sorbitol

Sorbitol is a sugar alcohol found in many fruits and plants and is used orally or rectally to relieve occasional constipation and irregularity in bowel movements.

Sorbitol is added to the solution used to irrigate the urinary passage (urethra) during transurethral surgical procedures. In addition, sorbitol is also used as an adjunct to sodium polystyrene sulfonate (SPS), a resin used to reduce potassium levels in patients with high blood potassium levels (hyperkalemia).

Sorbitol is an osmotic laxative that is poorly absorbed in the intestines and the unabsorbed drug retains water in the colon, softening the stools. Sorbitol also stimulates muscle contractions (peristalsis) that facilitate bowel movements. In hyperkalemia treatment, sodium polystyrene sulfonate causes excretion of potassium in the feces and sorbitol is added to dissolve SPS, loosen the stools and reduce the risk of fecal impaction and bowel obstruction.

Sorbitol has one-third fewer calories and 60 percent of the sweetening activity of sucrose, and is used as a sweetener for people with diabetes. Some people use sorbitol instead of sucrose for weight management.

Sorbitol is commonly used in the food industry as a sweetener and also to improve the texture and shelf-life of foods. Many chewing gums contain sorbitol and it is also added to sweeten some liquid medications. Fruits such as apples, apricots, figs, dates, plums, peaches, nectarines, strawberries, blackberries and raspberries are natural sources of sorbitol.

• Do not use sorbitol in patients with:
  • Lack of urine production (anuria)
  • Symptoms of appendicitis including acute abdominal pain, nausea and vomiting
  • Undiagnosed abdominal pain
• Use sorbitol with caution in patients with severe impairment of cardiopulmonary or renal function
• Sorbitol can cause dehydration and electrolyte imbalances, use with caution
• Use with caution in people who are unable to metabolize sorbitol (intolerance)
• Use with caution in infants. Excessive amounts of sorbitol can cause dehydration with elevated sodium levels

Common side effects of sorbitol include:

• Excessive bowel activity
• Diarrhea
• Nausea
• Vomiting
• Abdominal discomfort
• Dehydration
• Fluid and electrolyte losses
• Dry mouth (xerostomia)
• High glucose levels in blood (hyperglycemia)
• Swelling (edema)
• Lactic acid buildup in blood (lactic acidosis)

This is not a complete list of all side effects or adverse reactions that may occur from the use of this drug.

Call your doctor for medical advice about serious side effects or adverse reactions. You may also report side effects or health problems to the FDA at 1-800-FDA-1088.

Irrigation Solution

• 3g/100mL (3%)

Oral Solution

• 70%

Adult:

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 orally until diarrhea occurs

Transurethral Surgical Procedures

• 3-3.3% as surgical procedure irrigation

Pediatric:

Constipation

Children younger than 2 years

• Safety and efficacy not established

Children 2-11 years

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

Children 12 years or older

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

Sodium Polystyrene Sulfonate Adjunct

Children younger than 12 years

• Safety & efficacy not established

Children 12 years or older

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

• Sorbitol overdose can cause abdominal cramps and diarrhea.
• In case of overdose, discontinue sorbitol and hydrate well. If symptoms don’t resolve, seek medical help or contact Poison Control.

Inform your doctor of all medications you are currently taking, who can advise you on any possible drug interactions. Never begin taking, suddenly discontinue, or change the dosage of any medication without your doctor’s recommendation.

• Sorbitol has no known severe interactions with other drugs.
• Serious Interactions of sorbitol include:
  • lamivudine
  • sodium polystyrene sulfonate
• Moderate Interactions of sorbitol include:
  • deflazacort
  • dichlorphenamide
• Sorbitol has no known mild interactions with other drugs.

The drug interactions listed above are not all of the possible interactions or adverse effects. For more information on drug interactions, visit the RxList Drug Interaction Checker.

It is important to always tell your doctor, pharmacist, or health care provider of all prescription and over-the-counter medications you use, as well as the dosage for each, and keep a list of the information. Check with your doctor or health care provider if you have any questions about the medication.

• There are no adequate and well-controlled studies on the safety of sorbitol use during pregnancy. Use only if benefits outweigh potential risks.
• It is not known if sorbitol is present in breastmilk, use with caution in nursing mothers.

• Take sorbitol exactly as prescribed.
• Do not take for longer than 7 days. If bowel movement doesn’t occur, discontinue sorbitol and seek medical help.
• Do not take sorbitol if you have abdominal pain, nausea, or vomiting.
• Store sorbitol out of reach of children.