Citrucel

Methylcellulose is a hydrophilic colloid which absorbs water causing it to swell to a soft gel of uniform consistency.

Recommended clinical use

- In the control of colostomy, ileostomy and simple diarrhoea.

- In the management of diverticular disease and ulcerative colitis.

- In the management of simple constipation.

- As an aid to appetite control and the treatment of obesity.

.

Posology

Colostomy and ileostomy control and for simple diarrhoea: 3-6 tablets twice daily with the minimum of liquid. Liquids should be avoided for 30 minutes before and after each dose. Dosage should be adjusted to give stools of the required consistency.

Diverticular disease and ulcerative colitis: 3-6 tablets twice daily adjusted according to the degree of constipation (with 300 ml of liquid), diarrhoea (with a little liquid) or spastic pain.

Simple constipation: 3-6 tablets twice daily to be taken with at least 300 ml of liquid. The dose may be reduced as normal bowel function is restored.

As an aid to appetite control and the treatment of obesity: 3 tablets with at least 300 ml of warm liquid, half an hour before each meal and between meals when hunger pangs are severe.

Method of administration

It is recommended that the tablets should be broken in the mouth before swallowing. Citrucel Tablets swell in contact with water and should therefore be swallowed carefully. It is not recommended that these tablets be taken before going to bed.

Citrucel Tablets are contraindicated in patients:

- hypersensitive to methylcellulose or to any of the excipients listed in section 6.1

- with imminent or threatened intestinal obstruction

- with faecal impaction

- who have difficulty in swallowing

- with colonic atony

- with infective bowel disease

- with severe dehydration

Adequate fluid intake should be maintained to avoid intestinal obstruction.

Methylcellulose should be taken with sufficient fluid to prevent faecal impaction or oesophageal obstruction.

Supervision may be necessary for patients who:

- are elderly

- are debilitated

- have intestinal narrowing

- have decreased intestinal motility

Bowel obstruction is a rare complication of treatment with any bulk-forming hydrophilic colloid (refer also to section 4.8).

Patients with rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose-galactose malabsorption should not take this medicine.

Not relevant.

The most commonly reported reactions with methylcellulose are of a gastrointestinal nature and include flatulence and abdominal distention.

Reactions not already stated, which are attributable to bulk-forming laxatives include gastrointestinal obstruction, faecal impaction and hypersensitivity.

Reporting of suspected adverse reactions

Reporting of suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product. Healthcare professionals are asked to report any suspected adverse reactions via the Yellow Card Scheme, website: www.mhra.gov.uk/yellowcard.

Symptoms

Methylcellulose is not absorbed. The features to be expected would be abdominal distension which may be followed by intestinal obstruction.

Management

Gastric lavage should be employed where appropriate. The patient should be observed and fluid given. If obstruction develops, appropriate measures such as rectal washout must be taken.

ATC Code: A06AC06

Pharmacotherapeutic group: Bulk-forming laxative

The active ingredient is a simple bulking agent.

The active ingredient is not absorbed and hence the product cannot be described in terms of pharmacokinetics.

None listed.

None listed.

No special requirements.