Wal-Mucil Fiber (Aspartame) (psyllium husk/aspartame)
Bulk Laxatives Oral Powder (Gram)
Last reviewed · Source: First Databank (FDB) drug data
Overview
Cellulose derivatives (methylcellulose), malt soup extract, and psyllium preparations are bulk-forming laxatives.
USES: This medication is used to treat constipation. It increases the bulk in your stool, an effect that helps to cause movement of the intestines. It also works by increasing the amount of water in the stool, making the stool softer and easier to pass.
Psyllium, one type of bulk-forming laxative, has also been used along with a proper diet to treat high cholesterol.
Generic name: psyllium husk/aspartame
Drug class: Bulk Laxatives
Therapeutic class: Gastrointestinal Therapy Agents
Reference product & biosimilars
No reference, biosimilar or interchangeable associated with this drug.
Today’s intelligence on Wal-Mucil Fiber (Aspartame)
Indications
The following indications are listed for Wal-Mucil Fiber (Aspartame):
- Constipation
Dosing
Bulk-forming laxatives are usually administered 1-3 times daily. To reduce the risk of esophageal obstruction in patients receiving large (e.g., the maximum daily dosage recommended by the manufacturer) dosages of bulk-forming laxatives, these laxatives should be administered in divided doses instead of a single daily dose. The usual dosages for the individual bulk-forming laxatives are below; for dosages in children younger than the ages listed, a physician should be consulted.
Bulk-forming laxatives are administered orally. Commercially available powders, flakes, granules, tablets, and liquids should be dissolved and/or diluted according to the instructions of the manufacturer. In the treatment of constipation, at least one full glass (250 mL) of liquid should be administered with each laxative dose. When used to increase the bulk of stools in patients with chronic, watery diarrhea, one manufacturer suggests that one-third of a glass (80 mL) of liquid be administered with each dose.
No dosing information is available for this tab.
No dosing information is available for this tab.
Drug interactions
There is no enhanced messaging for this drug.
There are no contraindication interactions for this drug.
Severe Interaction: Action is required to reduce the risk of severe adverse interaction.
Laxatives/Trofinetide
SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction.
MECHANISM OF ACTION: Trofinetide commonly causes diarrhea of mild to moderate severity. Laxatives may increase the incidence or severity of diarrhea.(1)
CLINICAL EFFECTS: Concurrent use of laxatives with trofinetide may increase the risk of severe diarrhea.(1)
PREDISPOSING FACTORS: None determined.
PATIENT MANAGEMENT: Patients should stop laxatives before starting trofinetide. If diarrhea occurs, consider anti-diarrheal treatment and monitor hydration status. If severe diarrhea or dehydration occurs, interrupt, reduce dose, or discontinue trofinetide.(1)
DISCUSSION: In clinical trials, 85% of patients on trofinetide developed diarrhea. Concurrent use of laxatives may increase this risk.(1)
Laxatives; Stool Softeners/Tenapanor
SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction.
MECHANISM OF ACTION: Tenapanor commonly causes diarrhea of mild to moderate severity. Laxatives and stool softeners may increase the incidence or severity of diarrhea.(1)
CLINICAL EFFECTS: Concurrent use of laxatives or stool softeners with tenapanor may increase the risk of severe diarrhea.(1)
PREDISPOSING FACTORS: None determined.
PATIENT MANAGEMENT: The US manufacturer of tenapanor states that patients should be instructed to avoid stool softeners and laxatives with tenapanor. If severe diarrhea occurs, tenapanor should be discontinued.(1)
DISCUSSION: In clinical trials, 43-53% of CKD patients on dialysis treated with tenapanor developed diarrhea. Diarrhea usually occurred soon after treatment initiation and was severe in 5% of patients.(1)
Moderate Interaction: Assess the risk to the patient and take action as needed.
Bulk Forming Laxatives/Clozapine
SEVERITY LEVEL: 3-Moderate Interaction: Assess the risk to the patient and take action as needed.
MECHANISM OF ACTION: Clozapine has potent anticholinergic properties and inhibits serotonin receptors, including 5-HT3.(1-4) Both of these properties may cause inhibition of gastrointestinal (GI) smooth muscle contraction, resulting in decreased peristalsis.(3,4) If fluid intake is inadequate, bulk forming laxatives can increase the risk of gastrointestinal obstruction.(1-6)
CLINICAL EFFECTS: Concurrent use of clozapine and bulk forming laxatives with inadequate fluid intake may increase the risk of constipation (common) and serious bowel complications (uncommon), including complete bowel obstruction, fecal impaction, paralytic ileus and intestinal ischemia or infarction.(1-6)
PREDISPOSING FACTORS: The risk for serious bowel complications is higher with increasing age, higher frequency of constipation, and in patients on higher doses of clozapine or multiple anticholinergic agents.(1,5)
PATIENT MANAGEMENT: Concurrent use of bulk forming laxatives with clozapine may be used with caution in patients who can maintain adequate fluid intake. Evaluate the patient's bowel function regularly. If patient is unable to maintain adequate fluid intake and use bulk forming laxatives as prescribed, avoid the use of bulk forming laxatives with clozapine.(1-6) Monitor for symptoms of constipation and GI hypomotility, including having bowel movements less than three times weekly or less than usual, difficulty having a bowel movement or passing gas, nausea, vomiting, and abdominal pain or distention.(2) Consider a prophylactic laxative in those with a history of constipation or bowel obstruction.(2) Review patient medication list for anticholinergic agents which may have additive effects on decreased GI motility. When possible, decrease the dosage or number of prescribed anticholinergic agents, particularly in the elderly. Counsel the patient about the importance of maintaining adequate hydration. Encourage regular exercise and eating a high-fiber diet.(2)
DISCUSSION: The concurrent use of clozapine and bulk forming laxatives has not been studied. Use of bulk forming laxatives with inadequate fluid intake has been associated with gastrointestinal obstruction.
Contraindications
There is no enhanced messaging for this drug.
- Gastrointestinal obstruction
- Ileus
There are no severe contraindications for this drug.
There are no moderate contraindications for this drug.
Adverse reactions
There is no enhanced messaging for this drug.
Rare or Very Rare
- Allergic dermatitis
- Anaphylaxis
- Bronchospastic pulmonary disease
- Conjunctivitis
- Esophageal obstruction
- Gastrointestinal obstruction
- Intestinal impaction
- Pruritus of skin
- Rhinitis
- Skin rash
- Urticaria
There are no less severe adverse reactions for this drug.
Precautions
No enhanced messaging available.
No enhanced messaging available.
No enhanced messaging available.
No enhanced messaging available.
No enhanced messaging available.
ICD codes
| Code | Type | Description |
|---|---|---|
| Constipation | ||
| K59.0 | ICD10CM | Constipation |
| K59.00 | ICD10CM | Constipation, unspecified |
| K59.01 | ICD10CM | Slow transit constipation |
| K59.03 | ICD10CM | Drug induced constipation |
| K59.04 | ICD10CM | Chronic idiopathic constipation |
| K59.09 | ICD10CM | Other constipation |
ICD code information from First Databank (FDB).
Formulary status
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Last reviewed · Source: First Databank (FDB) drug data
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