Laxido: Uses, Dosage & Side Effects

What Is Laxido and What Is It Used For?

Laxido is an osmotic laxative containing macrogol 3350 (polyethylene glycol 3350) combined with electrolytes. It is used to treat chronic constipation and faecal impaction in adults and adolescents aged 12 years and over. Macrogol works by retaining water in the bowel, softening the stool and increasing its volume, which triggers the natural urge to have a bowel movement.

Constipation is one of the most common gastrointestinal complaints worldwide, affecting an estimated 14% of the global adult population according to a systematic review and meta-analysis published in the American Journal of Gastroenterology. It is characterised by infrequent bowel movements (typically fewer than three per week), hard or lumpy stools, straining, and a feeling of incomplete evacuation. Chronic constipation can significantly impair quality of life, lead to complications such as haemorrhoids, anal fissures, and faecal impaction, and is associated with increased healthcare costs.

Laxido belongs to the class of osmotic laxatives, which work by drawing water into the bowel lumen through osmosis. The active ingredient, macrogol 3350, is a large, inert polymer of ethylene oxide with a molecular weight of approximately 3,350 daltons. It forms hydrogen bonds with water molecules, retaining them within the intestinal tract rather than allowing them to be absorbed. This increases the water content and volume of the stool, making it softer and easier to pass. The increased stool volume also activates the stretch receptors in the colon wall, stimulating peristalsis – the wave-like muscular contractions that move stool through the bowel.

A critical advantage of Laxido over some other macrogol preparations is the inclusion of electrolytes: sodium chloride (NaCl), sodium bicarbonate (NaHCO₃), and potassium chloride (KCl). These electrolytes create an isotonic solution when dissolved in water, meaning that there is virtually no net gain or loss of sodium, potassium, or water across the intestinal wall during treatment. This is particularly important when Laxido is used at higher doses for faecal impaction, as large volumes of osmotically active solution passing through the bowel could otherwise cause electrolyte disturbances.

Approved Indications

Laxido is licensed for two main clinical indications, each with different dosing regimens:

• Chronic constipation: The treatment of chronic functional constipation in adults and adolescents aged 12 years and over, when dietary and lifestyle measures alone have been insufficient
• Faecal impaction: The resolution of faecal impaction (a large mass of hard stool lodged in the rectum or colon that cannot be passed naturally) in adults, using a higher-dose regimen over a short treatment course

How Laxido Differs from Other Laxatives

Laxatives can be classified into several categories based on their mechanism of action. Understanding these differences helps explain why macrogol-based products like Laxido are preferred as first-line treatment:

• Osmotic laxatives (Laxido, lactulose): Draw water into the bowel. Macrogol is generally preferred over lactulose because it is better tolerated (less bloating and flatulence) and more effective at higher doses
• Stimulant laxatives (senna, bisacodyl): Directly stimulate the nerve endings in the bowel wall to increase motility. Effective for short-term use but can cause cramping and, with prolonged use, may lead to tolerance and reduced bowel function
• Bulk-forming laxatives (psyllium, methylcellulose): Increase stool volume by absorbing water. Require adequate fluid intake and can worsen symptoms in some patients, particularly those with slow-transit constipation
• Stool softeners (docusate): Reduce surface tension of stool to allow more water penetration. Generally considered less effective than osmotic or stimulant laxatives

What Should You Know Before Taking Laxido?

Before taking Laxido, you should inform your doctor if you have any bowel obstruction, perforation, or severe inflammatory bowel disease. Laxido is generally well tolerated and has fewer contraindications than many other medications, but certain gastrointestinal conditions require careful assessment before treatment.

Contraindications – Do Not Take Laxido If You:

• Are allergic to macrogol (polyethylene glycol) or any of the other ingredients in Laxido (sodium chloride, sodium bicarbonate, potassium chloride)
• Have an intestinal obstruction (a blockage in the bowel that prevents the passage of stool and gas)
• Have an intestinal perforation (a hole in the wall of the bowel) or are at risk of perforation
• Have severe inflammatory conditions of the bowel, such as Crohn’s disease, ulcerative colitis, or toxic megacolon
• Have an ileus (paralysis of the bowel muscles, preventing normal peristalsis)

Warnings and Precautions

Talk to your doctor or pharmacist before taking Laxido if any of the following apply to you:

