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Generic Name: psyllium
Brand and Other Names: Metamucil, Konsyl, Reguloid
Drug Class: Antidiarrheals; Laxatives, Bulk-Producing
What is psyllium, and what is it used for?
Psyllium is a dietary fiber used to relieve occasional constipation and to maintain regularity of bowel movements.
Psyllium is a bulk-producing laxative that is available over-the-counter (OTC) as capsules or powders and is derived from the seed husks of the herb Plantago ovata. Psyllium husks are composed of insoluble fiber that cannot be digested. The psyllium husks absorb water and expand to many times their original size, increasing stool quantity and making stools softer and easier to eliminate.
Psyllium is also used as an antidiarrheal because it absorbs the excess water in the colon and adds bulk to the stools. It is popularly taken for weight management because it expands in the stomach and produces a feeling of fullness, resulting in reduced calorie consumption. In addition, studies indicate it may help in lowering unhealthy LDL cholesterol levels by absorbing bile acids and cholesterol in the intestines which are then eliminated in the stools.
Psyllium uses include the following:
- Constipation
- Diarrhea
- Fecal incontinence
- Hemorrhoids
- Ulcerative colitis
- Hyperlipidemia, a condition of high levels of blood fats (lipids)
Warnings
- Do not take psyllium in the following conditions:
- Hypersensitivity to psyllium
- Gastrointestinal (GI) obstruction
- GI ulceration
- Swallowing difficulties (dysphagia)
- Fecal impaction
- Symptoms of appendicitis or other conditions that require immediate surgical intervention (acute surgical abdomen)
- Rectal bleeding
- Use psyllium with caution in elderly patients. Elders may have insufficient fluid intake which may predispose them to fecal impaction and bowel obstruction.
- Some products may contain phenylalanine, an amino acid; avoid these products if you have phenylketonuria, a condition that causes excess phenylalanine buildup.
What are the side effects of psyllium?
Common side effects of psyllium include:
- Constipation
- Abdominal cramps
- Diarrhea
- Esophageal obstruction
- Intestinal obstruction
- Allergic reaction in people sensitive to inhaled or ingested psyllium
This is not a complete list of all side effects or adverse reactions that may occur from the use of this drug.
Call your doctor for medical advice about serious side effects or adverse reactions. You may also report side effects or health problems to the FDA at 1-800-FDA-1088.
What are the dosages of psyllium?
Amount expressed as soluble fiber
Capsule
- 400 mg (Reguloid)
Packet, Powder for Dissolution
- Konsyl: 60.3% (1 each)
- Metamucil MultiHealth Fiber Oral: 58.12% (1 each)
Bottle, Powder for Dissolution
Konsyl
- 30.9% (per gram)
- 60.3% (per gram)
- 71.67% (per gram)
Konsyl-D
- 52.3% (per gram)
Reguloid
- 28.3% (per gram)
- 48.57% (per gram)
- 58.6% (per gram)
Adult:
Constipation
Indicated for fiber supplementation, occasional constipation, or to help promote and maintain regularity
Dosage varies between products; check individual product labeling; generally, initiate with lower dose and gradually increase according to symptoms and tolerability
- 2.5-30 g/day orally in divided doses
Reduce Risk of Coronary Heart Disease
- Soluble fiber 7 g or more (psyllium seed husk 10.2 g or more) orally per day
Dietary Fiber Supplement
Indicated for daily fiber supplement
Daily recommended intake of total fiber (Journal of the Academy of Nutrition and Dietetics 2015)
Adults 19-50 years
- Males: 38 g/day
- Females: 25 g/day
Adults 51 years or older
- Males: 30 g/day
- Females: 21 g/day
- Pregnancy: 28 g/day
- Lactation: 29 g/day
Pediatric:
Constipation
Indicated for fiber supplementation, occasional constipation, or to help promote and maintain regularity
Dosage varies between products; check individual product labeling; generally, initiate with lower dose and gradually increase according to symptoms and tolerability
- Children 6-11 years: 1.25-15 g/day orally in divided doses
- Children 12 years and older: 2.5-30 g/day orally in divided doses
Reduce Risk of Coronary Heart Disease
Children 12 years and older
- Soluble fiber 7 g or more (psyllium seed husk 10.2 g or more) orally per day
Dietary Fiber Supplement
Indicated for daily fiber supplement
Daily recommended intake of total fiber (Journal of the Academy of Nutrition and Dietetics 2015)
Children 1-3 years
- 19 g/day
Children 4-8 years
- 25 g/day
Children 9-13 years
- Males: 31 g/day
- Females: 26 g/day
Children 14-18 years
- Males: 38 g/day
- Females: 26 g/day
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Overdose
- Psyllium is a dietary fiber that retains water and expands to many times its original size.
- Overdose of psyllium, particularly in the absence of drinking sufficient quantities of fluids, can worsen constipation and lead to intestinal obstruction.
- If bowel movement doesn’t occur after imbibing adequate water, seek medical help.
What drugs interact with psyllium?
Inform your doctor of all medications you are currently taking, who can advise you on any possible drug interactions. Never begin taking, suddenly discontinue, or change the dosage of any medication without your doctor’s recommendation.
- Psyllium has no known severe or serious interactions with other drugs.
- Moderate interactions of psyllium include:
- metoclopramide intranasal
- Mild interactions of psyllium include:
- sodium picosulfate
The drug interactions listed above are not all of the possible interactions or adverse effects. For more information on drug interactions, visit the RxList Drug Interaction Checker.
It is important to always tell your doctor, pharmacist, or health care provider of all prescription and over-the-counter medications you use, as well as the dosage for each, and keep a list of the information. Check with your doctor or health care provider if you have any questions about the medication.
QUESTION
Pancreatitis is inflammation of an organ in the abdomen called the pancreas.
See Answer
Pregnancy and breastfeeding
- Psyllium is not absorbed systemically. Taken with adequate fluids, psyllium is considered safe for relieving occasional constipation during pregnancy and breastfeeding, it is unlikely to pose a risk to the mother, fetus or a breastfeeding infant.
What else should I know about psyllium?
- Take psyllium with at least 8 ounces of fluid to avoid choking.
- Take only recommended amounts of psyllium with adequate fluids, it can expand several times and obstruct the gastrointestinal passage.
- Do not use psyllium for self-treating constipation that lasts longer than 7 days, seek medical help.
- Do not take psyllium if you have abdominal pain, nausea or vomiting.
- If you notice sudden changes in bowel habits that last longer than two weeks or have rectal bleeding, stop taking psyllium and consult your healthcare provider.
- Some products may contain substances you may be allergic to, such as soy, or minerals such as sodium, potassium or calcium which may have to be avoided if you are on any restricted diet. Check the label thoroughly for the ingredients.
- Psyllium is marketed as a dietary supplement and is not regulated the FDA. There may sometimes be discrepancy between the labeling and the actual ingredients and their amounts. Choose products from reliable manufacturers.
