What is the maximum number of Molaxole (polyethylene glycol) sachets that can be taken in 24 hours?

Maximum Molaxole (Polyethylene Glycol) Dosing in 24 Hours

For chronic idiopathic constipation, polyethylene glycol (PEG) has no clear maximum dose, with the standard starting dose being 17g daily and titration guided by symptom response and tolerability. 1

Standard Dosing Parameters

• Initial dose: 17g (one sachet) daily 1
• No defined maximum daily dose - titration should be based on individual symptom response and side effects 1
• The medication can be increased beyond the standard 17g dose as needed for adequate bowel movement frequency 1

Clinical Context and Dosing Strategy

• Treatment goal: One non-forced bowel movement every 1-2 days 1
• Response to PEG has been demonstrated to be durable over 6 months of continuous use 1
• The osmotic mechanism of action (trapping water in the intestine to increase stool bulk) allows for flexible dosing without the concerns associated with stimulant laxatives 1

Important Administration Considerations

• Ensure adequate hydration as PEG intake increases, since the medication works by drawing water into the intestinal lumen 1
• Common side effects include bloating, abdominal discomfort, and cramping - these should guide dose adjustments 1
• Unlike stimulant laxatives (bisacodyl, senna), PEG does not have the same concerns about prolonged use or electrolyte imbalance when used appropriately 1

Practical Dosing Algorithm

1. Start with 17g (one sachet) daily 1
2. Assess response after 3-5 days - evaluate stool frequency, consistency, and tolerability 1
3. If inadequate response: Increase by one sachet (17g) increments 1
4. If side effects develop: Reduce dose or temporarily discontinue 1
5. Maintenance: Use the lowest effective dose that achieves the goal of regular, non-forced bowel movements 1

Cost and Accessibility

• Monthly cost ranges from $10-$45, making it one of the most cost-effective osmotic laxatives available 1