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Psyllium (Ispaghula husk, laxative agent)

Psyllium, or ispaghula husk, is a source of soluble fiber derived from the seeds of the Plantago ovata plant.

psyllium

Uses

What is psyllium used for?

As a bulk-forming laxative, psyllium promotes a healthy digestive system, regular bowel movements, and relieves constipation and certain cases of diarrhea. Stools become well-formed and easier to pass.

Aside from its laxative properties, psyllium aids with regulating blood sugar, slows down digestion, and reduces cholesterol absorption from food. It may also serve as a diet aid by controlling appetite and promoting weight loss.

How should I take psyllium?

Psyllium is available as a powder that needs to be fully dissolved in a full glass of water or juice. It is also available in capsule form. The capsule form should be swallowed whole followed by a glass of water. Do not open, chew, crush, or dissolve the contents of the capsule. For the full lipid-lowering and appetite-controlling effects, it is best to consume the mixture before meals.

How do I store psyllium?

Store this product at room temperature away from direct light and moisture. To prevent drug damage, you should not store it in the bathroom or the freezer. 

There may be different brands of this drug that may have different storage needs. So, it is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush this product down the toilet or pour them into a drain unless instructed to do so. Additionally, it is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Precautions & warnings

What should I know before using psyllium?

Before using this drug, tell your doctor if you are/have:

  • Pregnant or breastfeeding.
  • Taking any other medicines. This includes any prescription, OTC, and herbal remedies.
  • An allergy to any of the ingredients of this product.
  • Any other illnesses, disorders, or medical conditions.

Is it safe during pregnancy or breastfeeding?

This drug is generally safe to use at any time before, during, or after pregnancy. It should only be used during pregnancy if there is a clear need and the potential benefits outweigh the potential risks, as determined by your doctor.

This drug is not excreted in breast milk. You may start or continue to breastfeed while using psyllium.

Side effects

What side effects can occur when using psyllium?

Like all drugs, this product may have side effects. If they occur, side effects are generally mild and resolve once treatment is finished or the dose is lowered. Some reported side effects include:

  • Bloating
  • Abdominal discomfort
  • Flatulence (gassiness)
  • Gastrointestinal impaction or obstruction
  • Hypersensitivity reactions
    • Runny nose
    • Conjunctivitis
    • Bronchospasm
    • Anaphylaxis
  • Cutaneous (skin) symptoms
    • Redness
    • Itching

However, not everyone experiences these side effects. In addition, some people may experience other side effects. So, if you have any concerns about a side effect, please consult your doctor or pharmacist.

Interactions

What drugs may interact with psyllium?

This medication may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. 

To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs, and herbal products) and share it with your doctor and pharmacist. 

Drugs with known interactions:

  • Cardiac glycosides
  • Coumarin derivatives
  • Lithium
  • Vitamin B complex
  • Minerals (e.g. calcium, iron, or zinc)

If you experience an adverse drug interaction, inform your doctor immediately to reevaluate your treatment plan. Approaches include dose adjustment, drug substitution, or ending therapy.

Does food or alcohol interact with psyllium?

The oral form of this drug should be taken on an empty stomach for optimal absorption, as food may reduce the amount of drug that is absorbed. It can be taken 1-2 hours before or 2-3 hours after meals. There are no notable interactions with alcohol with this drug.

What health conditions may interact with psyllium?

This drug may interact with underlying conditions. This interaction may worsen your health condition or alter the way the drug works. Therefore, it is important to always let your doctor and pharmacist know all the health conditions you currently have, especially:

  • Conditions that make swallowing difficult
  • Pre-existing fecal impaction
  • Intestinal obstruction
  • Reduced gut motility (e.g. paralytic ileus)
  • Colonic atony (e.g. senile megacolon)

Dosage

The information provided is not a substitute for any medical advice. Therefore, you should always consult with your doctor or pharmacist before using any medication.

What is the dose for an adult?

Constipation

Oral

  • Dissolve 3.5 g into a full glass of water or juice and drink it 1-3 times per day.

Mild-to-moderate hypercholesterolemia (high cholesterol)

Oral

  • Dissolve 7.5-10 g into a full glass of water or juice and drink it as an supplement to a low-fat or lipid-lowering diet.

What is the dose for a child?

Treating constipation

Oral

  • Children <12 years: dissolve ½ to 1 teaspoon in water or juice and give it once in the morning and evening. Each level teaspoonful (5 mL) contains 1.75 g of psyllium.

How is psyllium available?

This drug is available in the following brands, dosage forms and strengths:

  • C-Lium Fibre powder for oral suspension 5 g
  • C-Lium Fibre capsule 5 g
  • Fibro-Lium for oral suspension 5 g
  • Mucofalk powder for oral suspension 5 g
  • Trufit capsule 5 g

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to the nearest emergency room.

What should I do if I miss a dose?

If you miss a dose, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.

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Disclaimer

Hello Health Group does not provide medical advice, diagnosis or treatment.

Ispaghula husk https://www.mims.com/philippines/drug/info/ispaghula%20husk/?type=brief&mtype=generic Accessed July 6, 2021

C-Lium https://www.mims.com/philippines/drug/info/c-lium%20fibre Accessed July 6, 2021

Ispaghula husk https://www.ema.europa.eu/en/documents/herbal-summary/ispaghula-husk-summary-public_en.pdf Accessed July 6, 2021

Fybogel (ispaghula husk) https://www.nhs.uk/medicines/fybogel-ispaghula-husk/ Accessed July 6, 2021

Ispaghula. Lexi-Drugs. Lexicomp. Wolters Kluwer Health, Inc. Riverwoods, IL. Accessed July 6, 2021. http://online.lexi.com

 

Current Version

07/07/2021

Written by Stephanie Nera, RPh, PharmD

Updated by: Stephanie Nera, RPh, PharmD


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