ﺑﺎﺯﮔﺸﺖ ﺑﻪ ﺻﻔﺤﻪ ﻗﺒﻠﯽ
خرید پکیج
تعداد آیتم قابل مشاهده باقیمانده : 3 مورد
نسخه الکترونیک
medimedia.ir

Sorbitol: Drug information

Sorbitol: Drug information
(For additional information see "Sorbitol: Patient drug information" and see "Sorbitol: Pediatric drug information")

For abbreviations, symbols, and age group definitions used in Lexicomp (show table)
Pharmacologic Category
  • Genitourinary Irrigant;
  • Laxative, Osmotic
Dosing: Adult
Adjunct to sodium polystyrene sulfonate

Adjunct to sodium polystyrene sulfonate: 15 mL as 70% solution orally until diarrhea occurs (10 to 20 mL/2 hours) or 20 to 100 mL as an oral vehicle for the sodium polystyrene sulfonate resin.

Hyperosmotic laxative

Hyperosmotic laxative (as single dose, at infrequent intervals):

Oral: 30 to 45 mL (as 70% solution).

Rectal enema: 120 mL as 25% to 30% solution.

Transurethral surgical procedures

Transurethral surgical procedures: Irrigation: Topical: 3% to 3.3% as transurethral surgical procedure irrigation.

Dosing: Kidney Impairment: Adult

There are no dosage adjustments provided in the manufacturer's labeling.

Dosing: Hepatic Impairment: Adult

There are no dosage adjustments provided in the manufacturer's labeling.

Dosing: Pediatric

(For additional information see "Sorbitol: Pediatric drug information")

Constipation:

Note: Sorbitol is also found in some juices (eg, pear, apple, prune) and fruits (especially pureed or dried peaches or prunes), which may be recommended for use in infants and children before utilizing pharmacologic therapy (Blackmer 2010; Bolia 2020; Loening-Baucke 2005).

Oral: 70% solution: Note: Dietary sorbitol more commonly recommended:

Infants and Children <12 years: Limited data available: Oral: 1 to 3 mL/kg/day in divided doses once or twice daily; maximum daily dose 60 mL/day (Maqbool 2020).

Children ≥12 years and Adolescents: Oral: 30 to 60 mL in divided doses once or twice daily; maximum daily dose: 60 mL/day.

Rectal enema: 25% to 30% solution:

Children ≥12 years and Adolescents: Rectal: 120 mL once daily as needed.

Toxic ingestion, adjunct with charcoal: Children and Adolescents: Oral: 35% solution: 4.3 mL/kg; Note: Current guidelines recommend limiting use to a single dose administered with the initial charcoal dose of 1 g/kg (AACT/EAPCCT 2004).

Dosing: Kidney Impairment: Pediatric

There are no dosage adjustments provided in the manufacturer's labeling.

Dosing: Hepatic Impairment: Pediatric

There are no dosage adjustments provided in the manufacturer's labeling.

Dosing: Older Adult

Refer to adult dosing.

Dosage Forms: US

Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product

Solution, Irrigation:

Generic: 3% (3000 mL); 3.3% (2000 mL, 4000 mL [DSC])

Solution, Oral:

Generic: 70% (30 mL [DSC], 473 mL [DSC], 474 mL [DSC], 480 mL, 3840 mL)

Solution, Rectal:

Generic: 70% (473 mL)

Generic Equivalent Available: US

Yes

Administration: Pediatric

Oral: May administer without regard to food.

Rectal: Administer as a prepared enema.

Use: Labeled Indications

Genitourinary irrigant in transurethral prostatic resection or other transurethral resection or other transurethral surgical procedures; diuretic; humectant; sweetening agent; hyperosmotic laxative; facilitate the passage of sodium polystyrene sulfonate through the intestinal tract

Adverse Reactions

The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified. Frequency not defined.

Cardiovascular: Edema

Endocrine & metabolic: Electrolyte depletion, hyperglycemia, hypovolemia, lactic acidosis

Gastrointestinal: Abdominal distress, diarrhea, nausea, vomiting, xerostomia

Contraindications

Anuria (for irrigation)

OTC labeling: When used for self-medication, do not use for longer than 7 days or when abdominal pain, nausea, or vomiting is present.

Warnings/Precautions

Concerns related to adverse effects:

• Fluid/electrolyte imbalance: Large volumes may result in fluid overload and/or electrolyte changes.

Disease-related concerns:

• Cardiopulmonary disease: Use with caution in patients with severe cardiopulmonary disease.

• Renal impairment: Use with caution in patients with renal impairment.

• Unable to metabolize sorbitol: Use with caution in patients unable to metabolize sorbitol.

Warnings: Additional Pediatric Considerations

Excessive amounts of sorbitol may cause hypernatremic dehydration in pediatric patients; use with caution in infants; other causes of constipation should be evaluated prior to initiating therapy.

Metabolism/Transport Effects

None known.

Drug Interactions

Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the Lexicomp drug interactions program by clicking on the “Launch drug interactions program” link above.

