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Make a difference: what you need to know to recommend Movicol

Important changes to Movicol and what these mean for pharmacy teams and patients.
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Norgine
Photo of a family walking through an autumnal field, with a pregnant mother, child and father, and the new Movicol packaging on the right hand side of the image

Constipation is one of the most common gastrointestinal (GI) symptoms in patients of all ages and is a frequent presentation in pharmacy​[1]​. It is more common in older people and women, including around 40% of women during pregnancy, which may be owing to physiological, biochemical and dietary changes during this time​[2,3]​.

In constipation, the lower GI tract becomes dysfunctional, causing symptoms such as fewer bowel movements, abdominal pain or cramps, nausea and straining​[4,5]​. Pharmacy professionals should seek to understand a patient’s history and red flags, before outlining the best options for management, based on the patient’s preferences​[6]​.

For short-term constipation (lasting less than three months), patients can be provided with advice on lifestyle measures, such as increasing dietary fibre and ensuring adequate fluid intake, and activity levels, alongside recommended options for pharmacological management​[7]​.

Why Movicol?

Movicol, a National Institute for Health and Care Excellence (NICE)-recommended osmotic laxative, is now available over the counter (OTC) for the treatment of constipation. With 25 years of clinical use​[8]​, it is proven to relieve constipation in adults, children aged over 12 years, older patients and pregnant/breastfeeding women.

Movicol is an osmotic non-stimulant laxative, particularly effective for hard stools or those that are difficult to pass, that is not subject to the same restrictions as OTC stimulant laxatives​[7]​. It can help patients to have comfortable bowel movements, even if they have been constipated for a long time. Movicol also works in faecal impaction, which is caused by chronic or severe constipation​[9]​.

What’s new?

Movicol is now available OTC and in a new slim sachet, making it easier for patients to use the product. The product has not changed in any way, only the packaging.

How does it work?

Movicol is a macrogol that works by binding to water to relieve constipation by triggering a natural bowel movement in as little as 24 hours​[10]​. It is virtually unabsorbed by the body so it is safe to use during pregnancy and while breastfeeding.

Click on each step for more information.

What do you need to know?

Macrogols are recommended for constipation by NICE.  

Movicol’s packaging and sachet is changing, but the long-trusted product remains the same. You can confidently recommend Movicol as a safe, effective way to trigger a natural bowel movement and relieve constipation without the need for a prescription. It has superior efficacy and tolerability compared with lactulose and ispaghula husk​[11,12]​.

The paediatric version remains a prescription-only medicine, but the packaging will change in line with the rest of the range. Parents or carers of children aged under 12 years presenting with short-term constipation or who are using the medicine for reasons other than for short-term constipation should be referred to a prescriber​[7]​. Pharmacists should explain why the patient is being referred and signpost the parent to NHS webpages on constipation and constipation in children. Where appropriate, advice on diet and lifestyle and fluid intake can be offered​[7]​.

What do your patients need to know?

When taking Movicol, patients should be reminded to continue to consume plenty of fluids. The fluid content of Movicol should not replace a patient’s regular liquid intake​[9]​.

Recommendations should only be made based on a full patient history, including whether the patient takes any other medicines regulaly. Patients should not take any other medicines by mouth together with Movicol and for one hour before and after taking Movicol. Pharmacy professionals should always recommend that the patient reads the information leaflet before use.

Patients can trust Movicol as an effective treatment for constipation. It is recommended for the elderly population​[13]​ and is safe to use in pregnancy and while breastfeeding. 

Patients will find Movicol relieves their symptoms by triggering a natural bowel movement in as little as 24 hours​[10]​. This trusted product can be bought OTC in different flavours for patients aged 12 years and above with no pack size restrictions.

Side effects and adverse event reporting

Reactions related to the gastrointestinal tract occur most commonly. Suspected adverse reactions can be reported via the Yellow Card Scheme: www.mhra.gov.uk/yellowcard

For more information on Movicol, click here

  1. 1
    Constipation: How common is it? National Institute for Health and Care Excellence. 2024. https://cks.nice.org.uk/topics/constipation/background-information/prevalence/#:~:text=Constipation%20is%20a%20common%20problem,people%20%5BShafe%2C%202011%5D. (accessed April 2024)
  2. 2
  3. 3
    Shi W, Xu X, Zhang Y, et al. Epidemiology and Risk Factors of Functional Constipation in Pregnant Women. PLoS ONE. 2015;10:e0133521. https://doi.org/10.1371/journal.pone.0133521
  4. 4
    Gastrointestinal diseases. Cleveland Clinic. 2021. https://my.clevelandclinic.org/health/articles/7040-gastrointestinal-diseases (accessed April 2024)
  5. 5
    Rome IV Diagnostic Criteria for Functional Constipation. MD Calc. 2024. https://www.mdcalc.com/calc/10003/rome-iv-diagnostic-criteria-functional-constipation (accessed April 2024)
  6. 6
    Constipation. National Institute for Health and Care Excellence. 2024. https://cks.nice.org.uk/topics/constipation/#!prescribingInfoSub:2 (accessed April 2024)
  7. 7
    Royal Pharmaceutical Society. Dealing with over-the-counter stimulant laxatives in community pharmacy. Pharmacy guide. 2022. https://www.rpharms.com/resources/pharmacy-guides/dealing-with-over-the-counter-stimulant-laxatives-in-community-pharmacy (accessed April 2024)
  8. 8
    Candy D, Hammer H, Layer P, et al. MOVICOL® (PEG3350 plus electrolytes): 20 years of evidence-based use. Gastroenterology. 2016;3.
  9. 9
    Movicol package leaflet: Information for the patient. Norgine. 2023. https://www.medicines.org.uk/emc/files/pil.1025.pdf (accessed April 2024)
  10. 10
    Chaussade S, Minić M. Comparison of efficacy and safety of two doses of two different polyethylene glycol‐based laxatives in the treatment of constipation. Aliment Pharmacol Ther. 2002;17:165–72. https://doi.org/10.1046/j.1365-2036.2003.01390.x
  11. 11
    Lee-Robichaud H, Thomas K, Morgan J, et al. Lactulose versus Polyethylene Glycol for Chronic Constipation. Cochrane Database of Systematic Reviews. 2010. https://doi.org/10.1002/14651858.cd007570.pub2
  12. 12
    Wang H-J, Liang X-M, Yu Z-L, et al. A Randomised, Controlled Comparison of Low-Dose Polyethylene Glycol 3350 plus Electrolytes with Ispaghula Husk in???the Treatment of Adults with Chronic???Functional Constipation. Clinical Drug Investigation. 2004;24:569–76. https://doi.org/10.2165/00044011-200424100-00002
  13. 13
    Bassotti G, Usai Satta P, Bellini M. Chronic Idiopathic Constipation in Adults: A Review on Current Guidelines and Emerging Treatment Options. CEG. 2021;Volume 14:413–28. https://doi.org/10.2147/ceg.s256364
Last updated
Citation
The Pharmaceutical Journal, PJ, April 2024, Vol 312, No 7984;312(7984)::DOI:10.1211/PJ.2024.1.215874

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