What is Movicol?
Movicol is a licensed laxative treatment for constipation, manufactured by Norgine Ltd. It is available as individual powder sachets that are dissolved in water to produce a solution taken by mouth. The active ingredient, macrogol 3350, is an osmotic laxative, a class of laxative that works by retaining water within the bowel rather than by stimulating bowel muscle contractions.
Movicol is available in several formulations: Movicol Plain (unflavoured), Movicol Lemon & Lime and Movicol-Half, a lower-dose sachet containing half the quantity of macrogol 3350 intended for patients who require a reduced or maintenance dose. All standard Movicol sachets also contain a balanced combination of electrolytes (sodium chloride, sodium bicarbonate and potassium chloride) to help maintain the body's fluid and salt balance during treatment.
What is Movicol used for?
Movicol is indicated for two distinct conditions:
- Chronic constipation - difficulty passing stools, infrequent bowel movements or the passage of hard, dry stools.
- Faecal impaction - a more severe condition in which a large, hardened mass of stool becomes lodged in the rectum or lower colon, often as a consequence of prolonged untreated constipation.
Movicol is suitable for adults and adolescents aged 12 years and over.
How does Movicol work?
Macrogol 3350, the active ingredient in Movicol, is an osmotic laxative. It works by retaining water within the bowel through osmosis, drawing fluid into the intestinal contents to increase stool volume and soften its consistency. This increase in stool volume triggers bowel contractions through the neuromuscular pathways, promoting the natural movement of softened stools through the colon and facilitating defaecation.
Unlike stimulant laxatives, macrogol does not directly stimulate the muscles of the bowel wall. It also differs from bulk-forming laxatives (such as ispaghula husk) as it does not add fibre to the stool but instead acts on the water content within the bowel.
The electrolytes present in each Movicol sachet (sodium chloride, sodium bicarbonate and potassium chloride) are exchanged across the intestinal mucosa with serum electrolytes, meaning there is no net gain or loss of sodium, potassium or water in the body during normal therapeutic use.
How long does Movicol take to work?
For the treatment of constipation, Movicol typically produces a bowel movement within 1 to 2 days of starting treatment. However, the results can vary depending on the severity of constipation, individual bowel function and adherence to the recommended dose.
For faecal impaction, the high-dose regimen (see dosing guidance below) can produce results within the same six-hour treatment window, though this should only be undertaken under medical guidance.
If constipation has not improved after two weeks of treatment, or if symptoms worsen, you should seek advice from your GP.
Movicol Powder Sachets: Our Pharmacist's Advice
"A common pattern we see with Movicol is patients staying on one sachet a day when their symptoms call for a higher dose. The licensed range for adult constipation is one to three sachets daily, and adjusting within this range based on stool consistency often produces results that a fixed single dose does not. If stools become loose, the dose can simply be reduced.
Hydration is the other piece patients sometimes miss. Each Movicol sachet works by drawing water into the bowel, but the laxative action depends on the body having enough fluid available in the first place. We advise patients to maintain their normal daily fluid intake separately from the 125ml used to dissolve each sachet, rather than treating the dissolved solution as a substitute for their usual drinks."
How should Movicol sachets be taken?
Each standard Movicol sachet should be dissolved in 125ml of water, stirred until fully dissolved and drunk immediately. The solution should appear clear or slightly cloudy once properly mixed.
For constipation in adults and adolescents aged 12 and over: one to three sachets per day, depending on the severity of symptoms. Treatment should not normally continue for longer than two weeks without medical advice.
For faecal impaction: eight sachets per day, taken within a six-hour period. For convenience, all eight sachets may be dissolved in one litre of water and consumed at a rate of up to two sachets (250ml) per hour.
Movicol should be taken alongside adequate fluid intake. It is important not to substitute your normal daily fluid consumption with the Movicol solution alone.
When is the best time to take Movicol?
There is no specific recommended time to take Movicol. However, taking Movicol in the morning or spreading doses throughout the day allows any resulting bowel movement to occur during waking hours, which some patients find more convenient.
Movicol can be taken with or without food. If you are taking other oral medications, it is recommended to leave a gap of at least one hour before or after taking Movicol, as the large volume of fluid may affect the absorption of other medicines from the gut.
Can Movicol be taken every day?
Movicol is licensed for short-term use of up to two weeks for the self-management of constipation. If you find you need to use Movicol regularly beyond this period, you should seek advice from your GP. Long-term use may be appropriate in certain clinical situations, but should only continue under medical supervision.
For those managing ongoing or recurrent constipation, your doctor may recommend adjustments to diet, fluid intake or physical activity, or may consider an alternative maintenance regimen.
How long does Movicol stay in the system?
Macrogol 3350 is virtually unabsorbed from the gastrointestinal tract. It passes through the gut without entering the bloodstream in any clinically significant amount. Any small quantity that is absorbed is excreted via the urine unchanged.
Because macrogol does not accumulate in the body, its laxative effect subsides relatively quickly once treatment stops. Bowel function typically returns to its prior pattern within one to two days of stopping Movicol, depending on the underlying cause of constipation.