• Heart failure or kidney disease: Laxido contains sodium (187.5 mg per sachet) and potassium (25.1 mg per sachet). Patients on sodium-restricted diets or with impaired renal function should be monitored, especially when using the higher-dose faecal impaction regimen
• Impaired gag reflex or tendency to aspirate: The solution must be swallowed carefully. Patients with swallowing difficulties, neurological conditions affecting the gag reflex, or those at risk of aspiration pneumonia require special caution
• Severe or worsening symptoms: If your constipation does not improve within 14 days, or if you experience severe abdominal pain, vomiting, or bleeding from the rectum, stop taking Laxido and consult your doctor immediately. These symptoms may indicate a more serious underlying condition
• Dehydration: Ensure adequate fluid intake while taking Laxido. The osmotic effect draws water into the bowel, and insufficient fluid intake can lead to dehydration, particularly in elderly patients, young adolescents, and those with kidney problems
• Diabetes: Laxido powder is sugar-free and does not affect blood glucose levels. However, flavoured versions may contain aspartame (a source of phenylalanine)

Pregnancy and Breastfeeding

Macrogol-based laxatives are generally considered safe during pregnancy and breastfeeding. Since macrogol 3350 is not absorbed from the gastrointestinal tract, systemic exposure is negligible and there is no meaningful transfer to the fetus or into breast milk. NICE guidelines recommend macrogol as a first-line pharmacological treatment for constipation in pregnancy when dietary and lifestyle measures have been insufficient.

Constipation is extremely common during pregnancy, affecting up to 40% of pregnant women, primarily due to the effects of progesterone on bowel motility and the physical compression of the bowel by the growing uterus. Iron supplements, which are frequently prescribed during pregnancy, further exacerbate constipation. Despite the favourable safety profile of Laxido, you should always consult your doctor, midwife, or pharmacist before taking any medication during pregnancy or while breastfeeding.

Elderly Patients

No dose adjustment is required for elderly patients. However, older adults are particularly vulnerable to constipation due to reduced mobility, polypharmacy (multiple medications), decreased fluid and fibre intake, and age-related changes in bowel motility. Macrogol with electrolytes is well suited for use in elderly patients because it does not cause electrolyte disturbances when used as directed and does not interact significantly with other medications. Adequate hydration should be encouraged, particularly in elderly patients using the higher-dose faecal impaction regimen.

How Does Laxido Interact with Other Drugs?

Laxido has relatively few drug interactions because macrogol 3350 is not absorbed from the gastrointestinal tract. However, it can potentially reduce the absorption of other oral medications if taken at the same time, because the increased fluid volume in the bowel may accelerate intestinal transit and reduce contact time for absorption.

Because macrogol 3350 is pharmacologically inert – it is not metabolised, not absorbed, and does not bind to other drugs – it has a fundamentally different interaction profile compared to most other medications. There are no direct chemical or pharmacokinetic interactions. However, the physical effects of Laxido on intestinal transit time and fluid content can indirectly affect the absorption of co-administered oral medications.

The electrolyte components of Laxido (sodium chloride, sodium bicarbonate, and potassium chloride) are present in physiological quantities and are unlikely to cause clinically significant interactions in most patients. However, they should be considered in patients on strict sodium or potassium restrictions.

Potential Interactions

What Is the Correct Dosage of Laxido?

For chronic constipation, the usual adult dose is 1–3 sachets per day, dissolved in 125 ml of water per sachet. For faecal impaction, up to 8 sachets per day may be taken, dissolved in 1 litre of water. Treatment for faecal impaction should not normally exceed 3 days. Always follow the dosing instructions provided by your doctor or pharmacist.

Laxido comes as a powder in individual sachets. Each sachet must be dissolved in exactly 125 ml (approximately half a glass) of water. The solution should be stirred thoroughly until the powder is completely dissolved before drinking. Do not take the powder without dissolving it first, and do not use less water than recommended, as this could reduce the effectiveness of the treatment and cause gastrointestinal discomfort.

Adults and Adolescents (12 Years and Over)

Children (Under 12 Years)

Laxido is not recommended for children under 12 years of age. A specific paediatric formulation (such as Movicol Paediatric Plain) is available for children, with dosing based on the child’s age. Paediatric dosing should always be determined and supervised by a doctor. Macrogol-based laxatives are recommended by NICE as first-line pharmacological treatment for constipation in children, but the adult formulation should not be used without specific medical guidance.

Elderly Patients

No dose adjustment is required for elderly patients. The same dosing as for adults applies. However, elderly patients should pay particular attention to maintaining adequate fluid intake alongside Laxido treatment. When using the high-dose faecal impaction regimen, it may be advisable to start with a lower volume (e.g. 4–6 sachets) and increase if tolerated, under medical supervision.

How to Prepare Laxido

1. Open one sachet and empty the entire contents into a glass
2. Add exactly 125 ml (half a standard glass) of water
3. Stir well until the powder is completely dissolved – the solution may appear slightly cloudy
4. Drink the entire glass
5. For faecal impaction: dissolve 8 sachets in 1 litre of water and drink over 6 hours

Missed Dose

If you forget to take a dose of Laxido, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not take a double dose to make up for a missed one. Laxido works by gradually increasing the water content of the stool, so missing a single dose is unlikely to cause significant problems, though consistency of dosing produces the best results.

