Pharmacological properties
Pharmacodynamics. Picos is a combined contact laxative drug. Sodium picosulfate is a locally acting laxative of the triarylmethane group, which, after bacterial cleavage in the colon, stimulates its mucous membrane, improves peristalsis, contributing to an increase in the volume of water and electrolytes in the lumen of the colon. As a result: stimulation of defecation, reduction of passage time and softening of feces.
Senna anthraglycosides slow down the absorption of fluid and stimulate peristalsis of the intestinal walls.
Pharmacokinetics. After oral administration, sodium picosulfate reaches the colon without apparent absorption. The onset of action is 6-12 hours after administration, which is associated with the release of the active substance of the drug. After administration, a small amount of the drug is detected in the organs and systems of the body.
Indication
Constipation or cases where easier defecation is needed.
Application
Adults and children over 12 years old - 10-20 drops.
Picos should be taken 1 g/day at night to empty the bowels the next morning.
The minimum effective dose of the drug necessary to restore normal bowel function should be taken.
Picos should not be used daily or for a long period without determining the etiology of constipation.
Contraindication
Hypersensitivity to the active substances, other representatives of the triarylmethane group or any of the excipients of the drug;
Intestinal obstruction, intestinal obstruction, abdominal pain of unknown etiology, acute surgical diseases of the abdominal cavity (including, for example, acute appendicitis, nonspecific ulcerative colitis), acute inflammatory bowel diseases; acute abdominal pain accompanied by nausea and vomiting, which may indicate the above-mentioned acute diseases, condition after surgery on the gastrointestinal tract; gastric and duodenal ulcers, gastrointestinal bleeding, peritonitis, Crohn's disease; hemorrhoids, rectal fissures; spastic colitis, hepatitis and organic liver lesions, pancreatitis, diverticulitis; metrorrhagia; severe disorders of water and electrolyte balance; hereditary fructose intolerance; nephronephritis, cystitis; Strangulated hernia.
Side effects
On the part of the immune system: hypersensitivity reactions, including angioedema, skin rash, urticaria, itching, household and other generalized exanthema.
From the digestive system: indigestion, anorexia, urine discoloration, intestinal pseudomelanosis, water and electrolyte imbalance (hypokalemia, hypocalcemia), albuminuria, hematuria, abdominal cramps and pain, diarrhea, flatulence, nausea, vomiting. Prolonged and excessive use of the drug can cause loss of fluid, potassium and other electrolytes. This, in turn, can lead to weakening of muscle and impaired cardiac function, especially in the case of simultaneous use with diuretics or corticosteroids.
Nervous system: dizziness; syncope. The likelihood of dizziness and fainting is associated with a vasovagal reaction (such as abdominal spasm or defecation).
From the endocrine system: hyperaldosteronism.
Others: cardiac disorders, increased fatigue, fainting, drowsiness, muscle weakness, convulsions.
Special instructions
Patients with chronic constipation should undergo a complete diagnosis and determine its etiology if it is unknown.
The drug is intended for occasional use. Long-term and excessive use may cause water or electrolyte imbalance, hypokalemia, and increased intestinal atony. There have been reports of episodes of dizziness and/or fainting coinciding with the use of sodium picosulfate. Existing information suggests that the above phenomena correspond to syncope during defecation (associated with the Valsalva maneuver) or are associated with a vasovagal response to abdominal pain.
The drug contains sorbitol, so patients with rare hereditary fructose intolerance should not take it.
Use during pregnancy and breastfeeding. There are no adequate studies involving pregnant women. From a safety perspective, if possible, Picos should not be used during pregnancy. It is recommended to discontinue breastfeeding during treatment with the drug, as the components of the drug may pass into breast milk and cause frequent loose stools in the child. However, with proper dosage, the occurrence of undesirable effects in the child is unlikely.
Studies to assess the effect on fertility have not been conducted.
Children. The drug is not prescribed to children under the age of 12.
Ability to influence the reaction rate when driving vehicles or working with other mechanisms. Studies of the effect on the ability to drive vehicles and work with mechanisms have not been conducted. However, patients should be warned about the possibility of developing such adverse reactions as dizziness and / or fainting as a result of vasovagal reactions (in particular abdominal spasm). In the event of abdominal spasm, the patient should avoid such potentially hazardous activities as driving a vehicle and working with mechanisms.
Concomitant use of high doses of Picos and diuretics or corticosteroids may increase the risk of electrolyte imbalance, which may lead to increased sensitivity to cardiac glycosides. Concomitant use of antibiotics may reduce the laxative effect of the drug.
Overdose
May cause loose stools (diarrhea), intestinal cramps, and clinically significant loss of fluid, potassium, and other electrolytes.
In acute overdose, the effects can be minimized or eliminated by inducing vomiting or gastric lavage shortly after administration of Picos. Fluid replacement and electrolyte balance correction may be necessary. Antispasmodics may be used. Ischemia of the large intestine mucosa has been reported with high doses of sodium picosulfate, significantly exceeding those usually recommended for constipation.
Picos, like other laxatives, can cause chronic diarrhea and abdominal pain, hypokalemia, secondary hyperaldosteronism, and possibly kidney stones in long-term overdose. Renal tubular damage, metabolic alkalosis, and myasthenia gravis have been reported with prolonged laxative abuse.
Storage conditions
At a temperature not exceeding 25 °C.
