UNIT FARMASI KLINIKAL DAN MAKLUMAT DRUG,
JAB. FARMASI, HOSPITAL USM
EDARAN MAKLUMAT UBAT
Jun 2021, Volume 50; Issue 3
DRUGS – FUNCTIONAL CONSTIPATION IN PAEDIATRIC
NO CATEGORY DRUG / DOSAGE DRUG ACTION DOSE
FORM/STRENGTH
(HOSPITAL USM)
1 Stimulant Bisacodyl Stimulant laxatives increase Oral(2):
Laxative intestinal motility. (6) Child 1-5years: 5-10mg
TABLET – 5mg Child > 5years: 10-20mg
Tablets act in 10–12 hours;
SUPPOSITORY – 5mg & 10mg suppositories act in Suppository (2): (NOT per kg)
20–60 minutes (6) Child less than 12months: 2.5mg
Child 1-5 years: 5mg
Child > 5 years: 10mg
2 Lubricant/ Glycerol Glycerin can promote peristalsis Per rectal:(2)
Rectal and evacuation of the bowel by Infant: 0.7-1g
Stimulant ENEMA 20 ml virtue of its irritant action. (3) Child: 1.4-2g
Laxative (contain Glycerin 25% - 5 g/20ml
ampoule) Sodium chloride is the bile salt Child 1–11 months: 1 g*
involved in maintaining the osmotic Child 1–11 years: 2 g*
pressure of the blood and fluid Child 12–17 years: 4 g*
changes (3)
*as required per rectal(6)
3 Osmotic Lactulose Increase the amount of water in the 0.5ml/kg 12H oral (2)
Laxative large bowel, either by drawing fluid
SYRUP - 10G/15 ML from the body into the bowel or by *Child 1–11 months: 2.5 mL BD
retaining the fluid they were *Child 1–4 years: 2.5–10 mL BD
administered with. (6) *Child 5–17 years: 5–20 mL BD
*Lactulose - may take up to 48 *All doses adjusted according to
hours to act. (6) response.(6)
Monobasic Sodium Phosphate + Relieves constipation and cleanses Oral Solution (7)
Dibasic Sodium Phosphate lower bowel. It promotes Laxative:
(Disodium Phosphate evacuation of the bowel by Child 5 - 9 years: 5ml
Dodecahydrate + Sodium increasing the bulk volume and Child 10 - 11 years: 10ml
Dihydrogen Phosphate water content of stool (10) Child > 12 years old: 20ml
Dihydrate)
Enema for children (5)
ORAL SOLUTION Child < 2 years: DO NOT USE
Casen Phospho-soda Child 2-4 years: One-half bottle**
10.8g/24.4g (45ML) Child 5-11 years: one bottle
ENEMA 16% + 6% Enema adult (8)
a) Enema For Children Child ≥ 12 years: One bottle.
66 ml/bottle
(Sodium content 2.2g/59ml) *Single daily dose: Do not use more
b) Enema for Adult unless directed by a doctor.
133ml/bottle ** One half bottle preparation:
(Sodium content 4.4g/118ml) Unscrew cap and remove 2
Tablespoons of liquid with a
measuring spoon.
DRUGS – FUNCTIONAL CONSTIPATION IN PAEDIATRIC
NO CATEGORY DRUG / STRENGTH & DRUG ACTION DOSE
DOSAGE FORM
4 Bulk-Forming Isphagula Husk Relieve constipation Child < 6 years: Not recommended.
laxative by increasing faecal mass which (4)
3.5g of isphagula husk stimulates peristalsis. (6) Child 6 - 12 years : ½ to 1 spoonful
per 6g powder sachet (5ml spoon), depending on age and
(Brand: Fybogel) size, morning and evening. (4)
Child > 12 years: One sachet,
morning and evening. (4)
*If no bowel movement occurs
within three days, children of this
age should visit their doctors. (4)
How to consume: (4)
Stir the required amount of
isphagula husk into a glass of cold
water (150ml) and drink straight
away.
Isphagula husk is best take after
meal.
5 Stool Softener Liquid Paraffin Lubricate and soften impacted 1ml/kg OD (2)
Laxative faeces and promote a bowel
movement. (6)
REFERENCES:
1) Borowitz.S.M. 14 Dec 2018. Medscape,Pediatric Constipation Medication. Retrieved on 30 May 2021 at
https://emedicine.medscape.com/article/928185-medication#2
2) Shann, Frank. (2017-2020). Drug Doses 17th ed.
3) Royce Enema (glycerin and sodium chloride) [package insert]. Negeri Sembilan, Malaysia: Royce Pharma. RPI
0058-5
4) Fybogel (Isphagula Husk) [package insert]. United Kingdom: Reckitt Benckiser Healthcare (UK) Limited; 2006.
#0102172
5) Fleet enema children (Phospho-soda) [package box]. U.S.A: Fleet Company; 2010.
6) BNF Children. March-September 2020. BMJ Group and the Royal Pharmaceutical Society of Great Britain.
7) CASEN PHOSPHO-SODA(Phospho-soda) [package insert]. Zaragoza, Spain : Casen Recordati S.L; 20 March
2016
8) Fleet enema adult (Phospho-soda) [package box]. U.S.A: Fleet Company; 2015.
9) Hospital USM Formulary. Retrieved from: http://dformulary.h.usm.my/
10) Fleet Enema.(2021).MIMS Online. Retrieved from:
https://www.mims.com/singapore/drug/info/fleet%20enema?type=full
Prepared by: Approved by:
1. Amaal Farhana Mohamad Khairul Bariah Johan @ Rahmat
3. Nurul Izni Ahmad Zawawi
4. Nur Aida Murni Mamamad
