MACROGOL

Macrogol is used as a laxative to treat constipation in children and adults.
Macrogol is also used as an excipient.
Macrogol is also used to clear the bowels before a colonoscopy, when the onset of the laxative effect is more rapid, typically within an hour.

CAS Number: 25322‑68‑3 
EC / EINECS Number: 500‑038‑2 (for PEG‑type materials)
Molecular Formula: Variable — depends on polymer length (e.g., PEG 400 ≈ C₁₈H₃₆O₉, PEG 3350 ≈ C₁₄₈H₂₈₂O₇₁, etc.) 
Molecular Weight: Depends on grade (e.g., 200 to > 20,000 g/mol) 

SYNONYMS:
Polyethylene glycol, PEG, Poly(ethylene glycol), Polyethylene oxide (PEO), Polyoxyethylene (POE), Macrogol 200, Macrogol 300, Macrogol 400, Macrogol 1500, Macrogol 3350, Macrogol 4000, Macrogol 6000, Macrogol 8000, PEG‑3350, PEG‑4000, PEG‑6000, PEG 200, PEG 400, PEG 1500, PEG 8000, Carbowax, Kollisolv, GlycoLax, MiraLAX, MoviPrep, GoLYTELY, Fortrans, TriLyte, Colyte, Halflytely, Glycolax, Purelax

Macrogol acts as an osmotic laxative — it binds water and increases fluid volume in the intestinal lumen, softening stool and increasing bowel movements without significant absorption or metabolism in the gut.
Macrogol is the international nonproprietary name used for polyethylene glycol (PEG) as a medication ingredient.

Macrogol is usually followed by a number indicating the average molecular weight, indicating the length of the polymer of the specific molecule in use.
Hydrophilic polymer: Macrogol is strong water affinity; forms hydrogen bonds.

Non‑ionic: Macrogol is neutral polymer without a charge.
Chemical Stability: Macrogol is generally stable; inert under normal conditions.
Use Macrogol appears to be safe during pregnancy.

Macrogol is classified as an osmotic laxative.
Macrogol works by increasing the amount of water in the stool.
Macrogol came into use as a bowel prep in 1980 and was approved for medical use in the United States in 1999.

Macrogol is available as a generic medication and over the counter.
In 2023, Macrogol was the 196th most commonly prescribed medication in the United States, with more than 2 million prescriptions.
Macrogol is also formulated together with electrolytes.

In 2023, the combination with electrolytes was the 273rd most commonly prescribed medication in the United States, with more than 800,000 prescriptions.
Macrogol is indicated for cleansing of the colon in preparation for colonoscopy in adults.

Macrogol is a laxative taken to treat constipation (difficulty pooing).
You can also use Macrogol to help clear a build-up of hard poo in your bowel, which can happen if you've been constipated for a long time (faecal impaction).

Macrogol can also be given before a colonoscopy (a test to check inside your bowels) to empty your bowels before the test.
Macrogol comes as sachets of powder that you mix with water to make a drink, a ready-mixed liquid to drink, or a liquid that you dilute before drinking.

USES and APPLICATIONS of MACROGOL:
Macrogol is a type of laxative that helps to produce a soft bowel motion (poo).
Macrogol's used to treat and prevent constipation in adults and children.
Constipation (mate tūtae kore) is when your bowel motions (poo, stool or faeces) become hard and lumpy, making them painful or difficult to get out.

Macrogol's also when you pass bowel motions less often than usual.
Macrogol is also used to treat very severe constipation, called faecal impaction.
This happens when the poo builds up in the bowel and becomes stuck.

New poo will keep forming in the bowel but cannot get past the blockage, so it just builds up.
There are many different types of laxatives.
Macrogol is referred to as an osmotic laxative.

Macrogol works by keeping water in the bowel, making your poo slightly bigger, softer and easier to pass.
This stimulates the muscles of the walls of the bowel to contract and squeeze the poo along, causing a soft bowel motion.
Macrogol is used for constipation and comes as sachets of powder which need to be dissolved in water.

For macrogol to work well, it’s important to drink plenty of liquids while taking it.
Macrogol is available with a prescription or it can be bought over the counter from a pharmacy or supermarket.
Macrogol is used to treat constipation.

Macrogol may take one to two days to work.
Macrogol is used as a laxative to treat constipation in children and adults.
Macrogol is taken by mouth.

Benefits usually occur within three days.
Macrogol is also used as an excipient.
Macrogol is also used to clear the bowels before a colonoscopy, when the onset of the laxative effect is more rapid, typically within an hour.

