sorbitol (Rx)

Constipation

Oral: 30-150 mL (70% solution) once

Rectal enema: 120 mL of 25-30% solution once

Sodium Polystyrene Sulfonate Adjunct

15 mL of 70% solution or 10-20 mL/2 hours PO until diarrhea occurs

Transurethral Surgical Procedures

3-3.3% as surgical procedure irrigation

Constipation

< 2 years

• Safety & efficacy not established

2-11 years

• Oral: 2 mL/kg (as 70% solution) once
• Rectal enema: 30-60 mL as 25-30% solution

≥12 years

• Oral: 30-150 mL (70% solution) once
• Rectal enema: 120 mL of 25-30% solution once

Sodium Polystyrene Sulfonate Adjunct

<12 years: Safety & efficacy not established

≥12 years: 15 mL of 70% solution or 10-20 mL/2 hours PO until diarrhea occurs

Contraindicated (0)

Serious - Use Alternative (2)

• lamivudine

  sorbitol will decrease the level or effect of lamivudine by Other (see comment). Avoid or Use Alternate Drug. Sorbitol-containing solution decreased systemic exposure of lamivudine oral solution in a pediatric study (ARROW trial). Results showed lower rates of virologic suppression, lower plasma lamivudine exposure, and development of viral resistance more frequently than children receiving lamivudine tablets.

• sodium polystyrene sulfonate

  sodium polystyrene sulfonate, sorbitol. Mechanism: unknown. Avoid or Use Alternate Drug. Combination implicated in cases of colonic necrosis.

Monitor Closely (2)

• deflazacort

  sorbitol and deflazacort both decrease serum potassium. Use Caution/Monitor.

• dichlorphenamide

  dichlorphenamide, sorbitol. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Both drugs can cause metabolic acidosis.

Minor (0)

• deflazacort

  Monitor Closely (1)sorbitol and deflazacort both decrease serum potassium. Use Caution/Monitor.

• dichlorphenamide

  Monitor Closely (1)dichlorphenamide, sorbitol. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Both drugs can cause metabolic acidosis.

• lamivudine

  Serious - Use Alternative (1)sorbitol will decrease the level or effect of lamivudine by Other (see comment). Avoid or Use Alternate Drug. Sorbitol-containing solution decreased systemic exposure of lamivudine oral solution in a pediatric study (ARROW trial). Results showed lower rates of virologic suppression, lower plasma lamivudine exposure, and development of viral resistance more frequently than children receiving lamivudine tablets.

• sodium polystyrene sulfonate

  Serious - Use Alternative (1)sodium polystyrene sulfonate, sorbitol. Mechanism: unknown. Avoid or Use Alternate Drug. Combination implicated in cases of colonic necrosis.