Instructions for use Fortrans provides complete information about the drug, its mechanism of action, the likelihood of side effects and indications. Before you start taking it, you should study it and pay special attention to the calculation of the volume of the powder and the rules for use. It is necessary to know how long a laxative acts, when its effect on the body ends.
Composition, dosage and form of release Fortrans
Latin name Fortrans. The drug is a white powder that is easily soluble in water, has no taste or smell. The active ingredient of the drug is macrogol 400 at a dose of 64 grams. There are no tablet forms. According to the instructions for use, the list of auxiliary compounds includes sodium and potassium salts.
Produced in separate sachets of 4 pieces in a carton. One pack contains 73.69 grams of powder.
Therapeutic action of Fortrans
It is a laxative drug. Macrogol, due to its structure, is able to hold and attract water molecules. After taking, the amount of intestinal contents increases, pressure on the walls increases, peristalsis increases, feces are removed from the small and large intestines.
Sodium salts, which are included in the composition and described in the instructions, prevent the development of water and electrolyte imbalance.
One of the advantages of the drug is the fact that the substance is not metabolized in the digestive tract, is not absorbed into the general bloodstream.
Fortrans - indications for use
The drug is usually not prescribed, like all other laxatives, for constipation. The powder is used only to prepare the body for a surgical intervention that requires complete emptying of the intestine, or before endoscopic, x-ray diagnostics of the digestive tract, lumbar spine.
General rules for using Fortrans
The medicine is allowed to be used by persons over fifteen years of age, suitable for cleansing organs at home, does not require strict control by a specialist. Drink the solution two hours after eating. The amount of macrogol is selected individually, taking into account the weight and age of the patient. One sachet is designed for 15-20 kg of human body weight.
As stated in the instructions for use, pure boiled warm water is suitable for preparing the solution; it is not worth diluting the powder with juices, tea and other drinks. For one sachet you need to take a liter of liquid. The resulting remedy should be consumed gradually in small sips with breaks of 5-10 minutes.
If nausea, vomiting occurs, if there are no contraindications, add to water, mix and drink the medicine with a small amount of lemon juice. Defecation begins an hour and a half after the start of taking a laxative.
It should be understood that the use of Fortrans must be justified by medical indications. It is not necessary to use raw tap water when preparing the solution.
Preparing for a colonoscopy or barium enema
If usually cleansing before endoscopic research methods begins 12–15 hours before, then here in the drug regimen it is said that you need to finish drinking the solution in 3–4 hours. It is undesirable to eat before the procedure, if anesthesia is not planned, let's say a light breakfast.
With a very early diagnosis (at 7–8 in the morning), for convenience, you can prepare the intestines in the evening. If the drug causes vomiting, the nausea agent must be replaced with another substance.
How long does Fortrans work?
As mentioned just above, the first portion of the stool comes out about two hours after the start of the laxative.
Duration of action of Fortrans
Feces are excreted for three or four hours, the timing depends on the rate of peristalsis and the individual characteristics of the patient's body. The effect of the drug ends after 7-8 hours.
After diagnosis, removal of toxins and toxins, it is recommended to take probiotics to restore microflora and prevent dysbacteriosis.
Fortrans for children
The instructions indicate that at the moment there is no information on the clinical use of laxatives under the age of fifteen, for this reason, babies should not drink the solution, you need to choose an analogue.
Pregnancy and lactation
Now there is no complete information about the action of macrogol 400 during gestation, its effect on the child, so the use of Fortrans is possible when absolutely necessary, there is no alternative.
The active ingredient is not absorbed into the general circulation, therefore it does not penetrate into breast milk. Instructions for use states that during lactation, the medication is allowed to be used, if there is evidence for that.
Fortrans for weight loss
It is not necessary to use the drug for such purposes. This is due to two reasons:
- Excess body weight is the deposition of fat under the skin, and not in the intestines.
- Without diet and exercise, getting rid of feces will not give any results.
