Powerful Laxatives: Options Beyond Miralax

There are several alternatives to Miralax, which is used to treat constipation. These include Dulcolax, Colace, and docusate. Dulcolax is a faster-acting stimulant laxative, while Miralax is an osmotic laxative that takes longer to work. Other options include bulk-forming laxatives, stool softeners, and magnesium-based laxatives.

Dulcolax vs. Miralax

Dulcolax and Miralax are over-the-counter laxatives used to treat constipation. They work in different ways and have different active ingredients.

Dulcolax

Dulcolax is a stimulant laxative with the active ingredient bisacodyl. It directly stimulates the colon's nerves, increasing colonic motility and the water content of stools. It is available as an oral tablet or a rectal suppository. The suppositories are the fastest-acting option, typically producing a bowel movement within 15 minutes to one hour. The tablets usually take six to 12 hours to work.

Miralax

Miralax is an osmotic laxative with the active ingredient polyethylene glycol 3350. It is not absorbed by the gastrointestinal tract but attracts water into the colon by osmosis, making stools softer and easier to pass. It comes as a powder that is mixed with water or another beverage and is typically taken once a day for up to seven days. Miralax usually takes one to three days to produce a bowel movement.

Side Effects

Both Dulcolax and Miralax are generally well-tolerated, with most side effects being stomach-related. Dulcolax may cause abdominal discomfort, cramping, and diarrhoea, particularly with higher doses. Miralax may cause nausea and loose, watery, or more frequent stools.

Effectiveness

Dulcolax and Miralax have not been directly compared in clinical trials, so it is unclear which is more effective. However, Miralax has the most robust clinical evidence and is considered safe as it is not absorbed into the systemic circulation.

Usage

Dulcolax can be used by children aged six and above. Miralax is recommended for people aged 17 and older, although younger children can use it with guidance from a healthcare provider. Many paediatric gastroenterologists recommend Miralax for treating constipation in children.

Cost

The typical out-of-pocket price for a bottle of generic Dulcolax tablets is about $13, and a box of suppositories is also about $13. The out-of-pocket price for a bottle of generic Miralax is about $19.

Miralax vs. docusate/senna

Miralax (polyethylene glycol) and docusate/senna are both over-the-counter (OTC) medications used to treat occasional constipation. However, there are some differences between the two.

Miralax

Miralax is a single-ingredient medication that contains polyethylene glycol, a stool softener that increases water in the stools, making them easier to pass. It comes in powder form, which is mixed with a beverage and taken orally once a day for up to a week. Common side effects of Miralax include nausea, bloating, gas, and cramping. It is generally well-tolerated and is safe for short-term use.

Docusate/Senna

Docusate/senna is a combination medication containing two laxatives, docusate and senna, that work together to treat constipation. Docusate helps to soften stools by retaining water in the digestive tract, while senna stimulates intermittent contractions in the digestive tract, known as peristalsis, to promote bowel movements. Docusate/senna is also available over the counter and is typically taken for less than seven days. It works faster than Miralax, often resulting in a bowel movement within a day. However, it may cause stomach cramps and loose, watery stools.

Interactions and Precautions

Using polyethylene glycol (Miralax) in combination with senna may increase the risk of gastrointestinal side effects such as ulcerations in the colon and ischemic colitis, a potentially serious condition caused by reduced blood flow to the colon. Therefore, it is recommended to avoid using these medications together unless specifically advised by a doctor.

When choosing between Miralax and docusate/senna, it is essential to consider their respective advantages and disadvantages, as well as any potential interactions with other medications. It is always advisable to consult a healthcare professional before starting any new medication, including OTC treatments for constipation.

Miralax vs. Colace

Miralax and Colace are both over-the-counter medications used to treat constipation. However, they work in different ways and have distinct characteristics and effects on the body.

Miralax, or Polyethylene Glycol 3350, is an osmotic laxative. It is available as a tasteless and odourless powder that is mixed with 4 to 8 ounces of liquid, such as water or juice, before consumption. It is generally used once per day and can take up to three days to produce a bowel movement. Common side effects of Miralax include nausea, bloating, gas, and cramping. It is considered a safe option during pregnancy and for treating constipation caused by medications. However, it is not recommended for those with kidney problems.

