 8. 45 DT = £ 8. 45

LAXATIVES›OSMOTIC LAXATIVES

Lactulose

lINDICATIONS AND DOSE

Constipation

▶BY MOUTH

▶Child 1–11 months: 2. 5 mL twice daily, adjusted

according to response

▶Child 1–4 years: 2. 5 – 10 mL twice daily, adjusted

according to response

▶Child 5–17 years: 5 – 20 mL twice daily, adjusted

according to response

Hepatic encephalopathy (portal systemic encephalopathy)

▶BY MOUTH

▶Child 12–17 years:Adjusted according to response to

30 – 50 mL 3 times a day, subsequently adjusted to

produce 2 – 3 soft stools per day

PHARMACOKINETICS

▶Lactulose may take up to 48 hours to act.

lUNLICENSED USENot licensed for use in children for

hepatic encephalopathy.

lCONTRA-INDICATIONSGalactosaemia.intestinal

obstruction

lCAUTIONSLactose intolerance

lSIDE-EFFECTS

▶Common or very commonAbdominal pain.diarrhoea.

flatulence.nausea.vomiting

▶UncommonElectrolyte imbalance

lPREGNANCYNot known to be harmful.

lPATIENT AND CARER ADVICE

Medicines for Children leaflet: Lactulose for constipation

http://www.medicinesforchildren.org.uk/lactulose-for-constipation

lMEDICINAL FORMS

There can be variation in the licensing of different medicines

containing the same drug.

Oral solution

▶Lactulose (Non-proprietary)

Lactulose 666.667 mg per 1 mlLactulose 10 g/ 15 ml oral solution

15 ml sachets sugar free sugar-free| 10 sachetp£ 2. 51 DT = £ 2. 51

Lactulose 680 mg per 1 mlLactulose 3. 1 - 3. 7 g/ 5 ml oral solution|

300 mlp£ 1. 39 – £ 2. 73 | 500 mlp£ 4. 55 DT = £ 2. 32

▶Duphalac(Mylan)

Lactulose 680 mg per 1 mlDuphalac 3. 35 g/ 5 ml syrup| 200 mlp

£ 1. 92

▶Lactugal(Intrapharm Laboratories Ltd)

Lactulose 680 mg per 1 mlLactugal 3. 1 - 3. 7 g/ 5 ml oral solution|

500 mlp£ 4. 56 DT = £ 2. 32 | 2000 mlp£ 16. 42

BNFC 2018 – 2019 Constipation 41

Gastro-intestinal system

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