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Fybogel

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SUMMARY OF PRODUCT CHARACTERISTICS

1    NAME OF THE MEDICINAL PRODUCT

Fybogel.

2    QUALITATIVE AND QUANTITATIVE COMPOSITION

Each single dose sachet contains 3.5g ispaghula husk BP.

3    PHARMACEUTICAL FORM

Effervescent granules for preparation of an oral suspension

4    CLINICAL PARTICULARS

4.1    Therapeutic indications

The treatment of patients requiring a high fibre regimen: for example, for the relief of constipation including constipation in pregnancy and the maintenance of regularity; for the management of bowel function in patients with colostomy, ileostomy, haemorrhoids, anal fissure, chronic diarrhoea associated with diverticular disease, irritable bowel syndrome and ulcerative colitis.

4.2 Posology and method of administration

Fybogel should be stirred into a glass of water and taken as soon as effervescent subsides, preferably after meals.

When preparing the product for administration, it is important to try to avoid inhaling any of the powder in order to minimize the risk of sensitization to the active ingredient.

Adults and children over 12 years: One sachet morning and evening.

Elderly:    There is no indication the dosage need be

modified for the elderly.

Children 6-12 years:    Half to one level 5ml spoonful

depending on size and age morning and evening.

Children under 6 years:    To be taken only when prescribed by a

doctor. Half to one level 5ml spoonful depending on size and age morning and evening.

The last dose should not be taken immediately before going to sleep.

If there have been no bowel movements after 3 days of treatment a doctor

should be consulted.

4.3 Contraindications

Fybogel is contra-indicated in cases of intestinal obstruction, faecal impaction natural or drug-induced reduction of gut motility and colonic atony such as senile mega-colon. Hypersensitivity to the active substance or to any of the excipients in the product (See Section 4.4 Special warnings and precautions for use),

4.4    Special warnings and precautions for use

Warning on hypersensitivity reactions: In individuals with continued occupational contact to powder of Plantago ovata seeds (i.e. healthcare workers, caregivers) allergic sensitization may occur due to inhalation, this is more frequent in atopic individuals. This sensitization usually leads to hypersensitivity reactions which could be serious (see 4.8 Undesirable effects). It is recommended to assess clinically the possible sensitization of individuals at risk and, if justified, to perform specific diagnostic tests. In case of proven sensitization leading to hypersensitivity reactions, exposure to the product should be stopped immediately and avoided in the future (see 4.3 Contraindications).

Due to its aspartame content, Fybogel should not be given to patients with phenylketonuria.

Adequate fluid intake should be maintained. Therefore, they should always be taken with at least 150 mL of water or other liquid. The last dose should not be taken immediately before going to sleep since impaired or reduced gastric motility may impair the intestinal passage and then cause sub-obstruction.

If symptoms persist consult a doctor

4.5    Interaction with other medicinal products and other forms of interaction

Ispaghula and other bulk-forming laxatives may delay or reduce the gastrointestinal absorption of other drugs such as cardiac glycosides, coumarin derivatives, lithium, or vitamins (such as vitamin B12) and minerals (such as calcium, iron, or zinc).

4.6 Pregnancy and lactation

Fybogel may be used during pregnancy and lactation since the ispaghula husk is not absorbed from the gastrointestinal tract.

4.7 Effects on ability to drive and use machines

Not applicable in view of physical mode of action.

4.8    Undesirable effects

Ispaghula/psyllium husk contains potent allergens. The exposure to these allergens is possible through oral administration, contact with the skin and, in the case of powder formulations, also by inhalation. As a consequence to this allergic potential, individuals exposed to the product can develop hypersensitivity reactions such as rhinitis, conjunctivitis, bronchospasm and in some cases, anaphylaxia. Cutaneous symptoms as exanthema and/or pruritus have also been reported. Special attention should be given to individuals manipulating the powder formulations routinely (see 4.4 Special warnings and precautions for use).

A small amount of flatulence and abdominal distension may sometimes occur.

4.9    Overdose

In the event of overdosage conservative measures should be taken. The patient may notice abdominal discomfort and flatulence and attention should be paid to maintaining an adequate fluid intake, particularly if the granules have been taken without water, contrary to administration instructions.

5.    PHARMACOLOGICAL PROPERTIES

5.1    Pharmacodynamic properties

ATC Code: A06AC01

Ispaghula husk is capable of absorbing up to 40 times it own weight of water in vitro and part of its activity can be attributed to its action as a simple bulking agent. In addition colonic bacteria are believed to use the hydrated material as a metabolic substrate. This results in an increase in the bacterial cell mass with a consequent softening of the faeces.

5.2 Pharmacokinetic properties

The mode of action of Fybogel is physical and does not depend on absorption into the systemic circulation.

5.3 Preclinical safety data

No preclinical findings relevant to the prescriber have been reported.

6 PHARMACEUTICAL PARTICULARS

6.1 List of excipients

Potassium bicarbonate

USP

Sodium bicarbonate

Ph Eur

Citric acid

Ph Eur

Riboflavin sodium phosphate

Ph Eur

Beta-carotene 10% (E160a)

HSE

Aspartame

Ph Eur

Saccharin sodium

Ph Eur

Polysorbate 80

Ph Eur

Silica, colloidal anhydrous

Ph. Eur

Incompatibilities

None known

6.3 Shelf life

Three years

6.4 Special precautions for storage

Store below 30°C in a dry place.

6.5 Nature and contents of container

Sachets of paper/aluminium foil/polythene laminate enclosed in a cardboard outer carton.

Pack size(s): Ten or thirty sachets (pack size printed in bold is currently sold).

6.6 Special precautions for disposal

No special instructions.

7    MARKETING AUTHORISATION HOLDER

Reckitt Benckiser Healthcare (UK) Limited

Dansom Lane

Hull

HU8 7DS United Kingdom

8    MARKETING AUTHORISATION NUMBER(S)

PL 00063/0023

9 DATE OF FIRST AUTHORISATION/RENEWAL OF THE AUTHORISATION

15/01/1990 / 09/06/2003

10 DATE OF REVISION OF THE TEXT

13/03/14