On the other hand, Colace, or Docusate, is an emollient laxative or stool softener. It is available in capsule form, with regular and low doses, and as a liquid. Colace helps to soften stools, making them easier to pass. It typically takes one to three days to see an improvement in constipation with Colace. Common side effects include nausea, stomach pain, and vomiting. Colace is also considered safe during pregnancy and can be useful for individuals with hemorrhoids, heart conditions, or those recovering from surgery.

When deciding between Miralax and Colace, it is important to consider factors such as the desired speed of relief, as Dulcolax works faster than Miralax. Additionally, the type of medication and ease of administration may be important considerations, as Miralax is a powder mixed with liquid, while Colace is available in capsules or liquid form. It is always recommended to consult with a healthcare professional to determine the most suitable treatment option based on individual needs and medical history.

Miralax vs. Golytely

MiraLAX and Golytely are both used for bowel cleansing before a colonoscopy. However, they differ in their composition and effectiveness.

MiraLAX, or polyethylene glycol-3350, is often combined with an electrolyte drink, such as Gatorade, and bisacodyl tablets for bowel cleansing. This combination is meant to be more palatable and tolerable for patients. However, its effectiveness has been questioned, especially when compared to other bowel preparation methods.

Golytely, on the other hand, is a 4-liter PEG 3350 electrolyte solution. It has been found to be more efficacious than MiraLAX in several studies. In a study by Enestvedt et al., Golytely had a higher rate of achieving an excellent or good bowel cleansing score on the Boston Bowel Preparation Scale (BBPS). Additionally, Golytely was found to be associated with higher adenoma detection, which is important for the prevention of colorectal cancer.

The study by Enestvedt et al. concluded that Golytely should be the first-line treatment for bowel preparation before a colonoscopy. They suggested that larger studies are needed to confirm these findings. Another study by Hjelkrem et al. also found that MiraLAX was less effective than Golytely in bowel cleansing.

While MiraLAX may be more palatable for patients, Golytely has shown superior efficacy in bowel cleansing and adenoma detection. This makes Golytely a preferred choice for bowel preparation before a colonoscopy, especially for patients with a BMI of 30 or higher, who tend to have lower rates of optimal bowel prep quality.

Miralax vs. Ex-Lax

Constipation is a common problem that can usually be resolved with lifestyle and diet changes. However, when these changes do not help, over-the-counter (OTC) laxatives can be a good solution. Two of the most popular brands recommended by experts are Miralax and Ex-Lax.

Miralax

Miralax, also known as polyethylene glycol 3350, is an osmotic laxative that acts similarly to fibre laxatives. It draws water into the stool, making it softer and easier to pass, and stimulates more frequent bowel movements. It has been found to cause less gas and bloating than other osmotic laxatives. It is available as a powder for reconstitution, with a single dose of 17 grams generally producing a bowel movement in one to three days. It can be taken once per day for up to seven days and is recommended for adults 17 and older.

Ex-Lax

Ex-Lax is a stimulant laxative that contains the active ingredient senna. It triggers contractions in the bowels that push the stool along. It is available in various forms, including Ex-Lax Chocolated, Ex-Lax Gentle Nature, and Ex-Lax Milk of Magnesia. Ex-Lax has an average rating of 10 out of 10 from two ratings, with 100% of reviewers reporting a positive effect and 0% reporting a negative effect.

When choosing between Miralax and Ex-Lax, it is important to consider their respective advantages and disadvantages. Miralax is known to cause less gas and bloating than other osmotic laxatives, but it may take a couple of days before you notice a difference in your bowel movements. On the other hand, Ex-Lax is a stimulant laxative that works more quickly, usually within 6 to 12 hours. However, stimulant laxatives like Ex-Lax can cause side effects such as abdominal pain and diarrhoea. Therefore, it is recommended to use the gentlest and safest option first, such as a bulk-forming laxative, and consult a doctor if constipation persists.

Frequently asked questions