Ispaghula husk

Bisacodyl is a stimulant laxative that does not take long to act and is therefore useful in acute constipation. The bulk-forming laxative ispaghula husk takes longer to act when compared with bisacodyl but is useful for long-term administration. Lactulose, which is an osmotic laxative, has a lag time of about 48 hours before onset of action. Loperamide and kaolin and morphine mixture are antidiarrhoeals used in acute diarrhoea. 

Bulk-forming laxatives (such as ispaghula husk), which work by increasing faecal mass, but they may take several days to become fully effective. They are of most use in those patients that pass small stools and have a diet lacking in fibre (but they should not replace dietary lifestyle measures)... 

Certain bulk-forming laxatives, such as ispaghula husk and psyllium, can impair the absorption of lithium (654). 

Viscous (soluble) fibres, e.g. ispaghula, are effective and more palatable than bran. Ispaghula husk contains mucilage and hemicelluloses which swell rapidly in water. Methylcellulose takes up water to swell to a colloid about 25 times its original volume and sterculia, similarly, swells when mixed with water. 

Dettmar PW, Sykes J. A multi-centre, general practice comparison of ispaghula husk with lactulose and other laxatives in the treatment of simple constipation. Curr Med Res Opin 1998 14(4) 227-33. 

Perhnan BB. Interaction between lithium salts and ispaghula husk. Lancet 1990 335(8686) 416. 

It may be necessary to exclude certain undesirable contaminants from starting materials, such as pseudomonads from bulk aluminium hydroxide gel, or to include some form of pre-treatment to reduce their bioburdens by irradiation, such as for ispaghula husk and spices. For biotechnology-derived drugs produced in human or animal tissue culture, considerable efforts are made to exclude cell lines contaminated with latent host viruses. Official guidelines to limit the risk of prion contamination in medicines require bovine-derived ingredients to be obtained from sources where bovine spongiform encephalopathy (BSE) is not endemic. 

Bulk-forming laxatives contain ispaghula husk (the seed coats of a species of plantain), sterculia (a gum from a tropical shrub) or methylcellulose (a semisynthetic hydrophilic colloid). 

Ispaghula husk, a bulk-forming laxative, is licensed for the treatment of IBS as well as for constipation and diarrhoea. It may aggravate bloating. 

Hamamelidis folium Harpagophyti radix Hippocastani semen Horse-Chestnut Seed Iceland Moss Ispaghula Husk Juniper Berries Lichen islandicus Linseed... 

Thus, although on theoretical grounds ispaghula husk and lactulose might be expected to reduce the effects of mesalazine, no interaction of clinical importance seems to occur, and there have been no reports as yet that a clinically important interaction occurs with either ispaghula husk, lactulose or lactitol. Also note that this interaction is not mentioned by the US manufacturers of Asacol ... 

In an isolated case, the withdrawal of ispaghula husk resulted in an increase in lithium levels. Psyllium slightly reduced the absorption of lithium in a study in healthy subjects. 

A 47-year-old woman recently started on lithium was found to have blood-lithium levels of 0.4 mmol/L five days after an increment in her lithium dose and whilst also taking one teaspoonful ofispaghula husk twice daily. The ispaghula husk was stopped 3 days later and lithium levels measur 4 days later were found to be 0.76 mmol/L. ... 

Mucofalk consists of granules containing epidermal particles and the collapsed adjacent layers removed from the dried ripe seeds of Plantago ovata Forssk (Ispaghula husk)... 

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