In addition, prolonged use of a laxative disrupts the functional activity of the digestive tract, its departments cease to contract adequately, peristalsis is significantly reduced. The result of such weight loss is not weight loss, but sheer harm: chronic constipation, abdominal pain, the formation of fecal stones and intestinal obstruction. The benefits of such funds for a person in this case are imaginary.
In order to lose weight, you do not need to use laxatives, it is better to review your diet and lead an active lifestyle.
Fortrans - side effects
The undesirable effect of the drug was recorded extremely rarely, the consequences arose mainly due to violations of the rules of administration. Patients reported the following manifestations:
- nausea;
- vomit;
- flatulence (increased gas formation);
- allergy in the form of itching of the skin, rash, swelling of soft tissues.
Isolated cases of anaphylactic shock have been reported, which is very life-threatening for the patient. Influence on the ability to drive a car and work with mechanisms has not been established.
Overdose
In the annotation attached to the drug, data on overdose are not indicated.
Contraindications
In some cases, the reception of Fortrans is prohibited. These include:
- tendency to form hypersensitivity;
- dehydration;
- heart, kidney, liver failure in the stage of decompensation;
- the presence of intestinal obstruction;
- diarrhea for a long period of time;
- growth of a benign or malignant neoplasm.
Contraindications also include the child's age less than fifteen years.
Analogues
If it is impossible to use Fortrans to cleanse the intestines (if there is an allergic reaction, for example), the doctor selects another laxative. Previously recommended, now the following drugs are sold in pharmacies:
- Pikoprep. It is allowed to use in children from nine years of age. The active ingredient is sodium picosulfate.
- Microlax. Produced in the form of tubes, microclysters, which does not require a preliminary calculation of the dosage and dilution. Shown even to babies.
- Dufolac. The active substance is lactulose. Laxative gently acts on the intestine, often used to eliminate constipation.
Analogues may consist of other compounds, be called differently, but must perform the same function. If endoscopy is performed in an emergency, the issue of an urgent operation is resolved, the patient is given a cleansing enema.
Fortrans or Lavacol - which is better?
The drug is produced with the same active substance - macrogol. Its cost is lower, since the country of origin is Russia. It has a pleasant taste, dissolves well in water, however, experts note its lower efficiency.
Which is better: Fortrans or Fleet?
It is considered the same osmotic laxative, but with a different composition. It practically does not differ from Fortrans, it is in the same price category. Recommended for those patients who are allergic to macrogol.
Endofalk or Fortrans - which is better?
If we compare the two instructions for use, we can say that the mechanism of action, composition, indications and side effects are similar. Here, the choice of medication should be made by the doctor before prescribing a laxative.
Storage conditions
Clean the first-aid kit in a place inaccessible to children, while the air temperature should not exceed thirty degrees.
Best before date
It is five years, after the expiration of the packaging with the contents must be disposed of. Drink the resulting solution immediately, do not store in heat or refrigerator.
Terms of dispensing from pharmacies
Fortrans can only be purchased by providing a prescription to a pharmacist, as stated in the instructions for use.
Price
The cost depends on the region where the laxative is sold. On average, a patient will pay 500–600 rubles for a package.
Fortrans is an osmotic laxative, which includes Macrogol 4000 (polyethylene glycol) and electrolytes (sodium, potassium, bicarbonate and chlorides). The macromolecular compound Macrogol 4000 is a long linear polymers that, by means of hydrogen bonds
able to hold water molecules. After oral administration, the drug increases the volume of fluid in the intestine. The volume of unabsorbed fluid contained in the intestine provides a laxative effect of the drug solution.
The electrolytes included in the preparation ensure the maintenance of the composition of the blood plasma. The concentration of electrolytes in the Fortrans solution is such that the electrolyte exchange between the contents of the intestine and the blood plasma is practically reduced to zero. Thus, the presence of electrolytes in the Fortrans preparation prevents their loss from the body when a large amount of fluid passes through the gastrointestinal tract during the use of the drug.
