Constipation, occasional:
Note: Ensure adequate liquid intake. Use of fiber (either dietary or supplemental) has not shown efficacy in pediatric patients for treatment of constipation, and the NASPGHAN guidelines do not recommend the use of fiber supplements (NASPGHAN [Tabbers 2014]).
Children 6 to <12 years:
Citrucel tablet: Oral: 1 caplet (500 mg fiber); may increase as needed up to 6 doses/day; maximum daily dose: 6 caplets (3,000 mg fiber)/day.
Citrucel powder: Oral: 21/2 level teaspoons (~1,667 mg fiber); may increase dose as needed by 21/2 level teaspoons up to 3 doses/day.
Children ≥12 years and Adolescents:
Citrucel tablet: Oral: 2 caplets (1,000 mg fiber) may increase as needed up to 6 doses/day; maximum daily dose: 12 caplets (6,000 mg fiber)/day.
Citrucel powder: Oral: 1 heaping tablespoon (2,000 mg fiber); may increase dose as needed by 1 heaping tablespoon up to 3 doses/day.
There are no dosage adjustments provided in the manufacturer's labeling.
There are no dosage adjustments provided in the manufacturer's labeling.
(For additional information see "Methylcellulose: Drug information")
Constipation: Oral:
Citrucel tablet: Two caplets as needed up to 6 times/day; maximum: 12 caplets/day.
Citrucel powder: 2 g (1 heaping tablespoon) in 8 oz (240 mL) of cold water; increase as needed by 1 heaping tablespoon up to 3 times/day.
Citrucel powder (sugar free): 2 g (1 rounded tablespoon) in 8 oz (240 mL) of cold water; increase as needed by 1 rounded tablespoon up to 3 times/day.
There are no dosage adjustments provided in the manufacturer's labeling.
There are no dosage adjustments provided in the manufacturer's labeling.
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Powder, Oral:
Citrucel: (454 g, 850 g)
Citrucel: (479 g, 907 g, 1191 g) [gluten free, sugar free; orange flavor]
Soluble Fiber Therapy: (454 g)
Tablet, Oral:
Citrucel: 500 mg [contains fd&c yellow #6(sunset yellow)alumin lake]
GoodSense Fiber: 500 mg [contains fd&c yellow #6(sunset yellow)alumin lake]
May be product dependent
Oral:
Caplet: Administer each dose with ≥240 mL (8 ounces) of water or other liquid to prevent choking.
Powder: Mix dose with ≥240 mL (8 ounces) of water or other liquid; stir briskly until completely dissolved and drink immediately. Drinking an additional glass of water or other fluids is recommended.
Oral: Administer each dose with 8 ounces (240 mL) of water or other liquid to prevent choking.
Powder: Store below 25°C (77°F). Protect from humidity.
Tablets: Store at 15°C to 30°C (59°F to 86° F). Protect from moisture.
Relief of occasional constipation (OTC: FDA approved in ages ≥6 years and adults). Note: Although approved for treatment of occasional constipation in pediatric patients and improved bowel movement frequency, current guidelines do not recommend for treatment of functional constipation (NASPGHAN [Tabbers 2014]). Approved ages and uses for generic products may vary; consult labeling for specific information.
Citrucel may be confused with Citracal
There are no adverse reactions listed in the manufacturer's labeling.
Dosage form specific issues:
• Phenylalanine: Some products may contain phenylalanine.
Other warnings/precautions:
• Self-medication (OTC use): Prior to self-medication, patients should contact health care provider if they have abdominal pain, nausea, vomiting, or a sudden change in bowel habits lasting 2 weeks. Patients should stop use and call health care provider immediately if rectal bleeding, constipation lasting >7 days, chest pain, vomiting, difficulty breathing or swallowing occurs, or if no bowel movement after use. All doses must be taken with 8 ounces (240 mL) of water to prevent choking; patients who have difficulty swallowing should not use. Do not use for longer than 1 week unless directed by health care provider.
None known.
Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the Lexicomp drug interactions program by clicking on the “Launch drug interactions program” link above.
Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the Lexicomp drug interactions program
Dichlorphenamide: Laxatives may enhance the hypokalemic effect of Dichlorphenamide. Risk C: Monitor therapy
Some products may contain phenylalanine, potassium, and/or sodium.
When administered with adequate fluids, use is considered safe for the treatment of occasional constipation during pregnancy (Wald 2003).
Stool output.
Tablets (Citrucel Oral)
500 mg (per each): $0.14
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