PSYLLIUM HYDROPHILIC MUCILLOID 
(sill'i-um)
Hydrocil, Instant, Karasil  , Konsyl, Metamucil, Modane Bulk, Perdiem Plain, Reguloid, Serutan, Siblin, Syllact, V-Lax
Classifications: gastrointestinal agent; bulk laxative
Pregnancy Category: C
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3.4 g/dose powder; 2.5 g, 3.4 g, 4.03 g/teaspoon granules
Highly refined colloid of psyllium seed (Plantago ovata) with equal amount of dextrose added as dispersing agent.
Bulk-producing laxative that promotes peristalsis and natural elimination.
Chronic atonic or spastic constipation and constipation associated with rectal disorders or anorectal surgery.
Esophageal and intestinal obstruction, nausea, vomiting, fecal impaction, undiagnosed abdominal pain, appendicitis; children
<2 y.
Diabetics; pregnancy (category C), lactation.
Constipation or Diarrhea
Adult: PO 1–2 rounded tsp or 1 packet 1–3 times/d prn
Child: PO
>6 y, 1 tsp in water h.s.
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Oral
- Fill an 8-oz (240-mL) water glass with cool water, milk, fruit juice, or other liquid; sprinkle powder into liquid; stir briskly;
and give immediately (if effervescent form is used, add liquid to powder). Granules should not be chewed.
- Follow each dose with an additional glass of liquid to obtain best results.
- Exercise caution with older adult patient who may aspirate the drug.
Hematologic: Eosinophilia. GI: Nausea and vomiting, diarrhea (with excessive use); GI tract strictures when drug used in dry form, abdominal cramps.
Drug: Psyllium may decrease absorption and clinical effects of antibiotics, warfarin,
digoxin,
nitrofurantoin,
salicylates.
Absorption: Not absorbed from GI tract. Onset: 12–24 h. Peak: 1–3 d.
Assessment & Drug Effects
- Report promptly to physician if patient complains of retrosternal pain after taking the drug. Drug may be lodged as a gelatinous
mass (because of poor mixing) in the esophagus.
- Monitor therapeutic effectiveness. When psyllium is used as either a bulk laxative or to treat diarrhea, the expected effect
is formed stools. Laxative effect usually occurs within 12–24 h. Administration for 2 or 3 d may be needed to establish
regularity.
- Assess for complaints of abdominal fullness. Smaller, more frequent doses spaced throughout the day may be indicated to relieve
discomfort of abdominal fullness.
- Monitor warfarin and digoxin levels closely if either is given concurrently.
Patient & Family Education
- Note sugar and sodium content of preparation if on low-sodium or low-calorie diet. Some preparations contain natural sugars,
whereas others contain artificial sweeteners.
- Understand that drug works to relieve both diarrhea and constipation by restoring a more normal moisture level to stool.
- Be aware that drug may reduce appetite if it is taken before meals.
- Do not breast feed while taking this drug without consulting physician.
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