Cleen (Fleet) Enema

What are Cleen (Fleet) Enemas?

Cleen Ready-to-Use Enema is a bowel cleanser, which you administer yourself. It can be used in the relief of occasional constipation and where bowel cleansing is required, such as prior to your endoscopy, bowel surgery or X-ray examination.

Cleen acts by quickly drawing water into the bowel, increasing the water content of your stools (poo) which usually produces a soft, easy-to-pass bowel movement in two to five minutes. Bowel movements as a result of using Cleen should not be painful.

Cleen enemas are more commonly used when an urgent bowel movement is needed or the large intestine needs to be cleansed. For treatment of more regular or long-term constipation, you should view our other constipation treatments for advice on bulk-forming or osmotic laxatives.

Cleen enemas are a clear, colourless, odourless, solution, free from precipitation and turbidity. Each enema contains 133ml of liquid and 118ml is administered as the dose. Cleen enemas are manufactured by Casen Recordati and are latex-free.

Cleen enemas are no longer considered to be the first-line enema treatment for constipation. Micralax micro-enemas are the recommended first-line treatment. You should not use Cleen enemas unless they have been recommended to you by your doctor and they have explained how and when they are suitable for use.

Cleen enema patient information leaflet: https://www.medicines.org.uk/emc/files/pil.3772.pdf

Cleen Enema dosage

Adults, elderly and children over 12 years old: 1 bottle (118ml delivered dose) no more than once daily or as directed by your doctor.

Cleen enemas should only be used for occasional constipation, rectal enemas are to be used to provide short-term relief only. If you need long-term constipation treatment, you should speak to your doctor to find the best treatment for your situation.

How to use Cleen (Fleet) Enemas

Cleen enemas are for rectal use only.

For best results use as follows:

• Lie on your left side with both knees bent, and arms at rest.
• Remove the orange protective shield.
• With steady pressure, gently insert enema Comfortip into the anus with the nozzle pointing towards the navel.
• Squeeze the bottle until nearly all liquid is expelled.
• Discontinue use if resistance is encountered. Forcing the enema can result in injury.
• Return the enema to the carton for disposal.
• Generally, 2 to 5 minutes are sufficient to obtain the desired effect. If delayed discontinue further use and consult a physician

It is not necessary to empty the bottle completely. The bottle contains more than the amount of liquid needed for effective use, so a small residue will remain.

Ensure you read the enclosed patient information leaflet for supporting diagrams to aid use.

Cleen Enema ingredients

Each 118ml dose delivers the equivalent of 21.4g (18.1% w/v) Sodium Dihydrogen Phosphate Dihydrate and 9.4g (8.0% w/v) Disodium Phosphate Dodecahydrate.

Each dose also contains the following inactive ingredients:

• Disodium edetate
• Benzalkonium chloride
• Purified water

The nozzle lubricant is comprised of white soft paraffin.

Cleen (Fleet) Enema warnings

Do not use Cleen Ready-to-Use Enema and tell your doctor if you:

• Are allergic (hypersensitive) to sodium dihydrogen phosphate dihydrate, disodium phosphate dodecahydrate or any of the other ingredients of this medicine.
• Have a swollen large bowel (also known as megacolon).
• Have a narrowing or incomplete opening of the anus or rectum.
• Have a blockage of the lower colon (Hirschsprung’s disease).
• Have a suspected blockage of the gut.
• Have blockage of the gut or failure of normal bowel movements (sometimes called paralytic ileus).
• Have been told by your doctor that you may have:
  • Appendicitis
  • A pierced/damaged or blocked gut
  • An active inflammatory bowel disease (such as Crohn’s disease or ulcerative colitis)
• Have undiagnosed bleeding of the back passage.
• Have kidney problems.
• Have congestive heart failure (your heart is unable to properly pump blood around the body).
• Have recently been sick or feel sick or thirsty.
• Have pain in your stomach (abdominal pain).
• The patient is under 3 years of age.

Talk to your doctor or pharmacist before using Cleen Ready-to-Use Enema if:

• You are frail or elderly. You may need assistance from a carer or healthcare professional to use Cleen Ready-to-Use Enema.
• You have uncontrolled blood pressure.
• You have a heart or kidney condition.
• You suffer from ascites (excess fluid in the peritoneal cavity).
• You suffer from rectal ulceration (ulceration of the back passage) or fissures (tears in the skin of the back passage).
• You have had a colostomy.
• You suffer from electrolyte disturbances (changes in the salt levels in the body such as low calcium, low potassium, high phosphate or high sodium levels). Please consult your doctor, even if these statements were applicable to you at any time in the past. You may need to be more closely supervised during treatment.

Cleen Ready-to-Use Enema and other medicines

Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines, especially:

• medicines for the treatment of high blood pressure (hypertension) such as ACE-inhibitors (e.g. enalapril, ramipril, lisinopril) and angiotensin receptor blockers (e.g. losartan, candesartan, eprosartan, irbesartan, olmesartan, telmisartan, valsartan) or angina (calcium channel blockers).
• medicines to empty the bladder (diuretics).
• certain medicines for mental disorders (lithium).
• any other medicines that could make you dehydrated or alter the salt levels (potassium, sodium, phosphate or water) in your body, known as your electrolyte balance.
• certain medicines for cleaning the bowel (sodium phosphates).
• medicines that alter the rhythm of your heart (prolong the QT interval); such as amiodarone, arsenic trioxide, astemizole, azithromycin, erythromycin, clarithromycin, chlorpromazine, cisapride, citalopram, domperidone, terfenadine, procainamide.
• non–steroidal anti-inflammatory drugs (NSAIDs) such as aspirin or ibuprofen.

Pregnancy and breast-feeding

If you are pregnant or breastfeeding, think you may be pregnant or are planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine. As the main ingredients contained in Cleen Ready-to-Use Enema may pass into breast milk, it is advised that breast milk is expressed and discarded for at least 24 hours after receiving the Cleen Ready-to-Use Enema.

Cleen (Fleet) Enema side effects

Cleen Ready-to-Use Enema is well tolerated when used as indicated. However, adverse events possibly associated with the use of Cleen Ready-to-Use Enema have been infrequently reported. In some cases, adverse events may occur, especially if the enema is misused.

Side effects are considered to be very rare and only occur in up to 1 in 10,000 patients. You can read about the very rare side effects in the patient information leaflet.