Drugs & Therapy Perspectives

, Volume 34, Issue 7, pp 300–310 | Cite as

Macrogol (polyethylene glycol) 4000 without electrolytes in the symptomatic treatment of chronic constipation: a profile of its use

  • Katherine A. Lyseng-Williamson
Adis Drug Q&A


Macrogol 4000, a biologically inert, non-absorbable osmotic laxative, is a highly effective and well-tolerated first-line option for the treatment of the symptoms of chronic idiopathic/functional constipation in children and adults. High-molecular-weight (HMW) macrogols ± electrolytes have generally similar efficacy profiles; however, the taste of macrogol 4000 is generally preferred over that of macrogol 3350 + electrolytes. Macrogol 4000 is more effective than lactulose in improving stool frequency and consistency, and is associated with less vomiting and flatulence. Comparisons with other osmotic and bulk-forming laxatives are limited, with macrogol 4000 being at least as, or more effective than, psyllium hydrocolloid and magnesium hydroxide in treating chronic constipation. Current clinical treatment guidelines recommend the use of HMW macrogols over the use of lactulose and bulk-forming laxative in the symptomatic treatment of constipation in children and adults.



The manuscript was reviewed by: M. Alboraie, Department of Internal Medicine, Al-Azhar University, Cairo, Egypt; M. Bellini, Gastroenterology Unit, University of Pisa, Pisa, Italy; M.A. Benninga, Department of Pediatric Gastroenterology and Nutrition, Emma Children’s Hospital/Academic Medical Center, Amsterdam, the Netherlands; C. Blandizzi, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy. During the peer review process, Ipsen Consumer Healthcare, a marketing-authorization holder of macrogol 4000, was also offered an opportunity to provide a scientific accuracy review of their data. Changes resulting from comments received were made on the basis of scientific and editorial merit.

Compliance with ethical standards


The preparation of this review was not supported by any external funding.

Conflicts of interest

K. A. Lyseng-Williamson is an employee of Adis/Springer, is responsible for the article content and declares no conflicts of interest.


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Authors and Affiliations

  1. 1.SpringerAucklandNew Zealand

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