BNF for Children (BNFC) 2018-2019

lUNLICENSED USETabletsnot licensed for use in children
under 6 years.Syrupnot licensed for use in children under
2 years.
Doses inBNFCadhere to national guidelines and may
differ from those in product literature.

lCONTRA-INDICATIONSIntestinal obstruction.
undiagnosed abdominal pain

lSIDE-EFFECTSAlbuminuria.diarrhoea.electrolyte
imbalance.fluid imbalance.gastrointestinal discomfort.
haematuria.pseudomelanosis coli.skin reactions.urine
discolouration
SIDE-EFFECTS, FURTHER INFORMATIONProlonged or
excessive use can cause hypokalaemia.

lPREGNANCYgSpecialist sources indicate suitable for
use in pregnancy.k

lBREAST FEEDINGgSpecialist sources indicate suitable
for use in breast-feeding in infants over 1 month.k

lPATIENT AND CARER ADVICE
Medicines for Children leaflet: Senna for
constipationwww.medicinesforchildren.org.uk/senna-for-
constipation
lNATIONAL FUNDING/ACCESS DECISIONS
NHS restrictionsSenokot®tablets are not prescribable in
NHS primary care.

lEXCEPTIONS TO LEGAL CATEGORYSenna is on sale to the
public for use in children over 12 years; doses on packs
may vary from those in BNF Publications.

lMEDICINAL FORMS
There can be variation in the licensing of different medicines
containing the same drug.
Oral solution
▶Senokot(Forum Health Products Ltd, Reckitt Benckiser Healthcare
(UK) Ltd)
Sennoside B (as Sennosides) 1.5 mg per 1 mlSenokot 7. 5 mg/ 5 ml
Syrup Pharmacy sugar-free| 500 mlp£ 4. 76 DT = £ 4. 76
Tablet
▶Senna (Non-proprietary)
Sennoside B (as Sennosides) 7.5 mgSenna 7. 5 mg tablets|
20 tabletp£ 1. 00 | 100 tabletp£ 2. 15

Senna with ispaghula husk 24-Feb-2016

The properties listed below are those particular to the
combination only. For the properties of the components
please consider, senna p. 46 , ispaghula husk p. 40.

lINDICATIONS AND DOSE

Constipation

▶BY MOUTH

▶Child 12–17 years: 5 – 10 g once daily, to be taken at

night, 5 g equivalent to one level spoonful of granules

lPREGNANCYManufacturer advises avoid duringfirst
trimester. To be used only intermittently and only if
dietary and lifestyle changes fail.
lDIRECTIONS FOR ADMINISTRATIONTake at night with at
least 150 mL liquid.

lMEDICINAL FORMS
There can be variation in the licensing of different medicines
containing the same drug.
Granules
CAUTIONARY AND ADVISORY LABELS 25
EXCIPIENTS:May contain Sucrose
▶Manevac(Meda Pharmaceuticals Ltd)
Senna fruit 124 mg per 1 gram, Ispaghula 542 mg per
1 gramManevac granules| 400 gramp£ 9. 50 DT = £ 9. 50

Sodium picosulfate 06-May-2016

(Sodium picosulphate)

lDRUG ACTIONSodium picosulfate is a stimulant laxative.

After metabolism in the colon it stimulates the mucosa

thereby increasing the motility of the large intestine.

lINDICATIONS AND DOSE

Constipation

▶BY MOUTH

▶Child 1 month–3 years: 2. 5 – 10 mg once daily, adjusted

according to response

▶Child 4–17 years: 2. 5 – 20 mg once daily, adjusted

according to response

PHARMACOKINETICS

▶Onset of action 6 – 12 hours.

lUNLICENSED USESodium picosulfate doses in BNF

Publications adhere to national guidelines and may differ

from those in product literature.

lCONTRA-INDICATIONSIntestinal obstruction.

undiagnosed abdominal pain

lINTERACTIONS→Appendix 1 : sodium picosulfate

lSIDE-EFFECTS

▶Common or very commonDiarrhoea.gastrointestinal

discomfort

▶UncommonDizziness.nausea.vomiting

▶Frequency not knownAngioedema.skin reactions.

syncope

SIDE-EFFECTS, FURTHER INFORMATIONProlonged or

excessive use can cause diarrhoea and related effects such

as hypokalaemia.

lPREGNANCYManufacturer states evidence limited but not

known to be harmful.

lBREAST FEEDINGgSpecialist sources indicate suitable

for use in breast-feeding in infants over 1 month—not

known to be present in milk.k

lPATIENT AND CARER ADVICE

Medicines for Children leaflet: Sodium picosulfate for constipation

http://www.medicinesforchildren.org.uk/sodium-picosulfate-for-

constipation

lMEDICINAL FORMS

There can be variation in the licensing of different medicines

containing the same drug.

Oral solution

EXCIPIENTS:May contain Alcohol

▶Sodium picosulfate (Non-proprietary)

Sodium picosulfate 1 mg per 1 mlSodium picosulfate 5 mg/ 5 ml oral

solution sugar-free| 100 mlp£ 2. 37 sugar-free| 300 mlp£ 7. 10

DT = £ 7. 10

▶Laxoberal(Sanofi)

Sodium picosulfate 1 mg per 1 mlDulcolax Pico 5 mg/ 5 ml liquid

sugar-free| 100 mlp£ 1. 94 sugar-free| 300 mlp£ 4. 62 DT =

£ 7. 10

3 Diarrhoea

Diarrhoea (acute) 01-Aug-2017

Description of condition

Diarrhoea is the abnormal passing of loose or liquid stools,

with increased frequency, increased volume, or both. Acute

diarrhoea is that which lasts less than 14 days, but symptoms

usually spontaneously resolve within 2 – 4 days. It can result

from infection, as a side-effect of a drug, or as an acute

symptom of a chronic gastro-intestinal disorder (such as

Inflammatory bowel disease p. 25 or Irritable bowel

BNFC 2018 – 2019 Diarrhoea 47

Gastro-intestinal system

1