Macrogol Sandoz (Sodium Hydrogen Carbonate, Potassium Chloride, Sodium Chloride, Macrogol 3350)

Macrogol Sandoz, an osmotic laxative, is used to manage conditions affecting bowel regularity.

• Constipation: softens stool and promotes regular bowel movements in patients with functional constipation.
• Functional constipation: improves stool frequency and consistency in adults and children with chronic constipation.
• Opioid‑induced constipation: provides an osmotic effect to counteract reduced gastrointestinal motility caused by opioid therapy.

• Macrogol 3350 acts as a high‑molecular‑weight polymer that is poorly absorbed from the gastrointestinal tract. It retains water within the intestinal lumen by creating an osmotic gradient, increasing stool water content and volume. The resulting softening of feces and stimulation of peristalsis facilitate the passage of stool without stimulating intestinal secretions or markedly altering electrolyte balance.

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

Common Side Effects

• Abdominal bloating: sensation of fullness or swelling in the abdomen.
• Flatulence: increased gas production leading to passing of wind.
• Nausea: feeling of queasiness that may precede vomiting.
• Abdominal cramps: intermittent painful contractions of the gut.
• Diarrhoea: loose, watery stools occurring more frequently than normal.
• Thirst: increased desire to drink fluids.

Serious or Rare Side Effects

• Electrolyte imbalance: abnormal levels of sodium, potassium or chloride.
• Severe dehydration: marked loss of body fluids requiring medical attention.
• Allergic reaction: rash, itching, swelling or difficulty breathing.
• Severe abdominal pain: intense, persistent pain that may indicate obstruction.
• Rectal bleeding: presence of blood in stool or on toilet paper.

Before initiating therapy with Macrogol Sandoz, consider the following precautions.

• Renal function assessment: evaluate kidney health, especially in patients with chronic kidney disease.
• Electrolyte monitoring: check serum sodium, potassium and chloride levels during prolonged use.
• Bowel obstruction: avoid use in patients with known or suspected mechanical obstruction.
• Elderly patients: start with the lowest effective dose and monitor tolerance.
• Concomitant laxatives: use caution when combining with other laxative agents to prevent excessive fluid loss.
• Store at ambient temperature: keep below 25°C in the original packaging, protect from moisture and direct sunlight.

Macrogol Sandoz can interact with other medicines; awareness of the interaction level helps guide safe use.

Major Interactions (Avoid)

• Diuretics: concurrent use may exacerbate electrolyte disturbances.
• Mineral oil: co‑administration can reduce the effectiveness of both agents.
• High‑dose electrolyte supplements: may lead to excessive sodium or potassium load.

Moderate Interactions (Monitor Closely)

• Antacids containing sodium: can increase overall sodium intake.
• NSAIDs: combined use may increase risk of gastrointestinal irritation.
• Oral antibiotics: Macrogol may affect absorption of certain antibiotics; timing of doses should be separated.