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Pharmacologic Category
Dosing: Adult
Constipation: Rectal: One adult suppository once daily as needed or as directed
Mouth/throat irritation: Oral: Apply a one-inch strip directly to tongue and oral cavity as needed
Dosing: Geriatric
Refer to adult dosing.
Dosing: Pediatric
Fecal impaction, rapid disempaction: Limited data available: Rectal: Infants and Children <2 years: Suppository: 1 pediatric suppository once (Wyllie 2011)
Constipation: Rectal: Suppository:
Children 2 to 5 years: 1 pediatric suppository once daily as needed or as directed
Children ≥6 years and Adolescents: 1 adult suppository once daily as needed or as directed
Mouth/throat irritation: Oral: Oral gel: Children ≥2 years and Adolescents: Apply a 1-inch strip directly to tongue and oral cavity as needed
Use: Labeled Indications
Constipation: Relief of occasional constipation.
Mouth/throat irritation: Temporary relief of minor discomfort and protection of irritated areas in sore mouth and sore throat.
Clinical Practice Guidelines
Constipation:
AGA, “Guideline on the Medical Management of Opioid-Induced Constipation,” October 2018
Administration: Oral
Apply gel to tongue and around inside and outside of tooth and gum surfaces; do not rinse out.
Administration: Rectal
Insert suppository high in the rectum and retain ~15 minutes; suppository does not need to melt to produce response
Administration: Pediatric
Oral: Apply oral gel topically to oral mucosa (tongue and oral cavity); do not rinse after use; avoid swallowing product.
Rectal:
Suppository: Insert suppository in the rectum and retain 15 minutes; suppository does not need to melt to produce response
Enema: Remove protective shield; insert tip into rectum with light side to side movement; squeeze the until nearly all liquid expelled. Gently remove the unit; a small amount of liquid will remain in unit after use.
Storage/Stability
Store at room temperature; protect rectal products from heat.
Medication Patient Education with HCAHPS Considerations
What is this drug used for?
All rectal products:
• It is used to treat constipation.
All oral products:
• It is used to treat dry mouth.
Frequently reported side effects of this drug
• Nausea
• Abdominal cramps
• Passing gas
• Diarrhea
• Burning
• Rectal irritation
Other side effects of this drug: Talk with your doctor right away if you have any of these signs of:
• Severe abdominal pain
• Rectal pain
• Rectal bleeding
• Signs of a significant reaction like wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; or swelling of face, lips, tongue, or throat.
Note: This is not a comprehensive list of all side effects. Talk to your doctor if you have questions.
Consumer Information Use and Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only the healthcare provider has the knowledge and training to decide which medicines are right for a specific patient. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from the healthcare provider. You must talk with the healthcare provider for complete information about the risks and benefits of using this medicine.
Warnings/Precautions
Dosage forms specific issues:
• Oral products: For use as an oral demulcent; do not swallow excessive amounts.
• Rectal products: May cause rectal discomfort or a burning sensation.
Geriatric Considerations
The primary use of glycerin in the elderly is as a laxative, although it is not recommended as a first-line treatment
Warnings: Additional Pediatric Considerations
Frequent use of laxatives may lead to bowel dependence and should be avoided (Tabbers [NASPGHAN/ESPGHAN] 2014).
Suppository: Use suppository with caution in patients with abdominal pain, nausea, or vomiting; physician should be consulted prior to use. In children, if bowel movement does not occur within 1 hour of use or rectal bleeding occurs; consult a physician.
Oral gel: Should be applied topically to the oral mucosa area; swallowing of product should be avoided during application, especially in young children; if swallowing of an excessive amount of glycerin occurs, consult prescriber or a local Poison Control Center. If sore mouth symptoms associated with dry mouth do not improve within 7 days or if sore throat is severe, persists more than 2 days, or is accompanied by fever, headache, rash, nausea, or vomiting consult a physician.
Rectal: Neonatal use: Although several trials have been conducted, data supporting the use of glycerin enemas for rapid meconium evacuation or treatment of constipation in neonates is inconclusive and not supported in guidelines (Haiden 2007; Shah 2011; Tabbers [NASPGHAN/ESPGHAN] 2014)
Pregnancy Considerations
Glycerin suppositories are generally considered acceptable for use during pregnancy (Cullen 2007; Wald 2003).
Briggs' Drugs in Pregnancy & Lactation
Adverse Reactions
Frequency not defined.
Gastrointestinal: Abdominal cramps, rectal irritation, tenesmus
Metabolism/Transport Effects
None known.
Drug Interactions Open Interactions
Dichlorphenamide: Laxatives may enhance the hypokalemic effect of Dichlorphenamide. Risk C: Monitor therapy
Dosage Forms: US
Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product
Enema, Rectal:
Fleet Liquid Glycerin Supp: 5.4 g/dose (7.5 mL)
Suppository, Rectal:
Pedia-Lax: 1 g (12 ea); 2.8 g (4 mL) [contains edetate disodium]
Sani-Supp Adult: 2 g (10 ea [DSC], 25 ea [DSC])
Sani-Supp Pediatric: 1.2 g (10 ea [DSC], 25 ea [DSC])
Generic: 1 g (12 ea, 25 ea); 2 g (12 ea, 24 ea, 25 ea, 50 ea)
Anatomic Therapeutic Chemical (ATC) Classification
- A06AG04
- A06AX01
Generic Available (US)
May be product dependent
Pricing: US
Enema (Fleet Liquid Glycerin Supp Rectal)
5.4 g/dose (per mL): $0.14
Suppository (Pedia-Lax Rectal)
1 g (per each): $0.13
2.8 g (per mL): $0.22
Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided as reference price only. A range is provided when more than one manufacturer's AWP price is available and uses the low and high price reported by the manufacturers to determine the range. The pricing data should be used for benchmarking purposes only, and as such should not be used alone to set or adjudicate any prices for reimbursement or purchasing functions or considered to be an exact price for a single product and/or manufacturer. Medi-Span expressly disclaims all warranties of any kind or nature, whether express or implied, and assumes no liability with respect to accuracy of price or price range data published in its solutions. In no event shall Medi-Span be liable for special, indirect, incidental, or consequential damages arising from use of price or price range data. Pricing data is updated monthly.
