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Sodium picosulphate

Classification: A

Drug products: Cilaxoral, Laxoberal®

ATC code: A06AB08

Summary

One study has reported sex-divided results regarding the effect of sodium picosulphate in chronic constipation. The majority of women and slightly more than half of the men responded to treatment. However, the number of men in the study was very low and the clinical relevance is thus unclear.
When the tolerability of sodium picosulphate, sodium phosphate and polyethylene glycol were compared in a survey, women rated worse tolerability regardless of which bowel preparation used.
 
In our opinion, the described differences do not motivate differentiated dosing or treatment in men and women.

Additional information

Pharmacokinetics and dosing

No studies with a clinically relevant sex analysis regarding the pharmacokinetics or dosing of sodium picosulpahte have been found.

Effects

A randomized, placebo-controlled, double-blind study has investigated the efficacy of the acute use of sodium picosulphate in patients with chronic constipation (11 men, 46 women). The majority of women who received sodium picosulphate had a positive response (19/20, 95%) compared to 5/9 (56%) of the men. In the placebo group, there were equal numbers of responders and non-responders for men and women. However, there was a small number of men in the study, and the authors suggest that no conclusion whether there is a sex difference in response or not can be determined [2].

Adverse effects

The tolerability of the three bowel-preparation agents sodium picosulphate, sodium phosphate and polyethylene glycol used for colonoscopy have been compared in a questionnaire following a prospective randomized single-blind trial (292 men, 342 women). Regardless of the bowel preparation agent used, women had worse tolerability scores than men, with significance for taste, thirst, nausea, vomiting, bloating, headache, dizziness and sleep disturbance. Men were more likely than women to be willing to take the same bowel preparation again (89% vs 76%) [1].

Reproductive health issues

Regarding teratogenic aspects, please consult the Drugs and Birth Defects Database (in Swedish, Janusmed fosterpåverkan).

Updated: 2019-02-26

Date of litterature search: 2015-10-01

References

  1. Lawrance IC, Willert RP, Murray K. A validated bowel-preparation tolerability questionnaire and assessment of three commonly used bowel-cleansing agents. Dig Dis Sci. 2013;58:926-35. PubMed
  2. Wulkow R, Vix JM, Schuijt C, Peil H, Kamm MA, Jordan C. Randomised, placebo-controlled, double-blind study to investigate the efficacy and safety of the acute use of sodium picosulphate in patients with chronic constipation. Int J Clin Pract. 2007;61:944-50. PubMed
  3. Conicse. Stockholm: eHälsomyndigheten. 2015 [cited 2016-03-23.] länk

Authors: Linnéa Karlsson Lind, Desirée Loikas

Reviewed by: Mia von Euler

Approved by: Karin Schenck-Gustafsson