Macrogol 4000 Viatris (Macrogol 4000)

Macrogol 4000 is an osmotic laxative that works within the gastrointestinal tract to increase water content in stool.

• Constipation: softens stool and promotes regular bowel movements.
• Bowel preparation for colonoscopy: cleans the colon by inducing watery stools.
• Chronic idiopathic constipation: improves stool frequency and consistency in long‑term cases.
• Fecal impaction: facilitates evacuation of hardened stool.

• Macrogol 4000 (polyethylene glycol 4000) is a high‑molecular‑weight polymer that is poorly absorbed from the gastrointestinal lumen. It exerts an osmotic effect by retaining water within the intestinal tract, thereby increasing stool water content, reducing stool hardness, and enhancing peristaltic activity to promote bowel evacuation.

Macrogol 4000 may cause a range of adverse reactions, most of which are mild and transient.

Common Side Effects

• Abdominal bloating
• Flatulence
• Nausea
• Diarrhea
• Abdominal cramps
• Headache

Serious or Rare Side Effects

• Severe electrolyte imbalance
• Allergic reaction (rash, itching, swelling)
• Severe abdominal pain
• Dehydration
• Intestinal obstruction
• Renal impairment

When using Macrogol 4000, certain safety considerations should be observed.

• Renal function assessment: evaluate kidney status before initiating therapy.
• Electrolyte monitoring: check serum electrolytes in patients at risk of imbalance.
• Bowel obstruction: avoid use in known or suspected mechanical obstruction.
• Hypersensitivity: discontinue if allergic signs appear.
• Elderly patients: start with the lowest effective dose and monitor tolerance.
• Store at ambient temperature: keep in the original container, protect from moisture.

Macrogol 4000 can interact with other medications that affect fluid balance or gastrointestinal motility.

Major Interactions (Avoid)

• Concurrent use with other osmotic laxatives (e.g., sodium phosphate) may cause excessive fluid loss.
• Combination with loop diuretics can exacerbate electrolyte disturbances.
• Co‑administration with high‑dose magnesium salts may lead to additive osmotic effects.

Moderate Interactions (Monitor Closely)

• Opioid analgesics may reduce laxative efficacy.
• Anticholinergic agents could diminish gastrointestinal motility.
• Medications requiring stable intestinal pH (e.g., certain antibiotics) may have altered absorption.