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
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
Transurethral surgical procedures: Irrigation: Topical: 3% to 3.3% as transurethral surgical procedure irrigation
There are no dosage adjustments provided in the manufacturer's labeling.
There are no dosage adjustments provided in the manufacturer's labeling.
(For additional information see "Sorbitol: Pediatric drug information")
Constipation:
Oral: 70% solution:
Manufacturer's labeling: Children ≥12 years and Adolescents: Usual dose: 30 to 45 mL once daily as needed; maximum dose: 60 mL/dose; higher daily doses (60 to 90 mL in divided doses) may be necessary in some patients. Note: Consult product-specific labeling for detailed information.
Alternate dosing: Limited data available: Infants, Children and Adolescents: 1 to 3 mL/kg/day in divided doses, once or twice daily (Wyllie 2011). Usual range in adolescents: 30 to 90 mL/day
Rectal enema: 25% to 30% solution:
Children 2 to <12 years: 30 to 60 mL once daily as needed
Children ≥12 years and Adolescents: 120 mL once daily as needed
Fecal disimpaction, slow disimpaction: Oral: 70% solution: Limited data available: Infants, Children, and Adolescents: 2 mL/kg twice daily for 7 days (Pashankar 2005; Wyllie 2011)
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).
There are no dosage adjustments provided in the manufacturer's labeling.
There are no dosage adjustments provided in the manufacturer's labeling.
Refer to adult dosing.
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, 474 mL [DSC], 480 mL, 3840 mL)
Solution, Rectal:
Generic: 70% (473 mL)
Yes
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
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
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.
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.
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.
None known.
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
Animal reproduction studies have not been conducted.
The manufacturer recommends that caution be exercised when administering sorbitol to nursing women.
Monitor for fluid overload and/or electrolyte disturbances following large volumes; GI distress (bloating, flatulence)
A polyalcoholic sugar with osmotic cathartic actions
Onset of action: Rectal: 0.25-1 hour
Absorption: Oral, rectal: Poor
Metabolism: Primarily hepatic to fructose
Solution (Sorbitol Irrigation)
3% (per mL): $0.01
Solution (Sorbitol Oral)
70% (per mL): $0.01
Solution (Sorbitol Rectal)
70% (per mL): $0.01
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