Polycarbophil calcium (INN) is a drug used as a stool stabilizer. Chemically, it is a synthetic polymer of polyacrylic acid cross-linked with divinyl glycol, with calcium as a counter-ion.
Contents
1Clinical uses
2Adverse effects
3References
4Further reading
Clinical uses
It is used as stool stabilizer to treat constipation, diarrhea and abdominal discomfort. Bulk laxatives absorb liquid in the intestines and swell to form a soft bulky stool. The bulky mass stimulates the intestinal muscles, speeding stool transit time through the colon. Results usually occur within 12 to 72 hours. Calcium polycarbophil will not work without increased fluid intake.
Calcium polycarbophil has been marketed as an over-the-counter agent used for treating functional bowel disorder and as a bulk-producing agent.
A study looked at the effects of calcium polycarbophil on general irritable bowel syndrome (IBS) symptoms. Fourteen patients with IBS-diarrhea and twelve with IBS-constipation were given calcium polycarbophil for eight weeks and their colon transit times were measured with radiopaque markers in the colon. The patients with diarrhea reported fewer bowel movements, more solid stools and reduced abdominal pain. Patients with constipation reported more frequent bowel movements, looser stools and less pain.[1]
The human stomach presents a mild acidic environment due to the presence of HCl. Polycarbophil absorbs about ten times its own weight of water under acidic conditions, but the swelling ratio markedly increases at above pH 4.0 and reaches 70 times the initial weight under pH-neutral conditions. The swelling of polycarbophil is not affected by non-ionic osmolarity, but by ionic strength, showing a decrease with increase of ionic strength. Monovalent metal ions such as sodium and potassium ions in gastrointestinal fluid do not reduce the equilibrium swelling of polycarbophil, but divalent ions such as calcium and magnesium ions do. However, calcium ions only slightly reduce the equilibrium swelling under sodium-rich conditions.[2]
Adverse effects
Common side effects can include:[3]
Mild stomach pain
Bloating
Gas
Seek medical attention if:[3]
severe stomach cramps
rectal bleeding
no bowel movement within 3 days after using polycarbophil
A different representation: polyacrylic acid residues are shown in red, residues of the cross-linker divinyl glycol (3,4-dihydroxy-1,5-hexadiene) in blue.
References
↑"Colonic transit, bowel movements, stool form, and abdominal pain in irritable bowel syndrome by treatments with calcium polycarbophil". Hepato-Gastroenterology52 (65): 1416–20. 2005. PMID 16201086.
↑"Effect of calcium polycarbophil on bowel function after restorative proctocolectomy for ulcerative colitis: a randomized controlled trial". Digestive Diseases and Sciences52 (6): 1423–6. June 2007. doi:10.1007/s10620-006-9270-6. PMID 17394081.
"Laxative and anti-diarrheal activity of polycarbophil in mice and rats". Japanese Journal of Pharmacology89 (2): 133–41. June 2002. doi:10.1254/jjp.89.133. PMID 12120755.
"Management of irritable bowel syndrome". Internal Medicine43 (5): 353–9. May 2004. doi:10.2169/internalmedicine.43.353. PMID 15206545.
"Recommendations for the management of irritable bowel syndrome in family practice. IBS Consensus Conference Participants". CMAJ161 (2): 154–60. July 1999. PMID 10439825.
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Drugs for constipation (laxatives and cathartics) (A06)
Stool softeners
Docusate
Stimulant laxatives
Bisacodyl
Bisoxatin
Cascara
Castor oil
Dantron
Oxyphenisatine
Phenolphthalein
Senna glycosides
Sodium picosulfate
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Dietary fiber
Ethulose
Ispaghula
Methylcellulose
Polycarbophil calcium
Sterculia
Triticum
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White petrolatum (petroleum jelly)
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Laminarid
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Polyethylene glycol (macrogol)
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Oil
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Methylnaltrexone
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Others
Linaclotide
Lubiprostone
Oxyphenisatine
Prucalopride
Tegaserod
Ulimorelin
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