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The side effects of Citrucel

Citrucel is a trade name licensed by the GSK Group of Companies in the United States for an over-the-counter bulking laxative. It is also sold by the same company under the names of Citrucel Clear Mix, Citrucel Lax, Citrucel Food Pack and Citrucel SF [1]. Its chemical name is methyl cellulose. In some instances, it is written as one word: methylcellulose.

Methyl cellulose is sold in other countries, such as China, under various formulations, not all of which are designed for human consumption [2]. Methyl cellulose is also available as a generic laxative in tablet and powder forms [3].

Uses of Citrucel

Citrucel is a white powder that is obtained from cellulose, a crucial component within the cell wall structure of green plants and algae. Cellulose is also found within the vegetable fibers of materials such as cotton and paper.

Citrucel is designed to be taken by mouth once it has been thoroughly dissolved in cold water. It is typically prescribed by medical personnel as a laxative for use in the treatment of constipation. It does so by increasing the stool's bulk which, in turn, helps to prompt movement by the intestines. Citrucel is also designed to increase the amount of liquid found in the stool. This helps soften the stool so that it is easier to pass. In addition, Citrucel could be prescribed for the treatment of irritable bowel syndrome as well as other medical conditions [4].

Expanded list of uses for methyl cellulose

Besides laxatives, methyl cellulose is used in a wide variety of consumer products such as an additive in ice cream, toothpaste and shampoo. Methyl cellulose can also be found in personal lubricants, tile adhesives, self-leveling flooring, skim coats, stucco, artificial saliva, tile grout, joint filler, artificial tears, crack fillers and more [5].

How Citrucel works

Citrucel is a bulking laxative. It must be taken with copious amounts of water. As it moves through the intestines, Citrucel attracts and collects liquids and bulks up stools. It has all of the same negative effects on digestive organs as natural fiber, except it doesn't ferment, and is less likely to cause flatulence and bloating related to bacterial fermentation.

According to its manufacturer, Citrucel is not an allergen or toxic when taken as directed. Besides methyl cellulose, Citrucel also contains a number of inactive ingredients. These include natural and artificial orange flavors, FD&C Yellow #6 Lake, titanium dioxide, potassium citrate and several other ingredients.

Treatment of adults and children

According to the manufacturer's information on Citrucel, the over-the-counter medication is cleared for use on children with constipation who are as young as six years of age. The literature on this chemical compound urges parents to seek medical advice before giving Citrucel on a child under the age of six.

Citrucel cautions for pregnant and breastfeeding Women

As of yet, the Food and Drug Administration (FDA), has not assigned a formal pregnancy category to methyl cellulose. In addition, there have been no controlled studies on pregnant women so there is no clear data on its safety for use during pregnancy. As such, its use during pregnancy is only recommended when the benefits of Citrucel outweigh the potential risks to mother and baby. Similarly, there is no data that confirms that methyl cellulose is excreted into breast milk nor is there a denial of its possibility [6].

Cautions when taking citrucel

According to the manufacturer, Citrucel could cause choking if an adequate amount of liquid is not ingested at the same time. In addition to mixing the powder in a suitable amount of cold liquid, it is also recommended that patients drink another large glass of liquid right afterward. This caution is one that is particularly alarming for children and elderly who might already be facing challenges with swallowing and delayed stomach emptying.

If you have any of the following conditions or concerns, exercise extreme caution when deciding if taking Citrucel in any of its forms is the right step for you:

Please note that the manufacturer urges cautious while taking Citrucel irritable bowel syndrome with constipation, or IBS-C. Alarmingly, it is one of the conditions that often prompts medical personnel to prescribe Citrucel in the first place. Because Citrucel may contain phenylalanine, you should not take it if you have phenylketonuria (PKU) [7].

Side effects of Citrucel

In spite of the manufacturer's assurances that Citrucel is non-allergenic and non-toxic, serious side effects can still occur [8]. You should report the following serious side effects to your healthcare provider immediately:

There are a few other side effects that are not considered to be serious enough to warrant medical attention. These include the diarrhea and stomach cramps.

Other important considerations

Citrucel can take as long as three days to work, though the manufacturer notes that a bowel movement is typically produced within 12 to 72 hours. If your symptoms begin to worsen, or if you are not better within one week, consult a medical professional.

After taking Citrucel, you should wait at least two hours before taking other prescription and over-the-counter medications. In order to help prevent dehydration and address constipation, drinking several large glasses of water throughout the day is recommended.

Unlike some other types of laxatives, such as those that trigger intestinal contractions, doctors typically advise patients that Citrucel is safe for long-term use. However, Citrucel is more absorbent than other bulking fibers. It can cause serious conditions such as difficulty swallowing, intestinal blockage and difficulty breathing.

Experiences of real-life users

In spite of the assurances of the manufacturer of Citrucel as well as his doctor, one long-time user noted that the medication seemed to cause absorption problems. This was a critical issue because this user was also taking medication for high blood pressure as well as diabetes. His blood work indicated that he would need to increase the dosage of those medications though he made no recent changes. After discontinuing his usage of Citrucel, this user noted that his blood work was considerable more favorable. He also stated that he took Citrucel upon waking in the morning and then waited four hours to take his prescription medications while the manufacturer insists that only a two hour wait is necessary [9].

An advantage many users noted about Citrucel is that, unlike other products that are used to treat constipation such as psyllium, it is does not ferment in the colon. This fermenting process can cause visible bloating and embarrassing flatulence in some people. However, these laxatives should be avoided if you go for more than a day or two without a bowel movement or if you have the symptoms of colitis or appendicitis [10].