CosmoCol

What is CosmoCol?

CosmoCol is a laxative that comes in powder sachets that contain a mix of macrogol 3350 and electolytes. Macrogols act as laxatives by making your poo bigger and softer - this makes them easier to pass. It also contains electrolytes that regulate your levels of salts and water which can help to prevent dehydration or diarrhoea happening after your constipation has been relieved.

CosmoCol is manufactured by Sterling Anglian and is available in pack sizes of 20 and 30 sachets. Cosmol is available in four different flavours:

• Plain
• Lemon & lime
• Orange

How long does CosmoCol take to work?

CosmoCol normally takes one to two days to pull enough water into the bowel and allow your poo to soften enough for you to pass it comfortably.

CosmoCol, Laxido or Movicol

ComsoCol, Movicol and Laxido are very similar treatments for constipation. Most people will decide to use one of the products based on what they have been prescribed by their doctor before. Some people may choose to use CosmoCol over Laxido due to the larger range of flavours available.

Sources

• CosmoCol Patient Information Leaflet: https://www.medicines.org.uk/emc/files/pil.5396.pdf
• https://www.nhs.uk/medicines/macrogol

How to take CosmoCol

A course of treatment for chronic constipation with CosmoCol does not normally exceed 2 weeks, although this can be repeated if required. As for all laxatives, prolonged use is not usually recommended unless specifically at the direction of your doctor.

Adults, adolescents 12 years and over and the elderly: Take one to three sachets daily in divided doses, according to individual response.

Each sachet should be dissolved in 125ml of water. Reconstituted CosmoCol solution can be covered and stored in the refrigerator (2°C to 8°C), and should be used within 24 hours. After 24 hours, any unused solution should be discarded.

CosmoCol side effects

Side effects from CosmoCol don't occur often, however, those related to the gastrointestinal tract are the most likely to occur.

Gastro-intestinal Disorders

Potential gastro-intestinal effects that may occur include abdominal distension and pain, anal discomfort, flatulence, vomiting, borborygmi and nausea.

These reactions may occur as a consequence of expansion of the contents of the gastrointestinal tract, and an increase in motility due to the pharmacologic effects of CosmoCol Orange Lemon and Lime Flavour.

In the treatment of chronic constipation, diarrhoea or loose stools normally respond to a reduction in dose.

Diarrhoea, abdominal distension, anal discomfort and mild vomiting are more often observed during the treatment for faecal impaction. Vomiting may be resolved if the dose is reduced or delayed.

Immune System Disorders

Allergic reactions, including anaphylactic reaction. Other symptoms of allergic reactions include dyspnoea, urticaria and pruritus.

CosmoCol ingredients

Each CosmoCol sachet contains the following quantitative composition of active ingredients:

• Macrogol 3350: 13.125g
• Sodium Chloride: 0.3507g
• Sodium Hydrogen Carbonate: 0.1785g
• Potassium Chloride: 0.0466g

CosmoCol also contains colloidal anhydrous silica and saccharin sodium.

Depending on the flavour of CosmoCol you select, it may also contain the following ingredients:

Orange flavour

(Orange flavour contains: flavouring substances and flavouring preparations, maltodextrin, acacia gum, alpha-tocopherol)

Lemon lime flavour

(Lemon lime flavour contains: flavouring preparations, maltodextrin, mannitol, gluconolactone, sorbitol (E420), acacia gum, colloidal anhydrous silica)

CosmoCol warnings

When should you not use CosmoCol?

• CosmoCol is contraindicated in intestinal obstruction or perforation caused by functional or structural disorder of the gut wall, ileus and in patients with severe inflammatory conditions of the intestinal tract (e.g. ulcerative colitis, Crohn's disease and toxic megacolon).
• Hypersensitivity to the active substances or any of the excipients.

Precautions for using CosmoCol

• Confirm diagnosis of faecal impaction / faecal loading of the rectum by physical or radiological examination of the abdomen and rectum.
• Mild adverse drug reactions are possible as indicated in the side effects listed in the Patient Information Leaflet. If you develop any symptoms indicating shifts of fluids/electrolytes (e.g. oedema, shortness of breath, increasing fatigue, dehydration, cardiac failure) CosmoCol should be stopped immediately and you should see your doctor.
• When using high doses of this medicine to treat faecal impaction, use caution in patients with impaired gag reflex, reflux oesophagitis or reduced levels of consciousness.
• The lemon lime flavour in CosmoCol Orange Lemon and Lime Flavour contains sorbitol (E420). Patients with rare hereditary problems of fructose intolerance should not take this medicine.

Interaction with other medicines

Macrogol 3350 raises the solubility of medicinal products that are soluble in alcohol and relatively insoluble in water. It is a theoretical possibility that absorption of these drugs could be reduced transiently.

There have been isolated reports of decreased efficacy with some concomitantly administered medicinal products, e.g. anti-epileptics.

CosmoCol in pregnancy and lactation

There is no experience with the use of CosmoCol Orange Lemon and Lime Flavour during pregnancy and lactation and it should only be used if considered essential by the physician.

Effects of Cosmocol on the ability to drive and use machines

CosmoCol has no influence on the ability to drive and use machines.