Mechanism of Action
Osmotic dehydrating agent which increases osmotic pressure; draws fluid into colon and thus stimulates evacuation
Pharmacodynamics/Kinetics
Onset of action: Constipation: Suppository: 15 to 30 minutes
Absorption: Rectal: Poorly absorbed
Local Anesthetic/Vasoconstrictor Precautions
No information available to require special precautions
Effects on Dental Treatment
No significant effects or complications reported
Effects on Bleeding
No information available to require special precautions
Related Information
Index Terms
Glycerol
References
Bharucha AE, Dorn SD, Lembo A, Pressman A. American Gastroenterological Association medical position statement on constipation. Gastroenterology. 2013;144(1):211-217.[PubMed 23261064]
Cullen G and O'Donoghue D, "Constipation and Pregnancy," Best Pract Res Clin Gastroenterol, 2007, 21(5):807-18.[PubMed 17889809]
Fleet (glycerin suppository) [prescribing information]. Lynchburg, Virginia: C.B. Fleet Company; November 2012.
Haiden N, Jilma B, Gerhold B, et al. Small volume enemas do not accelerate meconium evacuation in very low birth weight infants. J Pediatr Gastroenterol Nutr. 2007;44(2):270-273.[PubMed 17255844 ]
Orajel Dry Mouth Moisturizing gel (glycerin) [prescribing information]. Princeton, NJ: Church & Dwight Co; November 2014.
Tabbers MM, DiLorenzo C, Berger MY, et al. Evaluation and treatment of functional constipation in infants and children: evidence-based recommendations from ESPGHAN and NASPGHAN. J Pediatr Gastroenterol Nutr. 2014;58(2):258-274.[PubMed 24345831 ]
Wald A, "Constipation, Diarrhea, and Symptomatic Hemorrhoids During Pregnancy," Gastroenterol Clin North Am, 2003, 32(1):309-22.[PubMed 12635420]
Wyllie R, Hyams JS, eds. Pediatric Gastrointestinal and Liver Disease: Expert Consult - Online and Print. 4th ed. Philadelphia, PA: Saunders; January 2011.
Zenk KE, Koeppel RM, and Liem LA, “Comparative Efficacy of Glycerin Enemas and Suppository Chips in Neonates,” Clin Pharm, 1993, 12(11):846-8.[PubMed 8275649]
Brand Names: International
Adulax (ES, UA); Babylax (AT, DE, IL); Bebegel (FR, PT); Benlax (IT); Bulboid (CH); Computer Eye Drops (HK, PH); Covonia (ZW); Covonia Dry & Tickly Cough Linctus (MT); Cristal (CH, FR); Czopki Glicerolowe (PL); Czopki Glicerynowe (PL); Dexeril (RU); Endura (BR); Estrin (MX); Farmino (AR); Finalina (PY); Fleet Baby Lax (PY); Fleet Babylax (CL, SG, VE); Formula Liquida Limpieza (AR); Gely (ES); Glicel (BR); Glicerina (ES, IT); Glicerina Cinfa (ES); Glicerina Quimpe (ES); Glicero Microlismi (GR); Glicerol Vilardell (ES); Glicerolo (IT); Glicerolo Dynacren (IT); Glicerolo Sofar (IT); Glicerotens (ES); Glicev (AR); Glycelax (PT, RU); Glycerol (EG); Glycerol ”Oba” (DK); Glycerotone (BE, FR, LU); Glycilax (AE, BH, CY, DE, KW); Glysup (BD); Gota PC (AR); Hidrate (IN); Jabon de glicerina (ES); Kalmo (EC); Kanova (ES); Kimos (ES); LASS (CR, DO, GT, HN, NI, PA, SV); Laxanova (PE); Laxolyne (AE, BH, ET, QA, SA); Laxovit (BE); Luxoral (IT); Micronema (AR); Milax (DE); Miniderm (FI, SE); Nene-Lax (DE); Neutrobar (MX); Novas (PH); Obifax (ES); PC Grin (MX); Petit Drill (FR); Practomil (CH); Prolax (HR); Q.V. Wash Soap Free Cleansing Liquid (AU); QV Flare (SG); QV Flare Up Cream (AU); Refenax Lagrimas (AR); RubieLax (DE); Slabinorm (UA); Supo Gliz (ES); Supo Kristal (ES); Supos Glicerina Mandri (ES); Suppositoria Glycerini (PL); Tixylix Baby Syrup (MT); Tixylix Toddler Syrup (MT); Verolax (ES, IT, PT); Vitrosups (ES); Vixorfit (AR); Xin Long (CN); Zen Care (MY); Zetalax (IT)
Last Updated 5/27/20
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