From the Guidelines
Miralax is not contraindicated for pediatrics, but its use should be individualized and monitored by a healthcare provider. According to the US Multi-Society Task Force on Colorectal Cancer 1, the selection of bowel preparation regimens for pediatric patients should be based on the patient's age, clinical state, and ability to comply with the medication.
Key Considerations
- Maintenance of adequate hydration is crucial, especially in children, when using bowel preparation regimens like Miralax.
- Few controlled trials have been conducted in pediatric patients, but many regimens, including Miralax, have been described and used in clinical practice.
- The use of Miralax (PEG-3350) in children has been reported to be effective, with a dose of 1.5 g/kg/d for 4 days before a procedure, along with a clear liquid diet on the fourth day, sometimes in combination with an enema 1.
Safety and Efficacy
- While some concerns have been raised about the use of sodium phosphate-containing bowel preparations, which can cause mucosal abnormalities, Miralax (PEG-3350) has been shown to be a safer alternative, with fewer reports of mucosal lesions and inflammation 1.
- The bowel cleansing effectiveness of Miralax has been reported to be similar to or superior to other preparations, such as sodium phosphate, in some studies 1.
Recommendations
- Parents should consult with their child's doctor before using Miralax, as the underlying cause of constipation should be evaluated.
- The typical pediatric dosing of Miralax ranges from 0.5-1.5 g/kg/day, with a common starting dose of 17 grams (one capful) daily for children over 6 years, and reduced doses for younger children.
- Treatment duration should be determined by a healthcare provider, and side effects, such as bloating, gas, or diarrhea, should be monitored and addressed promptly.
From the FDA Drug Label
children 16 years of age or under: ask a doctor The FDA drug label does not explicitly state that Miralax is contraindicated for pediatrics, but it advises to ask a doctor for children 16 years of age or under 2.
- The label does not provide a clear contraindication for pediatric use.
- It is recommended to consult a doctor before administering Miralax to children 16 years of age or under.
From the Research
Miralax Contraindication in Pediatrics
- There is no evidence to suggest that Miralax is contraindicated for pediatrics 3, 4.
- In fact, studies have shown that polyethylene glycol 3350 (MiraLax) is an effective and well-tolerated treatment choice for pediatric constipation 3.
- A study comparing three oral contrast preparations for magnetic resonance enterography in pediatric patients found that MiraLAX was more palatable and had a higher rate of completion compared to other preparations 4.
- Other studies have compared the effectiveness of polyethylene glycol (the active ingredient in MiraLax) to lactulose in treating constipation and hepatic encephalopathy, but these studies do not address contraindications in pediatrics 5, 6.
- A separate study on the use of methylene blue in pediatric and neonate patients is not relevant to the question of Miralax contraindication in pediatrics 7.