Pharmacokinetics
The solution prepared by dissolving 1 sachet of the drug in 1 liter of water is isotonic and iso-osmotic to the contents of the large intestine in the composition of electrolytes.The results of pharmacokinetic studies confirm the absence of absorption and biotransformation of Macrogol 4000 after oral administration.
Indications for use
A drug Fortrans used for:- preparation for endoscopic or X-ray examination of the colon;
- preparation for surgical interventions requiring the absence of contents in the intestine.
Mode of application:
A drug Fortrans can only be used in adult patients.
The drug is intended for oral administration.
Preparation of the drug solution: pour the contents of one sachet into 1 liter of water and stir well until completely dissolved. The resulting solution should be clear and colorless. Similarly, prepare the required amount of solution (3-4 l), using only whole (unbroken) sachets. To obtain 4 liters of Fortrans solution, it is necessary to dissolve the contents of 4 sachets in 4 liters of water.
To improve the taste, the solution is best taken chilled.
The recommended dose is 1 sachet / 1 liter of solution per 15-20 kg of the patient's body weight, or, on average, from 3 to 4 liters of the resulting solution.
It is recommended to drink one full glass (250 ml) of the resulting solution of the drug every 15 minutes until the prepared volume of the solution is completely consumed.
Usually taking the drug takes 4-6 hours. The full dose can be divided into two doses (2 liters in the evening and 1 to 2 liters the next morning). It is usually recommended to complete the last dose of the drug no later than 3 hours before the examination or surgical intervention. With a single dose of a full dose, 3-4 liters of solution are taken in the evening on the eve of the prescribed procedure.
When administering the drug through a gastric tube, the rate of administration should be 15-20 ml per minute.
Fortrans is designed to cleanse the gastrointestinal tract and promotes the evacuation of intestinal contents, as in diarrhea.
The first liquid stool should appear within 1-2 hours after the start of the procedure.
Side effects:
From the digestive system: rarely - nausea, vomiting, flatulence; at the beginning of the reception - a feeling of heaviness and discomfort in the abdomen.
Other: rarely - allergic reactions (skin rash, swelling).
Contraindications:
Contraindications to the use of the drug Fortrans are:
- hypersensitivity to the active substances or any other component of the drug;
- severe general condition of the patient, such as dehydration or severe heart failure;
- stomach ulcer;
- a common malignant tumor or other disease of the colon, accompanied by extensive damage to the intestinal mucosa;
- gastrointestinal obstruction;
- obstruction of the gastrointestinal tract;
- perforation or risk of perforation of the gastrointestinal tract;
- disorders of gastric emptying (including gastroparesis);
- toxic colitis or toxic megacolon;
- children under 18 years of age (efficacy and safety have not been established in this population).
With caution: in case of impaired renal function, heart failure, in patients with concomitant diuretic therapy; in patients prone to the development of water and electrolyte imbalance, including hyponatremia and hypokalemia; in patients with neurological disorders, in bedridden patients and / or in patients with impaired motor functions, in patients with a tendency to aspiration, and / or who are in a semi / unconscious state (see section "Special Instructions").
Pregnancy:
Experience with the drug Fortrans in pregnant women is limited. Data from preclinical studies of reproductive toxicity are insufficient.
The drug can be used during pregnancy only after a careful assessment of the ratio of risk to the fetus and benefit to the mother.
Experience with the use of the drug Fortrans during breastfeeding is limited. It is not known if Macrogol 4000 is excreted in breast milk.
A risk to the newborn/infant cannot be excluded.
The drug can be used during breastfeeding only if the benefit to the mother outweighs the possible risk to the baby.
Interaction with other drugs:
Drug-induced diarrhea Fortrans may interfere with the absorption of other concomitantly taken drugs.
Overdose:
Data on drug overdose Fortrans not provided.
Storage conditions:
A drug Fortrans should be stored below 30°C.
Keep out of the reach of children.
Release form:
Fortrans - powder for solution for oral administration, 64 g.
Packing: 73.69 g - sachets (4) - packs of cardboard.
