Pharmacology Book

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FiberAka: Dietary Fiber, Polycarbophil, Fibercon, Roughage, Bulk Laxative, Bulk-Forming agents, Psyllium, Metamucil, Methylcellulose, Citrucel

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  1. Indications
    1. Constipation
    2. Irritable Bowel Syndrome
    3. Diverticulosis
    4. Hemorrhoids
    5. Hypercholesterolemia
    6. Obesity
  2. Physiology
    1. Dietary fiber improves stool bulk and transit time
    2. Dietary fiber lowers serum Cholesterol
  3. Precaution
    1. Fiber content listed below is approximate
    2. Various texts list different fiber per serving
  4. Adverse Effects
    1. Use with >1.5 Liters/day non-caffeinated fluid
    2. Poorly tolerated in atonic colon (e.g. Megacolon)
    3. Bloating is common in larger doses initially
      1. Reduced by slowly increasing fiber intake
  5. Drug Interactions
    1. May interfere with absorption of medications
      1. Do not take medications at the same time as psyllium
      2. Space psyllium several hours apart from medications
    2. Agents known to be affected
      1. Carbamazepine (Tegretol)
        1. Etman (1995) Drug Dev Ind Pharm 21:1901
      2. Lithium
        1. Perlman (1990) Lancet 335:416
  6. Preparations: Dietary Fiber Sources
    1. Whole grain cereals or breads
      1. All-Bran or 100% Bran Cereal (>8 grams per serving)
      2. Wheaties (2.6 grams per serving)
      3. Shredded Wheat (6 grams per serving)
      4. Grits (5 grams per serving)
      5. Grape-nuts (5 grams per serving)
    2. Fresh fruits
      1. Raspberries (4.5 grams per serving)
      2. Fruits with 1-3 grams fiber per serving
        1. Apple with peal
        2. Orange
        3. Peach
        4. Pear
        5. Strawberries
      3. Fruits with negligible fiber
        1. Grape-fruit has only 0.6 grams fiber per serving
        2. Apple juice has no fiber content
    3. Vegetables (raw better than cooked)
      1. Beans (>8 grams per serving)
        1. Kidney beans
        2. Lima beans
        3. Navy beans
        4. Baked beans
      2. Peas (6 grams per serving)
      3. Corn on the cob (6 grams per serving)
      4. Parsnips (6 grams per serving)
      5. Lentils (4 grams per serving)
      6. Broccoli (3 grams per serving)
      7. Baked Potato with skin (3 grams per serving)
      8. Other vegetables with 1-2 grams fiber per serving
        1. Beets
        2. Cabbage
        3. Carrots
        4. Celery
        5. Corn
        6. Squash
        7. Green beans
        8. Turnips
    4. Other sources
      1. Whole wheat bread (1.3 grams per serving)
  7. Bulk-Forming agents
    1. Psyllium (Metamucil): 10 grams per day
      1. Dose: 1-2 tsp in 8 ounces of water or juice PO tid
    2. Methylcellulose (Citrucel): 6 grams per day
      1. Dose: 2 grams in 8 ounces liquid PO tid
    3. Calcium Polycarbophil (Fibercon)
      1. Dose: Two 625 mg tablets PO tid
      2. Synthetic bulk agent containing polyacrylic acid
    4. Dietary sources with as much fiber at 10% of cost
      1. Wheat bran, oat bran or all-bran cereal
      2. Lima, Navy, kidney and baked beans
  8. References
    1. Brody (1981) Nutrition Book, p. 147
    2. Cheskin in Barker (1995) Ambulatory Medicine, p. 479

Metamucil (C0025559)

ConceptsOrganic Chemical (T109) , Pharmacologic Substance (T121)
EnglishMetamucil
CreditsDerived from the NIH UMLS (Unified Medical Language System)


Methylcellulose (C0025729)