Calcium Polystyrene Sulfonate: Sorbitol may enhance the adverse/toxic effect of Calcium Polystyrene Sulfonate. More specifically, concomitant use of these agents may increase the risk for intestinal necrosis. Risk X: Avoid combination

LamiVUDine: Sorbitol may decrease the serum concentration of LamiVUDine. Management: When possible, avoid chronic coadministration of sorbitol-containing solutions with lamivudine, but if this combination cannot be avoided, monitor patients more closely for possible therapeutic failure associated with decreased lamivudine exposure. Risk D: Consider therapy modification

Sodium Polystyrene Sulfonate: Sorbitol may enhance the adverse/toxic effect of Sodium Polystyrene Sulfonate. More specifically, concomitant use of these agents may increase the risk for intestinal necrosis. Risk X: Avoid combination

Pregnancy Considerations

Animal reproduction studies have not been conducted.

Breastfeeding Considerations

The manufacturer recommends that caution be exercised when administering sorbitol to nursing women.

Monitoring Parameters

Monitor for fluid overload and/or electrolyte disturbances following large volumes; GI distress (bloating, flatulence)

Mechanism of Action

A polyalcoholic sugar with osmotic cathartic actions

Pharmacokinetics

Onset of action: Rectal: 0.25-1 hour

Absorption: Oral, rectal: Poor

Metabolism: Primarily hepatic to fructose

Pricing: US

Solution (Sorbitol Irrigation)

3% (per mL): $0.01

Solution (Sorbitol Oral)

70% (per mL): $0.01

Solution (Sorbitol Rectal)

70% (per mL): $0.01

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.

Brand Names: International
  • Agarol (CH);
  • Ardeanutrisol SO (CZ);
  • Cystosol (SE);
  • klysma Sorbit (DE);
  • Medevac (AU);
  • Progras (AR);
  • Resulax (SE);
  • Sladial (HR);
  • Sorbilande (IT);
  • Sorbilax (AU);
  • Sorbit Fresenius (AT);
  • Sorbit Leopold (AT);
  • Sorbit Mayrhofer (AT);
  • Sorbitol Aguettant (FR);
  • Sorbitol Baxter (LU);
  • Sorbitol Delalande (BE, FR);
  • Sorbitol-Infusionslosung (DE);
  • Syn M.D. (BE, CH, LU)


For country abbreviations used in Lexicomp (show table)
  1. American Academy of Clinical Toxicology and European Association of Poisons Centres and Clinical Toxicologists. Position Paper: Cathartics. J Toxicol Clin Toxicol. 2004;42(3):243-253. [PubMed 15362590]
  2. American Academy of Clinical Toxicology and European Association of Poison Centres and Clinical Toxicologists. Position Statement and Practice Guidelines on the Use of Multi-dose Activated Charcoal in the Treatment of Acute Poisoning. J Toxicol Clin Toxicol.1999;37(6):731-751. [PubMed 10584586]
  3. Blackmer AB, Farrington EA. Constipation in the pediatric patient: an overview and pharmacologic considerations. J Pediatr Health Care. 2010;24(6):385-399. doi:10.1016/j.pedhc.2010.09.003 [PubMed 20971414]
  4. Bolia R, Safe M, Southwell BR, King SK, Oliver MR. Paediatric constipation for general paediatricians: Review using a case-based and evidence-based approach. J Paediatr Child Health. 2020;56(11):1708-1718. doi:10.1111/jpc.14720 [PubMed 33197982]
  5. Brown AM and Masson E. Hidden Sorbitol in Proprietary Medicines - A Cause for Concern? Pharm J. 1990;245:211.
  6. Gazda-Smith E and Synhavsky A. Hypernatremia following treatment of theophylline toxicity with activated charcoal and sorbitol. Arch Intern Med. 1990;150(3):689-692.
  7. H & H solution (sorbitol) [prescribing information]. Brooklyn, NY: H&H Laboratories; June 2013.
  8. Lederle FA, Busch DL, Mattox KM, et al. Cost-effective treatment of constipation in the elderly: A randomized double-blind comparison of sorbitol and lactulose. Am J Med.1990;89(5):597-601. [PubMed 2122724]
  9. Loening-Baucke V. Prevalence, symptoms and outcome of constipation in infants and toddlers. J Pediatr. 2005;146(3):359-363. doi:10.1016/j.jpeds.2004.10.046 [PubMed 15756220]
  10. Maqbool A, Liacouras C. Encopresis and functional constipation. In: Kliegman RM and St. Geme J, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Saunders Elsevier; 2020: chap 358.3.
  11. Qualitest solution (sorbitol) [prescribing information]. Huntsville, AL: Qualitest Pharmaceuticals, Inc; February 2006.
  12. Sorbitol solution [prescribing information]. Mount Vernon, NY: Geritrex LLC; January 2018.
  13. Sorbitol solution rectal [prescribing information]. Brooklyn, NY: Geri-Care Pharmaceuticals Corp; December 2020.
Topic 9940 Version 139.0