From the Guidelines
Metamucil (psyllium husk) is contraindicated in individuals with intestinal obstruction, fecal impaction, or difficulty swallowing, and should be used with caution in patients with narrowing of the gastrointestinal tract, such as esophageal strictures or pyloric stenosis, as it may cause blockages 1. When considering the use of Metamucil, it is essential to evaluate the patient's medical history and current condition to ensure safe use. People with known hypersensitivity to psyllium should avoid it completely. Patients with acute abdominal pain, nausea, vomiting, or symptoms of appendicitis should consult a healthcare provider before use. Some key points to consider when using Metamucil include:
- Diabetic patients should be cautious as Metamucil contains sugar in some formulations, though sugar-free options are available 1.
- People taking certain medications should separate Metamucil intake by at least 2 hours, as it can interfere with absorption of drugs like warfarin, digoxin, and some antibiotics.
- Metamucil works by absorbing water to form a gel-like mass that promotes bowel movements, but this same mechanism can cause problems in contraindicated conditions by potentially worsening blockages or creating new ones.
- Always take Metamucil with adequate fluid (at least 8 ounces of water) to prevent choking or esophageal obstruction 1. It is crucial to follow these guidelines to minimize the risk of adverse effects and ensure the safe use of Metamucil.
From the FDA Drug Label
Ask a doctor before use if you have • abdominal pain, nausea or vomiting • a sudden change in bowel habits persisting for 2 weeks ALLERGY ALERT: This product may cause allergic reactions in people sensitive to inhaled or ingested psyllium. The contraindications for Metamucil (psyllium) are not explicitly stated, but the following conditions require consultation with a doctor before use:
- Abdominal pain
- Nausea or vomiting
- A sudden change in bowel habits persisting for 2 weeks
- Allergy to psyllium 2 2
From the Research
Contraindications for Metamucil
- Intestinal obstruction: Psyllium, the main ingredient in Metamucil, can cause intestinal obstruction if not taken with adequate amounts of fluids 3, 4.
- Esophageal obstruction: Elderly patients and those who have undergone gastric banding operations are at risk of esophageal obstruction when taking Psyllium 3.
- Bowel obstruction: Psyllium can worsen constipation and cause bowel obstruction if not taken appropriately, especially in long-term use 3.
- Gastric hypomotility disorders: Patients with gastric hypomotility disorders are at risk of bezoar-induced small bowel obstruction when taking Metamucil 4.
- Psychiatric conditions: Patients with psychiatric conditions are at risk of bezoar-induced small bowel obstruction when taking Metamucil 4.
- Prior abdominal or bariatric surgery: Patients who have undergone prior abdominal or bariatric surgery are at risk of bezoar-induced small bowel obstruction when taking Metamucil 4.
- Inadequate fluid intake: Taking Metamucil without adequate amounts of fluids can lead to intestinal obstruction, bowel obstruction, and other adverse effects 3, 4.