Citramag Bowel Evacuant Powder 29.5g Pack of 10

Citramag sachets contain magnesium carbonate and citric acid. When these are mixed in water magnesium citrate is formed. Magnesium citrate is the active ingredient of this medicine. It is known as an osmotic laxative.

Magnesium citrate works by causing water to be drawn into the large intestine. This increases the water content and volume of the stools, which stimulates the colon to contract and move its contents along to the rectum, so that the bowel can then be emptied.It causes frequent, liquid stools to be passed until the bowel is emptied. This laxative medicine is used to cleanse the bowel prior to examination or surgical procedures that require the colon to be clean of stools, eg colonoscopy or barium enema. It is not used to treat constipation.

What is it used for?

• To empty the bowel before surgery or an examination such as colonoscopyor barium enema.

Citramag should be taken the day before your appointment. Follow the instructions given by your doctor. Two doses will be needed, one in the morning and one in the afternoon. The amount to take with each dose depends on age. This will be printed on the dispensing label that your pharmacist has put on the packet of medicine. If you are unsure about anything ask your doctor or pharmacist for advice.

For adults, the usual dose is one sachet taken at 8am, followed by a second sachet between 2 and 4 pm.

Each sachet of Citramag should be prepared when needed by dissolving the contents of one sachet into 200ml of hot water. The solution should be allowed to cool for about 30 mintues before you drink it.

You should expect to start having frequent bowel movements from any time after you have taken the first dose of Citramag. You should make sure you stay near a toilet until the effects of the medicine have worn off.

When taking Citramag it is important to make sure that water lost from the body is replaced by drinking plenty of clear fluids (eg water, fruit squash, clear soup, black tea or black coffee). You should start drinking plenty of fluids after your first dose of Citramag and continue up until your procedure.

You should make sure that you drink plenty of fluids while taking this medicine (see above).

It is important to make sure that you will always have access to a toilet after taking a dose of Citramag, as loose bowel motions can start at any time after taking it.

Your doctor may ask you to follow a special low residue diet one day before starting treatment with the Citramag sachets. Follow the instructions given by your doctor.

Use with caution in

• Elderly people.
• Weak or debilitated people.
• Decreased kidney function.
• People with heart disease.
• People taking diuretic medicines.
• People who have disturbances in the normal levels of electrolytes (such as sodium, potassium and magnesium) in their blood.
• Inflammatory bowel disease such as ulcerative colitis or Crohn's disease.
• People who have recently had surgery on the stomach or intestines.

Not to be used in

• People who are very dehydrated.
• People with a blockage in the stomach or intestines.
• People with an abnormal hole in the stomach or intestines (gastrointestinal perforation).
• People with reduced muscle activity in the intestines (ileus).
• People with retention of food in the stomach (gastric retention).
• People with severe inflammation of the large intestine (toxic colitis).
• People with a sudden expansion of the large intestine seen in advanced ulcerative colitis or Crohn's disease (toxic megacolon).
• Severely decreased kidney function.

This medicine should not be used if you are allergic to any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.

If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

• The safety of this medicine during pregnancy and breastfeeding has not been established. It should only be used during pregnancy or breastfeeding if considered essential by your doctor.

Label warnings

• Dissolve or mix this medication with water before taking.
• Follow the printed instructions you have been given with this medication.

Side effects

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Just because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.

• Abdominal pain.
• Swelling of the abdomen.
• Flatulence (wind).
• Nausea and vomiting.
• Soreness of the back passage (anus).
• Headache.
• Dizziness.
• Dehydration.
• Changes in the amounts of salts (electrolytes) in the blood.
• Allergic reactions.

The side effects listed above may not include all of the side effects reported by the medicine's manufacturer.For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

How can this medicine affect other medicines?

You should tell your doctor or pharmacist what medicines you are taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine.This is particularly important if you are taking any regular medicines, for example, oral contraceptives, medicines for epilepsy or diabetes or antibiotics, because Citramag may delay or completely prevent the absorption of these medicines, making them less effective or ineffective. Your doctor or pharmacist will advise you on the action to take; this will be different for each medicine.This medicine can sometimes cause an imbalance in the amount of fluid and salts (electrolytes) in your body. This effect may be enhanced if you are also taking certain other medicines, including the medicines listed below. If you are taking one of these, your doctor may recommend that you don't take it on the day you start taking this medicine and for up to three days after:

• ACE inhibitors, eg captopril, enalapril
• angiotensin-II receptor antagonists, eg losartan, valsartan
• diuretic medicines, eg furosemide or bendroflumethiazide
• non-steroidal anti-inflammatory painkillers (NSAIDs) , eg diclofenac, indometacin
• steroid medicines, eg prednisolone, dexamethasone.

Ask your doctor or pharmacist for further information and advice.    

Magnesium carbonate, anhydrous citric acid