Treatment Name: Polyethylene Glycol (MiraLAX®)

Polyethylene Glycol (MiraLAX®) is a Supportive Care Therapy to treat Constipation

How does polyethylene glycol work?
Polyethylene glycol (MiraLAX®) is designed to prevent your intestines from absorbing some of the water you drink. When extra water is kept within the intestines, it softens the stool and stimulates the intestines, which produces a bowel movement.

Goals of therapy:
Polyethylene glycol is taken to relieve occasional constipation. It is commonly taken on an as needed basis with the goal of treating constipation.

Polyethylene glycol (MiraLAX®) is available as an over-the-counter (OTC) medication not requiring a doctor's prescription.

Schedule

Polyethylene glycol (MiraLAX®) is commonly taken at home on an as needed basis to treat constipation and maintain normal, regular bowel movements daily or every other day. When dosed adequately, polyethylene glycol generally induces a bowel movement in approximately one to three days.

Polyethylene glycol (MiraLAX®) powder:

Fill bottle cap with polyethylene glycol powder to the indicated line (17 grams), then mix with 4 to 8 ounces of any beverage (can be cold, hot or room temperature) until dissolved, then drink beverage. Do not take more than once a day unless instructed by your doctor or pharmacist

Polyethylene glycol powder packets:

Mix one packet (17 grams) with 4 to 8 ounces of any beverage (can be cold, hot or room temperature) until dissolved, then drink beverage. Do not take more than once a day unless instructed by your doctor or pharmacist

Polyethylene glycol is usually taken at home. Typical duration of therapy is until polyethylene glycol no longer works in relieving constipation, or constipation is resolved and polyethylene glycol is no longer needed. Do not take polyethylene glycol for more than seven days without talking to your doctor.

Store polyethylene glycol (MiraLAX®) at room temperature (68°F – 77°F).

Side Effects

In the prescribing label information (polyethylene glycol (MiraLAX®) package insert), the most commonly reported side effects from polyethylene glycol (MiraLAX®) are shown here:

Note: Nausea or vomiting may also be due to other medications, conditions, or severe constipation rather than polyethylene glycol.

Note: The exact percentages of patients that will experience polyethylene glycol side effects is unknown because it has been used under widely varying patient populations in a variety of clinical trials.

Stop using polyethylene glycol (MiraLAX®) if you have diarrhea, bleeding from the rectum or blood in the stool, or if cramping in the abdomen (belly) gets worse.

Side effect videos
PainDiarrheaNausea and Vomiting

Monitoring

How often is monitoring needed?
Labs (blood tests) are usually not necessary to start or continue polyethylene glycol therapy.

How often is imaging needed?
Imaging may be checked if there is concern of a small bowel obstruction (SBO) or blockage. Imaging may include: Abdominal X-ray, or CT scan of the abdomen and pelvis.

How might blood test results/imaging affect treatment?
Depending upon the results, your doctor may advise to continue polyethylene glycol as planned, add additional laxatives, place you on “bowel rest” (nothing by mouth until the obstruction clears), or switch to an alternative therapy for constipation.

Questions to Ask Your...

A better understanding of your treatments will allow you to ask more questions of your healthcare team. We then hope that with the answers, you will get better results and have greater satisfaction with your care. Because we know it's not always easy to know what questions to ask, we've tried to make it easy for you!

Choose any healthcare provider below to see common questions that you may want to ask of this person. Then, either print each list to bring to your clinic visits, or copy the questions and send them as a message to your healthcare team through your electronic medical record.

Questions to ask your Doctor Nurse Pharmacist

Questions to ask your Nurse Doctor Pharmacist

Questions to ask your Pharmacist Doctor Nurse

ChemoExperts Tips

Polyethylene glycol is an inexpensive, yet effective over-the-counter remedy for constipation
To maintain regular bowel movements, polyethylene glycol may be combined with over-the-counter scheduled senna + docusate. Talk to your doctor or pharmacist if you have trouble maintaining normal bowel movements
If you are receiving chemotherapy, do NOT attempt to use an enema or suppository unless you have discussed this with your doctor. Use of enemas or suppositories could cause a tear in the rectum and may lead to a serious infection
Walking helps to stimulate the bowels to move stool down the intestinal tract. A diet high in fiber (found in fruits, vegetables, and whole grains) also helps to maintain a healthy colon (large intestine)
It is important to have regular bowel movements, usually once daily or every other day. Otherwise, your small bowel (intestine) may become blocked. Call your doctor if you have not had a bowel movement for 3 days or more, especially if you feel bloated. If you feel pain in your abdomen/belly, feel nauseated, or vomit at any point while constipated, call your doctor immediately
A pharmacist should ALWAYS review your medication list to ensure that drug interactions are prevented or managed appropriately

Patient Assistance & Co-payment Coverage

References

Polyethylene Glycol prescribing label information. (MiraLAX) package insert.

Created: September 2, 2017 Updated: November 8, 2018

What is Constipation?

What is constipation?

Constipation means bowel movements happen less often than usual, or the stool becomes hard, dry, or difficult to pass. Constipation does not only mean “not going often,” but can also include straining, feeling like the bowel does not empty fully, or having pain when trying to go.

What does constipation look like?

Constipation may look like fewer bowel movements, hard or lumpy stool, straining, stomach cramps, bloating, or a feeling of fullness. Some patients also feel nauseated or have a decreased appetite because stool is moving too slowly through the intestines. In very severe cases, stool can build up in the intestines and cause a blockage.

Who gets constipation?

Constipation can happen due to low fluid intake, not enough dietary fiber, decreased physical activity, changes in routine, or certain medications. In patients with cancer, constipation is common because cancer treatment can affect diet, activity, and normal bowel function. One common cause of constipation in patients with cancer is the use of opioid pain medications. Opioids slow the movement of the intestines, reduce normal gut secretions, and can make stool drier and harder.

How is constipation prevented?

Prevention usually starts with simple daily habits such as drinking enough fluids, staying as active as possible, and eating fiber when appropriate. Patients who are at high risk of constipation, such as those receiving opioid pain medications, may be started on a bowel regimen with certain laxatives to help prevent constipation. Medications that are commonly used as part of a bowel regimen include sennosides + docusate (Senna-S®) and polyethylene glycol (MiraLAX®).

How is constipation treated?

Treatment depends on the cause and how severe the constipation is. Common medication options include stimulant laxatives, osmotic laxatives, and enemas. Stool softeners help make stool easier to pass, while stimulant laxatives help the bowel contract and move stool along. Osmotic laxatives work by pulling water into the bowel to soften stool and help it move. Some examples of these medications, most of which are available over-the-counter (OTC), include:

Stimulant laxatives
- Sennosides (Senna®)
- Bisacodyl (Dulcolax®)
Osmotic laxatives
- Polyethylene glycol (MiraLAX®)
- Magnesium citrate
- Magnesium hydroxide
- Lactulose
- Sorbitol
Enemas
- Sodium phosphate (Fleet®)
- Mineral oil
- Glycerin
- Tap water

For patients that have low white blood cells (neutrophils) or low platelets, it is not recommended to treat constipation with enemas.

For constipation related to opioids, if regular laxatives do not work well enough, some patients may need additional medications that are specifically used for opioid-induced constipation such as methylnaltrexone (Relistor®), naldemedine (Symproic®), or naloxegol (Movantik®).

NOTE: Treatment Options listed below are not all-inclusive. Other treatments may be available. ChemoExperts provides drug information and does not recommend any one treatment over another. Only your Doctor can choose which therapy is appropriate for you.