Overdose

Taking more Laxido than recommended can cause diarrhoea, abdominal pain, bloating, nausea, and vomiting. In severe cases, excessive doses may lead to fluid loss and electrolyte disturbances, particularly in vulnerable patients (elderly, those with kidney or heart disease). If you or someone else has taken significantly more than the recommended dose, stop taking Laxido, ensure adequate fluid intake to prevent dehydration, and contact your doctor or local poison control centre for advice.

What Are the Side Effects of Laxido?

Laxido is generally well tolerated. The most common side effects are gastrointestinal in nature, including abdominal pain, bloating, nausea, and diarrhoea. These are usually mild and transient, often occurring at the start of treatment or with higher doses. Serious side effects are rare.

Like all medicines, Laxido can cause side effects, although not everybody gets them. Most side effects are related to the gastrointestinal system and are a natural consequence of the drug’s mechanism of action – drawing water into the bowel and increasing stool volume. These effects are usually dose-dependent and often resolve as the body adjusts to treatment or when the dose is reduced.

The following side effects have been reported based on clinical trials and post-marketing surveillance data. The frequency categories follow the standard medical classification: very common (affects more than 1 in 10 people), common (affects 1 in 10 to 1 in 100 people), uncommon (affects 1 in 100 to 1 in 1,000 people), and rare (affects fewer than 1 in 1,000 people).

If diarrhoea occurs, reduce the dose or temporarily stop treatment. Diarrhoea is the most common reason for dose adjustment and usually resolves when the dose is lowered. Persistent diarrhoea can lead to dehydration and electrolyte imbalance, so it is important to increase fluid intake and contact your doctor if diarrhoea is prolonged or severe.

How Should You Store Laxido?

Store Laxido sachets in the original packaging below 25°C in a dry place. Keep out of the reach and sight of children. Once dissolved, the solution should be used immediately or stored covered in a refrigerator (2–8°C) and used within 6 hours.

Proper storage of Laxido ensures that the powder remains effective and safe to use throughout its shelf life. The individual sachets are designed to protect the powder from moisture and light, so it is important to keep them in their original foil packaging until you are ready to use them.

• Unopened sachets: Store below 25°C in a dry place, away from direct sunlight and heat sources. Do not refrigerate the dry powder
• Dissolved solution (chronic constipation – single sachet): The reconstituted solution should ideally be drunk immediately after preparation. If not consumed immediately, it may be covered and kept at room temperature for up to 6 hours
• Dissolved solution (faecal impaction – 8 sachets in 1 litre): The larger volume of solution can be covered and stored in a refrigerator (2–8°C) for up to 6 hours. Discard any unused solution after this time
• Expiry date: Do not use Laxido after the expiry date printed on the sachet and outer carton. The expiry date refers to the last day of that month
• Disposal: Do not dispose of medicines via wastewater or household waste. Ask your pharmacist how to dispose of medicines you no longer need. These measures help protect the environment

What Does Laxido Contain?

Each Laxido sachet contains macrogol 3350 (13.125 g) as the active ingredient, along with three electrolytes: sodium chloride (350.7 mg), sodium bicarbonate (178.5 mg), and potassium chloride (46.6 mg). It also contains flavouring and sweetening agents depending on the formulation.

Laxido is available in two main formulations: Laxido (plain/unflavoured) and Laxido Orange (orange-flavoured). The active ingredient and electrolyte content are identical in both formulations; only the flavouring excipients differ.

Active Ingredients (Per Sachet)

Electrolyte Content When Dissolved

When one sachet of Laxido is dissolved in 125 ml of water, the resulting solution contains the following electrolyte concentrations:

• Sodium: 65 mmol/l
• Potassium: 5.4 mmol/l
• Chloride: 53 mmol/l
• Bicarbonate: 17 mmol/l

These concentrations are chosen to produce an approximately isotonic solution, minimising the net exchange of electrolytes and water across the intestinal wall. This is the key safety feature that distinguishes macrogol with electrolytes from macrogol-only preparations.

Excipients (Inactive Ingredients)

Laxido (plain): Acesulfame potassium (E950) as sweetener.

Laxido Orange: Orange flavouring containing acacia (E414), maltodextrin, alpha-tocopherol (E307), natural flavouring substances, orange juice flavouring, and acesulfame potassium (E950). Some formulations contain aspartame (E951) – a source of phenylalanine. Patients with phenylketonuria should check the specific product information.

Frequently Asked Questions About Laxido