Dear Pharmacist

Suzy Cohen, R. Ph.

6 Important Tips To Stay Safe

By Suzy Cohen, R. Ph.

Laxatives are intended to stay in the gut, however, some can affect the central nervous system indirectly by impacting electrolyte balance or stripping away the body’s natural gut microflora.

One in particular called MiraLAX® (PEG 3350) is an “osmotic” laxative. It draws water into the colon which softens the stools and stimulates peristalsis and ultimately a bowel movement. Like all other osmotic laxatives, it has the potential to mildly alter electrolyte balance in the bloodstream, although that effect is rare if it is used properly according to label directions.

MiraLAX is FDA-approved to treat constipation in adults only and is only supposed to be used for a week. It is recommended for opiate-induced constipation in adults. In a short time frame like these scenarios, you should not experience any untoward effects.

But what if you took it for several months? What if you gave an adult-only drug to a small child? What if your doctor told you to keep taking it beyond a week?

Overusing, misusing or abusing laxatives is common and leads to unwanted side effects. The electrolytes that were in homeostasis in the bloodstream become altered unnaturally when laxatives are used chronically.

The FDA has received reports of behavioral changes over the years, especially in children taking PEG 3350. These include agitation and aggression and other behavioral issues. The relationship between PEG 3350 and these side effects hasn’t been formally tied together with a clinical trial. It’s what’s called “anecdotal” and these types of laxatives remain popular all over the world.

But are psychiatric/emotional problems even