FDA warns exceeding laxative dose may be deadly for some

By RYAN JASLOW

Constipation can be quite unpleasant, and people experiencing the condition may be tempted to run to the drug store and buy laxatives. But, the FDA is warning such people to read the label carefully and not exceed the recommended dose, or they may risk their lives.

The problems stem from laxatives with the active ingredient sodium phosphate, which are recommended to be taken in a single dose once a day and for no more than three days. They can be taken orally or rectally, depending on the product.

Sodium phosphate laxatives, also called saline laxatives, are sold under the brand name Fleet and also sold as store and generic brands. They work by drawing water into the bowel, which softens the stool to allow it to pass easier.

The FDA is now finding that adults older than 55 and children with certain health conditions may face added risks if they exceed the laxative dosage. The agency has received 54 reports of side effects, including 13 deaths, linked to over-the-counter sodium phosphate laxatives.

Serious side effects include dehydration and/or abnormal levels of electrolytes in the blood that can lead to serious complications, including kidney damage and sometimes death.

The most harmful side effects occurred when people overdosed by taking a single dose that was higher than recommended or took more than one dose in a day because the first laxative didn’t have the desired effect, said Dr. Mona Khurana, a medical officer in the FDA’s division of nonprescription regulation development.

Twelve adults and one child died after they overdosed on over-the-counter sodium phosphate products. Side effect case counts could be higher than the 54 reported cases, she added, since not everybody who develops problems reports them to the FDA.

"The bottom line is that these products are safe for otherwise healthy adults and older children for whom dosing instructions are provided on the Drug Facts label as long as they follow these dosing instructions and don't take the product more often, or in greater amounts, than the label instructs," she said in a statement. 

The FDA's new warning also urges people to check with their doctors if they are taking drugs that affect how the kidneys work, including diuretics; angiotensin-converting enzyme (ACE) inhibitors used to lower blood pressure; angiotensin receptor blockers (ARBs) used to treat high blood pressure, heart, or kidney failure; and nonsteroidal anti-inflammatory drugs such as ibuprofen and aspirin.

People with inflammation of the colon should also check with a doctor before taking laxatives, according to the FDA. These warnings are not currently on product labels.

The product labels do warn people to not to orally or rectally take another dose of the product if they have yet to have a bowel movement after taking the laxative. In addition, the labels tell adults and children to ask health care professionals before using these products if they have kidney disease, heart problems or dehydration.

Children under 2 years old should never take laxatives rectally, the label adds.

Constipation is marked by infrequent bowel movements or trouble passing stools. Causes include insufficient water intake, not enough fiber in diets, a disruption of regular routine (such as traveling), stress, eating large amounts of dairy products, hemorrhoids, medications, pregnancy, depression, eating disorders and other medical conditions, according to WebMD. People may take a laxative to help relieve their symptoms. 

Laxatives are also often misused following eating binges by people with eating disorders who mistakenly believe the medications will rush food and calories through the guy before they can be absorbed, according to the National Eating Disorders Association.

Taking too many laxatives overtime may weaken the bowel muscles, further leading to constipation.

Contact a doctor after taking laxatives if you experience symptoms including dry mouth, thirst, reduced urine output and lightheadedness, especially with changes in position, after taking these laxatives. These may all be signs of dehydration. People experiencing kidney injury may report drowsiness, sluggishness, and swelling of the ankles, feet and legs.

If the rectal laxative doesn’t leave the body for more than 30 minutes, contact a doctor.

Comments:

Laxatives can be dangerous and are not designed for weight loss. Many people will still use them. For a longer term solution look through the articles on this site and pick out the ones that relate to you the most. There will be many things you can apply that will help you lose fat. (There is no one solution fits all because we are all a little different. This includes what diets work well to nourish ourselves, keep appetite at bay, the lifestyles we lead and the exercise that are suitable as well as what we have to work with.)

No one is equal - it is not just genetics

by Kyn Chan

I draw so much inspiration from sport. From school there would be people that excelled in soccer, rugby, cricket, badminton etc. These people were often selected for the teams - quite an exclusive group. Most people would not qualify because they weren't quite there. Either they lacked the talent or even with good talent they did not put the time to perfecting that talent.

Now, many of these people that excelled were fairly quickly moved onto different programs at a higher level than they worked again. Again many of these people turned out to be not as good in their new group. This process was usually not so simple because success at this higher level provided a passport to even better groups - yet more people were let go. This process of selection went on for many rounds until the group left were near the best of the best. Thankfully, there were sometimes different leagues where the not so great have a chance. But the vast majority fail. I would include myself amongst the not so great at sport - I got into the team for rugby. But didn't get into any better groups.

How equal is that? Not at all right. It almost seems talent was the only factor involved. I just lacked the talent, So right off the cuff I knew I didn't have it.

But the gleaming light is I sometimes see a less talented athlete win over a talented one because the less talented one wanted it more and was prepared to work much harder consistently. (While the talented person got success easily and early so became complacent - just coasting through life.) It is in these instances where you think you had no chance but actually through consistent work and retaining the will to win you will get you something even besting someone with much better talent that you.

In life, this happens far more than in sport. (Professional sport is of course one of the most competitive fields anyone can get into.) In life, many people still get to where they want EVEN when they were not the most talented. But the journey was much harder than with someone suited for that opportunity. In life, the focussed and consistent action builds up to make you more ready for any particular event you choose.

Just not giving up and making improvements makes a huge difference in the course of life than, in nearly all circumstances over unfocused talent. (Naturally, it would be quite nice to be born with that talent).

The longer I live the more unequal I see people are. Over a long enough time frame unstoppable motivation in a narrow focused field usually produces our specialists - that distinguishes them from anyone else. Most people will have many interests and touch on this and that - usually when the going gets tough is the time to switch to something else. The really special people push through. This is a better attitude to live life with.

When talking about fat loss the same goes. It is easy to give up and move back to what you know but the most important thing is to take on the habits that move you closer and closer to your goals. Do that consistently and you will get to your goal.