Recommended Liquids for Mixing PEG 3350 in Children
PEG 3350 should be mixed in 4 to 8 ounces of water, juice, soda, coffee, or tea for children with constipation. 1
Approved Mixing Options
The FDA-approved drug label for PEG 3350 explicitly states that the powder can be dissolved in any of the following beverages 1:
- Water (most commonly used)
- Juice (any type)
- Soda
- Coffee
- Tea
The standard dose of 17 grams should be stirred and dissolved in 4 to 8 ounces of the chosen liquid. 1
Practical Considerations for Juice Selection
When choosing juice as the mixing liquid, certain juices may provide additional benefit for constipation management:
- Prune, pear, and apple juices contain sorbitol and other carbohydrates that can help increase stool frequency and water content, making them particularly useful choices for mixing PEG in constipated children. 2
- White grape juice has equal concentrations of fructose and glucose, which may be better absorbed than apple or pear juice when consumed in appropriate amounts (10 mL/kg body weight). 2
- The carbohydrate content in these juices works synergistically with PEG's osmotic mechanism to soften stool. 2
Dosing and Administration Guidelines
For children, the effective dose ranges from 0.26 to 1.5 g/kg/day, with most children responding to approximately 0.8 g/kg/day. 3, 4
- Mix the prescribed dose in 4-8 ounces of liquid using the provided dosing cup or one heaping tablespoon of powder. 1
- The powder should be completely dissolved before administration. 1
- Adequate fluid intake throughout the day is essential for PEG to work effectively. 5
Age-Specific Considerations
- Infants younger than 18 months: PEG 3350 is safe and effective at a mean maintenance dose of 0.78 g/kg/day, with similar safety profiles to older children. 4
- Children 6 months to 15 years: Studies demonstrate efficacy with doses ranging from 0.26-1.42 g/kg/day, typically starting at 1 g/kg/day and adjusting every 3 days based on response. 3, 6
Expected Response and Timeline
- The first bowel movement typically occurs within 2 to 4 days of starting therapy, though individual response may vary. 1
- Stool frequency increases significantly from baseline (approximately 2-3 stools/week to 7-17 stools/week) within the first weeks of treatment. 3, 6
- PEG achieves best results when used for 1-2 weeks, though it can be safely continued for up to 6 months if needed. 1, 2
Common Pitfalls to Avoid
- Insufficient liquid volume: Many treatment failures occur because patients do not mix PEG with adequate liquid (minimum 4 ounces, preferably 8 ounces). 5, 1
- Inadequate overall fluid intake: PEG works by retaining water in the stool, so children must maintain adequate daily fluid intake beyond just the mixing liquid. 5
- Unpasteurized juices: If using juice as the mixing liquid, parents should be informed that unpasteurized juice products may contain pathogens and should be avoided. 2
Side Effects and Monitoring
Common side effects include nausea, stomach fullness, cramping, diarrhea, and gas. 1 If unusual cramps, bloating, or severe diarrhea occur, the dose should be adjusted or the physician consulted. 1 Taking more than the prescribed dose may cause fluid loss due to severe diarrhea. 1