Definition (NCI)The methyl ether of cellulose with laxative activity. Methylcellulose is not absorbed by the intestines and attracts large amounts of water into the colon, thereby increasing viscosity, producing a softer and bulkier stool and stimulating the constriction of intestinal smooth muscles.
Definition (MSH)Methylester of cellulose. Methylcellulose is used as an emulsifying and suspending agent in cosmetics, pharmaceutics and the chemical industry. It is used therapeutically as a bulk laxative.
Definition (CSP)methylester of cellulose; used as an emulsifying and suspending agent in cosmetics, pharmaceutics and the chemical industry and is used therapeutically as a bulk laxative.
ConceptsCarbohydrate (T118) , Pharmacologic Substance (T121) , Indicator, Reagent, or Diagnostic Aid (T130)
EnglishMethyl Cellulose, Methylcellulose, METHYLCELLULOSE PREPARATION
Spanishmetilcelulosa
CreditsDerived from the NIH UMLS (Unified Medical Language System)


Psyllium (C0033979)

Definition (MSH)Dried, ripe seeds of Plantago psyllium, P. indica, and P. ovata (Plantaginaceae). Plantain seeds swell in water and are used as demulcents and bulk laxatives.
Definition (NCI)The husk of the dried ripe seeds of the Plantago psyllium, P. Indica, P. Ovata, and P. Arenaria plants with laxative and cholesterol lowering activities. The husks contain mucilage that swells on exposure to water and provides an indigestible mucilaginous mass in the intestines, thereby causing lubrication, contraction of the smooth muscles of the intestinal walls, and thus stimulating bowel movement. Psyllium husk is rich in soluble fiber and has a cholesterol-lowering effect.
ConceptsOrganic Chemical (T109) , Pharmacologic Substance (T121) , Biologically Active Substance (T123)
EnglishIspaghula, Psyllium, Psyllium gum, Psyllium Husk, PSYLLIUM PREPARATION, Psyllium Seed Gum, Psyllium Seed Husk
Spanishispágula, ispagula, preparado de psilio, preparado de psilium, psilio, psyllium
CreditsDerived from the NIH UMLS (Unified Medical Language System)


calcium polycarbophil (C0054480)

Definition (NCI)A loosely cross-linked synthetic polycarboxylic-type hydrophilic polymer resin, laxative and anti-diarrheal Calcium Polycarbophil increases stool frequency, fecal water content, and fecal weight in a dose-dependent manner. It is used for idiopathic constipation, secretory diarrhea, and irritable bowel syndrome. (NCI04)
ConceptsOrganic Chemical (T109) , Pharmacologic Substance (T121)
EnglishCALCIUM POLYCARBOPHIL, CALCIUM POLYCARBOPHIL PREPARATION, polycarbofil, Polycarbophil, POLYCARBOPHIL CALCIUM, POLYCARBOPHIL CALCIUM PREPARATION, POLYCARBOPHIL PREPARATION
Spanishpolicarbófilo de calcio, policarbofil, policarbofilo, policarbofilo de calcio
CreditsDerived from the NIH UMLS (Unified Medical Language System)


Roughage (C0086941)

ConceptsFood (T168)
EnglishRoughage, Roughages
CreditsDerived from the NIH UMLS (Unified Medical Language System)


Citrucel (C0305648)

ConceptsCarbohydrate (T118) , Pharmacologic Substance (T121)
EnglishCitrucel, SmithKline Beecham Brand of Methylcellulose
CreditsDerived from the NIH UMLS (Unified Medical Language System)


FiberCon (C0720432)

ConceptsOrganic Chemical (T109) , Pharmacologic Substance (T121)
EnglishFiberCon
CreditsDerived from the NIH UMLS (Unified Medical Language System)


Bulk Laxatives (C1955900)

ConceptsPharmacologic Substance (T121)
EnglishBulk Laxatives
CreditsDerived from the NIH UMLS (Unified Medical Language System)



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