-Medical & Pharmaceutical uses of Macrogol:
• Osmotic laxative to treat constipation and fecal impaction (e.g., Macrogol 3350).
• Whole bowel cleansing before colonoscopy or gastrointestinal procedures.
• Macrogol is used as a pharmaceutical excipient in oral, topical, and parenteral drugs (binder, solvent, coating).
• PEGylation of therapeutic proteins to enhance pharmacokinetics and reduce immunogenicity.

-Industrial & Consumer Uses of Macrogol:
• Cosmetic ingredient (humectant, solvent, lubricant).
• Ingredient in personal care products (creams, shampoos).
• Use Macrogol in food additives (JECFA INS 1521) as carrier / solvent.
• Industrial utilities: Macrogol is used solvents, lubricants, plastics processing aids, inks.
• Wood preservation and conservation.

MEDICAL USES OF MACROGOL:
**Constipation
Macrogol, often in combination with electrolytes, is used for short-term relief of constipation as well as for long-term use in constipation of various causes, including in people with multiple sclerosis or Parkinson's disease as well as constipation caused by pharmaceutical drugs such as opioids and anticholinergics.

Whole bowel irrigation with macrogol is part of the bowel preparation before surgery or colonoscopy.
Limited data also support its use for the treatment of fecal impaction.
In those with chronic constipation it works better than lactulose.

Popular types of Macrogol include: macrogol 3350, macrogol 4000, and macrogol 6000.
The number represents the molecular weight.
Combining different molecular weights provides some control over the consistency.

**Excipient
Macrogol is used as an excipient in pharmaceutical products.
Lower-molecular-weight variants are used as solvents in oral liquids and soft capsules, whereas solid variants are used as ointment bases, tablet binders, film coatings, and lubricants.
For example, PEG-2000 is one of the excipients in the Moderna COVID-19 vaccine.

**PEGylation
Macrogol is also attached to biopharmaceutical drugs to slow down their degradation in the human body and increase their duration of action, as well as to reduce immunogenicity.
This process is called PEGylation.

PHARMACOLOGY OF MACROGOL:
Mechanism of action as a laxative
Macrogol is an osmotically acting laxative; that is, an inert substance that passes through the gut without being absorbed into the body.
Macrogol relieves constipation because it causes water to be retained in the bowel instead of being absorbed into the body.
This increases the water content and volume of the stools in the bowel, making them softer and easier to pass, as well as improving gut motility.

CHEMISTRY OF MACROGOL:
For the synthesis of macrogol, see Polyethylene glycol § Production.

KEY POINTS ABOUT MACROGOL:
Macrogol is a laxative used to treat and prevent constipation.
Macrogol is also used to treat faecal impaction.
Macrogol is also called Molaxole, Lax-Sachets or Movicol.

SO JUST WHAT IS MACROGOL?
Macrogol - otherwise known as polyethylene glycol – is an osmotic laxative which helps to relieve stubborn stools by drawing water from the rest of the body into your bowel, where it hydrates your poo to make it bigger, softer and easier to pass.

IS MACROGOL MORE EFFECTIVE THAN LACTULOSE?
Both macrogol and lactulose are osmotic laxatives that are taken orally, but there are some distinct differences between the two.
Most importantly, a number of studies have found macrogol to be more effective than lactulose, with better outcomes in terms of stool frequency per week and stool consistency.
Macrogol is also easier to obtain as it can be bought outside pharmacy, unlike lactulose which requires a visit to a pharmacy or a prescription from a doctor.

IS MACROGOL WELL TOLERATED?
Macrogol is generally well tolerated by the vast majority of people, including the elderly and those who are pregnant.
There are also some groups of people that should avoid macrogol altogether:
people who have previously had an allergic reaction to macrogol

people who have ulcerative colitis
people who have Crohn’s disease
people with a hole or breakage (perforation) in the wall of their intestine or a rare condition named toxic mecagolon

people receiving treatment for heart failure, or who have an irregular heartbeat
people on a low-salt (low-sodium) diet particularly if they need 3 or more sachets daily
and people who have a blockage in the intestine

HOW LONG DOES MACROGOL TAKE TO WORK?
Macrogol works by drawing water into the bowel, and then into dry, stubborn stools, so that they become bigger, softer and more easily able to travel through the digestive system.
Because of the speed of this process – and the digestive system itself – macrogol generally takes effect within 1-2 days.

KEY FACTS OF MACROGOL:
Macrogol relieves constipation by making your poo slightly bigger and softer.
This helps poo travel through your bowels more easily.
Macrogol can take 1 to 2 days to work.

Talk to a doctor if you're still constipated after 3 days.
The most common side effects are stomach pain, diarrhoea, wind and a sore bottom (anus).
These are usually mild and do not last long.