Compound:
1 (g/sachet) Fortrans contains active substances: macrogol 4000 64.0.
Excipients: Sodium chloride 1.46, Potassium chloride 0.75, Sodium bicarbonate 1.68, Anhydrous sodium sulfate 5.70, Sodium saccharinate 0.10.
Compound
Each package contains:
Active ingredients:
Macrogol 4000 64.00 g
Sodium sulfate anhydrous 5.70 g
Sodium bicarbonate 1.68 g
Sodium chloride 1.46 g
Potassium chloride 0.75 g
Auxiliary components:
Sodium saccharinate 0.10 g
Total weight 73.69 g
Description
The white powder is highly soluble in water.
Pharmacotherapeutic group
Osmotic laxative
ATS code: A06AD65
Pharmacological properties
Pharmacodynamics
High molecular weight (4000) macrogols are long linear polymers on which water molecules are held by hydrogen bonds. When taken orally, they increase the volume of fluid contained in the intestines. The laxative properties of the solution are explained by the volume of non-absorbable fluid in the intestine.
Pharmacokinetics
The content of electrolytes in the solution is such that the electrolyte exchange between the intestine and plasma can be considered zero.
Pharmacokinetic data confirm the lack of digestive absorption and bioconversion of macrogol 4000 after oral administration.
Indications for use
Intestinal lavage (bowel cleansing), providing preliminary preparation of patients for:
endoscopic or x-ray examination of the intestine
surgical interventions on the intestines.
Fortrans is prescribed only for adult patients.
Contraindications
Hypersensitivity to any of the components of the drug.
Severe violations of the general condition of the patient, such as dehydration or severe heart failure.
Progressive carcinoma or any other disease of the intestine, accompanied by significant damage to the mucous membrane.
Patients with a tendency to develop or existing intestinal or gastrointestinal obstruction.
Perforation or risk of perforation of the gastrointestinal tract.
Disorders of gastric emptying (for example, gastric paresis).
Toxic colitis or toxic megacolon.
Dosage and administration
ADULTS ONLY
Orally.
Dissolve the contents of each sachet in 1 liter of water. Stir the powder until completely dissolved.
The dose is approximately 1 liter of solution per 15-20 kg of weight, i.e. on average 3-4 liters per patient.
Mode of application
The use of the drug can be carried out in one or two doses, provided that the patient in any case needs to take the entire amount of the diluted solution (an average of 3-4 liters of solution, depending on the patient's body weight).
When dividing into separate doses: 2 liters of solution is taken the night before and from 1 to 2 liters in the morning, but in such a way that the drug is finished 3-4 hours before the procedure.
With a single dose: 3 to 4 liters of solution is taken the night before (if the procedure is scheduled for the morning). A break of one hour is possible after taking two liters of the solution.
It is recommended to take from 1 to 1.5 liters of solution per hour (that is, 250 ml every 10-15 minutes).
The regimen of taking the drug may be recommended by the attending physician in accordance with the clinical condition of the patient and the potential risk of complications.
Patients with renal insufficiency
Data on the use of the drug in this group of patients are limited.
Children
The safety and efficacy of the drug in children under 18 years of age have not been studied.
Special instructions and precautions for use
Elderly people with poor health are advised to take the drug only under medical supervision.
Diarrhea caused by the use of this drug can significantly impair the absorption of concomitantly used drugs.
This medicine contains macrogol (polyethylene glycol or PEG).
There is evidence of the occurrence of various types of allergic reactions when using drugs based on macrogol: anaphylactic shock, rash, urticaria, angioedema.
Electrolyte disturbances when taking the drug are not expected due to its isotonic composition, however, such disturbances very rarely developed in patients at risk. Patients with existing electrolyte abnormalities should be corrected prior to bowel cleansing. The drug should be used with caution in such conditions, as well as in patients with concomitant disorders (such as impaired renal function, heart failure), taking certain drugs (for example, diuretics), as the risk of fluid and electrolyte disorders, including hyponatremia, increases and hypokalemia, and increases the risk of potential complications. In such cases, patients should be under medical supervision.
