Cremalax Uses

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• Cremalax indications
• Uses of Cremalax in details
• Cremalax description
• Cremalax dosage
• Cremalax interactions
• Cremalax side effects
• Cremalax contraindications

Cremalax indications

* this medicineis used to relieve constipation (difficulty with bowel movements).

* It is a stimulant laxative, which induces a laxative effect (stimulating stool production).

* It is used to relieve constipation and works by stimulating nerve endings in the walls of part of the gut called the large intestine (colon) and rectum. This causes the muscles in the intestine wall to contract more often and with increased force, emptying the bowel and relieving constipation. As this medicineis activated by natural bacteria found in the colon, it does not start working until it reaches this part of the gut.

* In general, this drug is used to relieve constipation and to empty the bowel before surgery, childbirth or certain medical procedures such as radiological examination of the bowel.

* Benefits of being on this drug can include regular bowel movements.

Listed below are the typical uses of Cremalax.

* Short-term relief of constipation

* Management of constipation (of any cause)

* Clearing the bowel before surgery, childbirth or radiological investigations.

Uses of Cremalax in details

Cremalax is used to provide relief from constipation (difficulty in passing stools). It also used (in combination with magnesium oxide and anhydrous citric acid) to empty the bowel before colonoscopy (internal examination of colon to check for cancers or other abnormalities).

Cremalax description

Each 5 mL syrup contains 5 mg 4,4'-(2-pyridyl-methylene)-diphenol-bis(hydrogen sulfate-ester) disodium salt (equivalent to Cremalax 5 mg). It also contains the following excipients: Sodium carboxymethylcellulose, methylparaben, propylparaben, glycerin, aroma tutti frutti, sodium saccharin, FD & C yellow #6, ethanol and purified water.

Cremalax dosage

A low residue diet is recommended on the day prior to the hospital procedure. To avoid dehydration, it is recommended to drink a sufficient amount of clear liquids whilst the effects of Cremalax persist. Clear liquids may include water, clear soup, fruit juice without pulp, softdrinks, tea and/or even coffee without milk.

Adults (including the Elderly): Split-Dose Regimen (evening-before and day of the procedure): The 1st Cremalax sachet is taken the night before the procedure and the 2nd is taken the next day, in the morning prior to the procedure. On the day before the procedure: 1 sachet. The 1st reconstituted sachet is taken in the evening (eg, 5-9 PM), followed by at least five 250 mL drinks of clear liquids, spread over several hrs.

On the day of the procedure: 1 sachet. The 2nd reconstituted sachet is taken in the morning (5-9 hrs before the procedure), followed by at least three 250 mL drinks of clear liquids, spread over several hours.

Day-Before Regimen (evening-before the procedure): The 1st Cremalax sachet is taken in the afternoon or early evening and the 2nd is taken approximately 6 hrs later, the night before the procedure.

On the day before the procedure: 2 sachets. The 1st reconstituted sachet is taken in the afternoon or early evening (eg, 4-6 PM), followed by at least five 250 mL drinks of clear liquids, spread over several hours. The 2nd reconstituted sachet is taken in the late evening (eg, 10-12 AM), followed by at least three 250 mL drinks of clear liquids, spread over several hours.

Clear liquids may be consumed until 2 hrs before the time of the procedure.

Administration: Directions for Reconstitution: Reconstitute the Cremalax powder right before each administration. Do not prepare the solution in advance. Reconstitute the contents of 1 sachet in a cup of water (approximately 150 mL). Stir for 2-3 minutes, the solution should now become an off-white, cloudy liquid with a faint odour of orange.

Cremalax interactions

As a purgative, Cremalax increases the gastrointestinal transit rate. The absorption of other orally administered medicines (eg, antiepileptics, contraceptives, antidiabetics, antibiotics) may therefore be modified during the treatment period.

Oral medication administered within 1 hr of the start of administration of Cremalax solution may be flushed from the gastrointestinal tract and the medication may not be absorbed. Tetracycline and fluoroquinolone antibiotics, iron, digoxin, chlorpromazine and penicillamine, should be taken at least 2 hrs before and ≥6 hrs after administration of Cremalax to avoid chelation with magnesium.

The efficacy of Cremalax is lowered by bulk-forming laxatives.

Prior or concomitant use of antibiotics with Cremalax may reduce efficacy of Cremalax as conversion of Cremalax to its active metabolite, bis-(p-hydroxyphenyl)-pyridyl-2-methane (BHPM) is mediated by colonic bacteria.

Use caution when prescribing Cremalax for patients with conditions or who are using medications that increase the risk for fluid and electrolyte disturbances or may increase the risk of seizure, arrhythmias and prolonged QT in the setting of fluid and electrolyte abnormalities. This include patients receiving drugs which may be associated with hypokalemia (eg, diuretics or corticosteroids, or drugs where hypokalaemia is a particular risk ie, cardiac glycosides). Caution is also advised when Cremalax is used in patients on angiotensin converting enzyme inhibitors, NSAIDs or drugs known to induce syndrome of inappropriate antidiuretic hormone secretion (SIADH) eg, tricyclic antidepressants, selective serotonin re-uptake inhibitors, antipsychotic drugs and carbamazepine as these drugs may increase the risk of water retention and/or electrolyte imbalance.

Cremalax side effects

MedDRA Organ Class: Common (≥1/100 to ≤1/10); uncommon (≥1/1000 to ≤1/100); not known (cannot be estimated from the available data).

Immune System Disorder: Uncommon: Anaphylactic reaction, hypersensitivity.

Metabolism and Nutrition Disorders: Uncommon: Hyponatremia and hypokalaemia.

Nervous System Disorders: Common: Headache. Uncommon: Epilepsy, grand mal convulsion, convulsions, confusional state.

Gastrointestinal Disorders: Common: Nausea and proctalgia. Uncommon: Vomiting, abdominal pain, aphthoid ileal ulcers^*. Not Known: Diarrhea, faecal incontinence.

Skin and Subcutaneous Tissue Disorders: Uncommon: Rash (including erythematous and maculopapular rash, urticaria, purpura).

^*Isolated cases of mild reversible aphthoid ileal ulcers have been reported.

The frequencies of the side effects are based on post-marketing experience.

Diarrhea and faecal incontinence are the primary clinical effect of Cremalax. Isolated cases of severe diarrhea have been reported post-marketing.

Hyponatremia has been reported with or without associated convulsions. In epileptic patients, there have been isolated reports of seizure/grand mal convulsion without associated hyponatraemia. There have been isolated reports of anaphylactoid reaction.

Cremalax contraindications

Hypersensitivity to Cremalax or any of the component of Dulcolax. In case of rare hereditary conditions that may be incompatible with the excipients, the use of Cremalax is contraindicated. Patients with ileus, intestinal obstruction, acute abdominal conditions including appendicitis, acute inflammatory bowel diseases and severe abdominal pain associated with nausea and vomiting which may be indicative of the aforementioned severe conditions. It is also contraindicated in severe dehydration.

Active ingredient matches for Cremalax:

Sodium Picosulfate in India.

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Information checked by Dr. Sachin Kumar, MD Pharmacology