Most macrogol sachets contain sodium chloride, potassium chloride and sodium bicarbonate (known as electrolytes).
The powder sachets are usually flavoured, but if you do not like the flavour you can add fruit squash to the drink.

AVAILABLE FORMS OF MACROGOL:
When sold for gut cleansing (and as a laxative), Macrogol is usually in combination with salts such as sodium bicarbonate, sodium chloride and potassium chloride to help mitigate the possibility of electrolyte imbalance and dehydration.

HOW SHOULD I TAKE OR USE MACROGOL?
Do not stop taking your medication without checking with your healthcare professional.
You may take this medication with or without food.
Each sachet should be dissolved in a full glass of water.

WHAT SHOULD I DO IF I FORGET TO TAKE OR USE MACROGOL?
If you forget to take a dose, take it as soon as you remember.
Then take your next dose at the usual time.
Do not take two doses to make up for the missed dose.
Macrogol provides comfortable, effective relief from constipation – but how?
The key ingredient is something called macrogol, which gets to work on redirecting water to the dehydrated stools that cause constipation.

PHYSICAL and CHEMICAL PROPERTIES of MACROGOL:
Common Name: Macrogol
Systematic Name: Polyethylene Glycol (PEG)
IUPAC Name: Poly(oxyethylene)
General Chemical Formula: H–(O–CH₂–CH₂)ₙ–OH (where “n” defines average chain length)
Primary Substance Class: Polyether, hydrophilic polymer
Structure: Linear polyether polymer made from repeating ethylene glycol units (O–CH₂–CH₂) linked together by ether bonds. 

Molecular Formula: Variable — depends on polymer length (e.g., PEG 400 ≈ C₁₈H₃₆O₉, PEG 3350 ≈ C₁₄₈H₂₈₂O₇₁, etc.) 
Molecular Weight: Depends on grade (e.g., 200 to > 20,000 g/mol) 
Appearance:
Lower MW PEGs (e.g., 200–600): clear, colorless liquids
Mid MW (e.g., 1000–4000): viscous liquids or semisolids
Higher MW (e.g., 6000–8000+): waxy, white solid flakes/powders 

Solubility:
• Soluble in water (very good)
• Soluble in many organic solvents (alcohols, acetone, etc.) 
Density: Approx. 1.125 g/cm³ (varies slightly with grade) 
Melting Behavior:
• Lower molecular weight PEGs are liquids;
• Higher MW PEGs show solid melting ranges (approx. 50 – 70 °C depending on grade) 
Viscosity: Increases with molecular weight.

FIRST AID MEASURES of MACROGOL:
-Description of first-aid measures
*General advice:
Show this material safety data sheet to the doctor in attendance.
*If inhaled:
After inhalation: 
Fresh air.
*In case of skin contact: 
Take off immediately all contaminated clothing. 
Rinse skin with
water/ shower.
*In case of eye contact:
After eye contact: 
Rinse out with plenty of water. 
Call in ophthalmologist. 
Remove contact lenses.
*If swallowed:
After swallowing: 
Immediately make victim drink water (two glasses at most). 
Consult a physician.
-Indication of any immediate medical attention and special treatment needed.
No data available

ACCIDENTAL RELEASE MEASURES of MACROGOL:
-Environmental precautions:
Do not let product enter drains.
-Methods and materials for containment and cleaning up:
Cover drains. 
Collect, bind, and pump off spills. 
Observe possible material restrictions. 
Take up dry. 
Dispose of properly. 
Clean up affected area.

FIRE FIGHTING MEASURES of MACROGOL:
-Extinguishing media:
*Suitable extinguishing media:
Carbon dioxide (CO2) 
Foam 
Dry powder
*Unsuitable extinguishing media:
For this substance/mixture no limitations of extinguishing agents are given.
-Further information:
Prevent fire extinguishing water from contaminating surface water or the ground water system.

EXPOSURE CONTROLS/PERSONAL PROTECTION of MACROGOL:
-Control parameters:
--Ingredients with workplace control parameters:
-Exposure controls:
--Personal protective equipment:
*Eye/face protection:
Use equipment for eye protection. 
Safety glasses
*Body Protection:
protective clothing
*Respiratory protection:
Recommended Filter type: Filter A 
-Control of environmental exposure:
Do not let product enter drains.

HANDLING and STORAGE of MACROGOL:
-Conditions for safe storage, including any incompatibilities:
*Storage conditions:
Tightly closed. 
Dry.

STABILITY and REACTIVITY of MACROGOL:
-Chemical stability:
The product is chemically stable under standard ambient conditions (room temperature).
-Possibility of hazardous reactions:
No data available