The drug should be used with caution and under medical supervision in patients with a tendency to aspiration (in patients who are bedridden, with neurological or motor disorders) due to the risk of developing aspiration pneumonia. In such cases, the drug is taken in the sitting position of the patient or with the help of a nasal probe.
Patients with heart or kidney failure are at risk of developing acute pulmonary edema due to fluid overload.
Fortrans contains 1.967 g sodium per sachet. This should be taken into account when prescribing to patients with a strict restriction of the amount of salt in the diet.
Interaction with other drugs
Before prescribing a drug, the physician should be informed about any medications taken orally by the patient. When using Fortrans, other oral medications may be absorbed, so they should be taken at least 2 hours before the start of the bowel cleansing procedure. Medicines should be avoided before and after the use of a laxative until the examination is completed. Especially, the effectiveness of drugs with a narrow therapeutic range and a short half-life may decrease.
Use during pregnancy and lactation
Pregnancy
Data on the use of Fortrans in pregnant women are very limited. Animal studies are not sufficient to assess the reproductive toxicity of the drug.
Fortran should only be used in pregnant women if the benefit outweighs the risk.
breastfeeding period
There is limited data on the use of Fortrans during lactation. It is not known whether macrogol 4000 passes into breast milk. The risk of using the drug in neonates/infants cannot be excluded. Fortrans can be taken during breastfeeding only in cases where the benefit outweighs any risk of using the drug.
Fertility
There are no data on the effect of Fortrans on fertility.
The effect of the drug on the ability to drive vehicles and work with moving mechanisms
Studies to study the effect of the drug on driving a car and controlling mechanisms have not been conducted.
Fortrans is one of the few medicines designed for rapid evacuation of chyme and feces from the intestines in full, as well as to replenish the lost volume of salts and fluids.
The main advantage of the drug is the absence of drug interactions and the impossibility of dehydration when taking it.
However, this laxative is only available by prescription, and it is recommended to use it strictly in accordance with the official instructions for use.
1. Instructions for use
The peculiarity of taking Fortrans is that it can be used exclusively orally, that is, to drink. Thanks to this, the most complete cleansing of the gastrointestinal tract is achieved.
When using enemas or laxative tablets, this is very difficult to achieve, since the former act exclusively in the lower sections of the intestine, and the latter in the middle section.
The remaining parts of the digestive tract may remain filled with chyme, which makes it impossible to carry out some diagnostic or therapeutic procedures.
Indications for use
A direct indication for use is the need to wash the intestines and completely free it from the masses in it for certain diagnostic or therapeutic procedures:
- x-ray of the intestine (irrigography);
- colonoscopy;
- irrigoscopy;
- surgical intervention on the intestines and neighboring organs, in which manipulations are possible only with an empty intestine.
In addition, Fortrans is used to free the intestines from too hard feces in adult patients (over 15 years old) suffering from chronic constipation.
Mode of application
Manufacturers of the product recommend taking Fortrans after meals with an interval between them of at least 2 hours. To do this, it is recommended to calculate in advance the amount of solution that will be required for complete emptying.
According to the official instructions, 1 sachet with a drug is diluted in one liter of water (boiled and cooled in advance).
The solution should be prepared no more than 10-12 hours before taking, and it is better to make each portion of the remedy immediately before taking it. The dosage of the agent (the amount of the prepared solution per dose) depends on the patient's body weight.
According to the manufacturer of the laxative, it should be calculated based on the scheme 1 sachet per 15 or 20 kg of body weight. if, when calculating the number of sachets required for the occurrence of a laxative effect, it turns out to be fractional, rounding up occurs.
It is recommended to prepare the solution in full, without prior dissolution in a small amount of water. So, if, according to calculations, it is necessary to drink 3 liters of Fortrans solution, the agent is diluted in an appropriate amount of water.