What is Movicol-Half and when is it used?
Movicol-Half sachets contain 6.9g of powder, compared to 13.8g in a standard Movicol sachet. Each Movicol-Half sachet contains 6.5625g of macrogol 3350, approximately half the dose of the standard formulation. Movicol-Half should be dissolved in 62.5ml of water per sachet.
The lower-dose sachet may be more appropriate for individuals who experience loose stools on the standard dose, or for those who require a lower maintenance dose once constipation has resolved. The usual dose of Movicol-Half for adults and adolescents is two to four sachets per day. Your GP can advise on which formulation is most appropriate for your needs.
Is Movicol suitable for elderly patients?
Yes. Movicol is suitable for use in elderly patients at the same dose as other adults. However, elderly patients should ensure adequate hydration during treatment, as they may be at greater risk of dehydration.
Elderly patients on a low-sodium diet, for example, those with heart failure or hypertension, should be aware that each standard Movicol sachet contains the equivalent of 9.3% of the World Health Organisation's (WHO) recommended maximum daily intake of sodium. If a low-sodium diet has been prescribed, this should be discussed with your GP before starting treatment.
Is Movicol available without a prescription?
Yes. Standard Movicol sachets (plain, lemon & lime, and Movicol-Half variants) are available to purchase over the counter from pharmacies in the UK without a prescription, for adults and adolescents aged 12 and over. Movicol can also be ordered online through a registered pharmacy such as Pharmica following a short health questionnaire.
If your constipation has persisted for more than two weeks, or if you suspect faecal impaction, you should consult your GP or pharmacist before beginning or continuing treatment.
Can Movicol be taken during pregnancy or breastfeeding?
Macrogol 3350 (the active ingredient in Movicol) can be used during pregnancy. Since the active ingredient is negligibly absorbed from the gastrointestinal tract, no clinically significant systemic exposure occurs, and no effects on the developing foetus are anticipated.
Similarly, Movicol can be used if you are breastfeeding, as systemic exposure in the breastfeeding mother is negligible and no effects on the breastfed infant are anticipated.
As with all medicines taken during pregnancy or breastfeeding, it is important to consult your GP before starting treatment.
Can Movicol be dissolved in something other than water?
Dissolving the powder in liquids other than water has not been formally studied and is not recommended unless advised by a healthcare professional. If you have difficulty tolerating the taste of Movicol, speak to your pharmacist, who may be able to suggest suitable alternatives within the licensed product range, for example, the lemon & lime flavoured sachets.
How does Movicol differ from lactulose?
Both Movicol and lactulose are laxatives, but they work differently and are suited to different circumstances. Lactulose is an osmotic laxative derived from a synthetic disaccharide sugar. It is fermented by colonic bacteria, which can cause bloating and flatulence as common side effects. Lactulose is available as a syrup and generally takes one to two days to produce an effect.
Movicol contains macrogol 3350, a large inert polymer that is not broken down or absorbed. It is generally associated with fewer gastrointestinal side effects than lactulose and is recommended by NICE guidelines for the treatment of constipation in adults when simpler measures have not worked. The choice between treatments depends on individual circumstances and should be discussed with a GP.
Is Movicol suitable for children?
Standard Movicol sachets (13.8g) are not recommended for children under 12 years of age. A separate paediatric formulation, Movicol Paediatric Plain or Movicol Paediatric Chocolate, is available for children aged 2 to 11 years, but this requires a prescription and should only be used under medical supervision with dosing determined by a GP or paediatrician.
If a child under 12 is experiencing constipation, consult your GP to help determine an appropriate treatment.
Who should not take Movicol?
Do not take Movicol if you:
- Are allergic to macrogol 3350 or any of the other ingredients listed in the patient information leaflet
- Have a known or suspected perforation or obstruction of the intestine
- Have a history of paralytic ileus, a condition in which the intestine fails to propel its contents
- Have severe active inflammatory bowel disease, including ulcerative colitis, Crohn's disease or toxic megacolon
Speak to your GP or pharmacist before taking Movicol if you:
- Have heart failure or another condition requiring fluid restriction
- Have been advised to follow a strictly low-sodium diet, due to the sodium content of each sachet
- Have impaired gag reflex, reflux oesophagitis, or any condition that affects swallowing
- Are taking other oral medications that may be affected by gut transit
Always read the patient information leaflet supplied with the product before starting treatment, and inform your GP or pharmacist of all other medicines you are taking.
What is in Movicol?
Each standard Movicol sachet (13.8g) contains the following active ingredients:
- Macrogol 3350: 13.125g
- Sodium chloride: 350.7mg
- Sodium bicarbonate: 178.5mg
- Potassium chloride: 46.6mg
The other ingredients are acesulfame potassium (E950) as a sweetener, and (in the lemon & lime variant) lemon flavour, lime flavour and sulphur dioxide (E220). For the full list of ingredients, including those in Movicol-Half, please refer to the patient information leaflet for Movicol.