What is the prescription for psyllium (bulk-forming laxative) for treating constipation?

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Last updated: June 19, 2025View editorial policy

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From the Guidelines

For treating constipation with psyllium, a typical adult dose is 1 teaspoon (approximately 3.5 grams) to 1 tablespoon (approximately 7 grams) of psyllium husk powder mixed in 8 ounces of water, taken 1-3 times daily, as recommended by the most recent guidelines 1. When using psyllium, it is essential to take it with at least 8 ounces of water or other fluid and drink an additional 6-8 glasses of water throughout the day.

  • Start with a lower dose and gradually increase to avoid bloating and gas.
  • Take psyllium at least 2 hours before or after other medications to prevent interference with absorption. Psyllium works by absorbing water in the intestines, forming a gel-like mass that adds bulk to stool, making it easier to pass.
  • It typically produces effects within 12-72 hours. This natural fiber supplement is generally safe for long-term use and doesn't typically cause dependency like stimulant laxatives. However, it's crucial to note that psyllium may not be effective for opioid-induced constipation, as suggested by studies 1. If constipation persists beyond 7 days of treatment or is accompanied by pain, fever, or rectal bleeding, consult a healthcare provider. In pregnant individuals, psyllium is considered safe due to its lack of systemic absorption, and increasing dietary fiber intake can help promote regular bowel movements and prevent constipation 1.

From the Research

Psyllium Prescription for Constipation

  • Psyllium is a bulk-forming laxative used to treat constipation, and its prescription typically involves taking a specific dose with an adequate amount of fluids 2.
  • The recommended dose of psyllium varies, but studies have used doses ranging from 5-7.2 grams per day, divided into two or more doses 3, 4.
  • It is essential to instruct patients to drink a good amount of fluids when taking psyllium to avoid the development of bowel obstruction, especially with long-term use 2.
  • Psyllium has been shown to increase stool frequency, weight, and improve stool consistency in patients with idiopathic constipation 3, 4.
  • Comparison studies have found psyllium to be more effective than other laxatives, such as docusate sodium, in softening stools and increasing bowel movement frequency 5.
  • However, psyllium may not be as effective as other treatments, such as polyethylene glycol 3350 plus electrolytes, in some cases 6.

Important Considerations

  • Patients should be advised to take psyllium with an adequate amount of fluids to avoid intestinal obstruction 2.
  • Psyllium can worsen constipation if not taken appropriately, and patients should be instructed on proper use 2.
  • The efficacy and safety of psyllium have been demonstrated in various studies, but individual results may vary 3, 4, 6, 5.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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