It is necessary to drink the drug in small portions, half or full glass with an interval of 10-15 minutes. On average, it should take about 2-3 hours to consume the entire cooked serving. The chair in most cases occurs within 1 hour. Doctors recommend doing this as follows - drinking a new portion of the remedy after each visit to the toilet.
If there is no need to quickly empty the intestines (with chronic constipation, for example), the prepared solution can be taken in two approaches: drink half the volume in the evening, and the rest in the morning. In this case, the chair will be normal throughout the day.
Due to the presence of a specific aftertaste, it is recommended to drink the remedy with a small amount of any sour juice - pomegranate or lemon. It will be enough to take a tablespoon of juice to avoid the appearance of a gag reflex.
Release form and composition
The drug Fortrans is produced exclusively in the form of a fine powder for the preparation of a solution.
The composition of this remedy includes the main active synthetic compound - macrogol, which has the property of increasing the osmotic pressure in the intestinal lumen, thereby stimulating the occurrence of stool.
Additional components of Fortrans are:
- chloride salts of potassium and sodium;
- bicarbonate and anhydrous sodium sulfate;
- sodium saccharin (sweetener).
The color of the powder is white, the taste is sweet, the aroma is absent. The product dissolves quickly in water without forming lumps.
drug interaction
The active substance of Fortrans (macrogol) is absolutely inert, and therefore does not interact with other chemical compounds that are in the stomach at the time of taking the solution. Moreover, the laxative is not absorbed in the stomach and intestines, and does not enter the systemic circulation. Due to this property of Fortrans, the drug does not enter into drug interactions with other drugs.
2. Side effects
When taking the laxative Fortrans, the onset of unwanted reactions from some internal organs and their systems is possible.
Most often, patients notice the following side effects:
- heaviness and feeling of fullness in the intestines and / or stomach;
- nausea (occurs mainly due to the rejection of the taste of the solution);
- increased gas formation;
- allergic reactions in the form of a rash, swelling and / or itching.
Undesirable reactions disappear on their own after a day or two after the end of the laxative. No specific treatment is required.
Contraindications
Fortrans does not have a list of diseases and conditions in which the drug should be taken with caution. However, the list of strict (absolute) contraindications is quite extensive. It includes:
- complete or partial intestinal obstruction or a high risk of its occurrence;
- dehydration;
- expansion of the colon of toxic etiology;
- perforation of any part of the digestive tract;
- malignant tumors of the intestine and stomach;
- pathological narrowing of the intestine;
- erosion and ulcers on the mucous membrane of the digestive tract;
- intolerance to any component of the laxative.
In the presence of the above diagnoses, Fortrans is not prescribed.
Use during pregnancy and lactation
There is no information on the use of the Fortrans laxative during pregnancy, therefore it is recommended to use it only in case of urgent need or in the presence of unconditional indications for its use.
When breastfeeding, the drug is allowed for use, since it does not enter the systemic circulation and directly into breast milk, and therefore cannot enter the child's body.
3. Terms and conditions of storage
The period during which the drug can be stored and taken without the risk of poisoning is 5 years from the date of manufacture. At the same time, it is important to follow the recommendations for its storage, avoiding sunlight on the packaging and keeping the drug in rooms with temperatures above 30 degrees Celsius.
4. Price
The average cost of the drug Fortrans in Russia is 140 rubles for one sachet and 580 rubles for a pack of 4 bags.
In Ukraine, the cost of a laxative is 110 hryvnias for one package, and about 500 hryvnia for a package of 4 packages.
5. Analogues
On the pharmaceutical market, there are many analogues of Fortrans in terms of the active substance or the effect it has. Structural analogues or synonyms contain the same active ingredient - macrogol. The only way they differ from Fortrans is the list of additional components that improve the taste and smell of the solution.
The most popular synonyms are:
- Osmogol;
- Realaxan;
- Forteza Rompharm.
In the case when a patient has developed a severe allergy to macrogol, it is possible to replace Fortrans with analogues, that is, drugs that contain a different set of components.
These funds include:
- Goodluck in the form of syrup;
- Dinolac in the form of an emulsion;
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