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Macrogol is the international nonproprietary name used for polyethylene glycol ( PEG) as a medication ingredient. It is usually followed by a number indicating the average , indicating the length of the polymer of the specific molecule in use. Macrogol is used as a to treat in children and adults.

(2025). 9780857113382, Pharmaceutical Press.
It is taken by mouth. Benefits usually occur within three days. It is also used as an . It is also used to clear the before a , when the onset of the laxative effect is more rapid, typically within an hour.

Side effects may include , abdominal pain, and nausea. Rare but serious side effects may include an abnormal heartbeat, , and problems. Use appears to be safe during . It is classified as an : It works by increasing the amount of water in the .

Macrogol came into use as a bowel prep in 1980 and was approved for medical use in the United States in 1999.

(2025). 9780323401630, Elsevier Health Sciences.
(2025). 9781437735703, Elsevier Health Sciences.
It is available as a generic medication and over the counter. In 2022, it was the 209th most commonly prescribed medication in the United States, with more than 1million prescriptions. It is also formulated together with .
(2025). 9780444537164, Elsevier.
In 2022, the combination with electrolytes was the 282nd most commonly prescribed medication in the US, with more than 600,000 prescriptions.


Medical uses

Constipation
Macrogol 3350, often in combination with , is used for short-term relief of constipation as well as for long-term use in constipation of various causes, including in people with multiple sclerosis or Parkinson's disease as well as constipation caused by pharmaceutical drugs such as and . Whole bowel irrigation with macrogol is part of the bowel preparation before or . Limited data also support its use for the treatment of .

In those with chronic constipation it works better than .

Popular types include: macrogol 3350, macrogol 4000, and macrogol 6000. The number represents the . Combining different molecular weights provides some control over the consistency.


Excipient
Macrogol is used as an in pharmaceutical products. Lower-molecular-weight variants are used as solvents in oral liquids and soft capsules, whereas solid variants are used as bases, tablet binders, , and .

For example, PEG-2000 is one of the excipients in the Moderna COVID-19 vaccine.


PEGylation
Macrogols are also attached to biopharmaceutical drugs to slow down their degradation in the human body and increase their duration of action, as well as to reduce . This process is called .


Contraindications
Contraindications for macrogol taken orally as a laxative are intestinal perforation, bowel obstruction, , inflammatory bowel diseases, and .

The doses of macrogol as an are too low to have relevant contraindications.

to macrogol is rare, and usually appears as an allergy to an increasing number of seemingly unrelated products, including cosmetics, drugs that use it as an excipient, and peri-procedural substances such as ultrasound gel.


Adverse effects
Oral macrogol is generally well tolerated. Possible side effects include headache, bloating, nausea, , and electrolyte imbalance, mainly (low blood levels) and (high blood potassium levels). Hyperkalaemia is not an effect of macrogol itself but of potassium salts which are usually part of macrogol formulations.


Interactions
The interaction potential is low. Absorption of other pharmaceutical drugs can be reduced because oral macrogol accelerates intestinal passage, but this is seldom clinically relevant. For antiepileptic drugs, such a mechanism has been described in rare cases.


Pharmacology

Mechanism of action as a laxative
Macrogol is an osmotically acting laxative; that is, an inert substance that passes through the gut without being absorbed into the body. It relieves because it causes water to be retained in the bowel instead of being absorbed into the body. This increases the water content and volume of the in the bowel, making them softer and easier to pass, as well as improving .


Chemistry

Available forms
When sold for gut cleansing (and as a laxative), it is usually in combination with salts such as sodium bicarbonate, and potassium chlorideeg. to help mitigate the possibility of electrolyte imbalance and . Brand names include Cosmocol, Cololyt, Glycoprep, Laxido, Miralax, Molaxole, Movicol, and Osmolax.

Polyethylene glycol-electrolyte solution is a fixed-dose combination medication sold under various brand names in the US, including Colyte, Gavilyte, Golytely, Nulytely, Moviprep, and Trilyte. Brand names available in the UK include Cosmocol, Klean-Prep, Laxido, Molaxole, Movicol, Plenvu, Transisoft, and Vistaprep. , polyethylene glycol 3350 is available in the US as a combination with sodium sulfate, potassium chloride, magnesium sulfate, and sodium chloride and sold under the brand name Suflave. It is for cleansing of the colon in preparation for colonoscopy in adults.


Research

PEGylation
When attached to various biopharmaceutical medications (which are proteins), macrogol results in a slowed clearance of the carried protein from the blood. This makes for a longer-acting medicinal effect and reduces , and it allows for longer dosing intervals. It also reduces the proteins' immunogenicity. Examples for PEGylated proteins include peginterferon alfa-2a and -2b, which are used to treat , , which is used to treat , and for the treatment of .


Nerves and spinal cords
There is evidence demonstrating PEG-induced repair of specific nerve cells in animal models:
  • It has been shown that macrogol can improve healing of injuries in dogs.
  • One of the earlier findings is that macrogol can aid in nerve repair in .
  • The subcutaneous injection of macrogol 2000 in guinea pigs after spinal cord injury leads to rapid recovery through molecular repair of nerve membranes. The effectiveness of this treatment to prevent in humans after an accident is not known yet.
  • Macrogol is being used in the repair of motor neurons damaged in crush or laceration incidents and in rats. When coupled with melatonin, 75% of damaged sciatic nerves were rendered viable.


Cancer prevention
  • High-molecular-weight macrogol (e.g., 8000 g/mol) has been shown to be a dietary preventive agent against colorectal cancer in animal models.
  • The Chemoprevention Database shows macrogol is the most effective known agent for the suppression of chemical carcinogenesis in rats. Cancer prevention applications in humans, however, have not yet been tested in .

Other
  • Macrogol is also used to fuse B-cells with cells in monoclonal antibody production.


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