Psyllium fibre belongs to two groups of medications: bulk-forming laxatives and cholesterol-lowering medications. It is used to treat constipation, as well as mild to moderately high cholesterol (when taken with a low-fat diet). It can also be used as a fibre supplement.

For the treatment of constipation, psyllium fibre works by absorbing water from the intestines to produce larger, softer stools. It usually works within 12 hours to 72 hours.

For the treatment of mild to moderately high cholesterol, it works by increasing bile acid loss from the body by trapping bile acids in the small intestine. This causes more bile to be produced. Since cholesterol is used in the production of bile acids, cholesterol levels in the blood are reduced when more bile acid is made.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it or if their pharmacist has not recommended it.

Powder: To increase fibre intake or treat constipation, the usual recommended dose for adults is one rounded teaspoon (or one rounded tablespoon for Smooth Texture, orange-flavoured) or one packet up to 3 times a day. For children 6 years of age and older, the usual dose is ½ teaspoon (of ½ tablespoon for Smooth Texture, orange-flavoured) or ½ packet 1 to 3 times a day.

For lowering cholesterol, the total daily recommended dose is 10.2 g divided in 2 or 3 equal doses. The number of teaspoons per dose can range from 3 to 6, depending on the specific product you are using and how many times a day you are taking it. Follow the directions by your doctor, pharmacist, or the product information. For best results in lowering cholesterol, take this medication with a meal.

To take this medication, dissolve the powder in 240 mL of cool liquid (water, fruit juice, lemonade, iced tea), stir it briskly, and drink right away.

Capsules: To increase fibre intake or to treat constipation, the usual recommended dose is 5 capsules up to 3 times a day. Take the capsules with at least 240 mL of cool liquid. Swallow the capsules one at a time.

Since this medication can affect how other medications are absorbed from the stomach, do not take it 2 hours before or after taking other medications.

People who experience bloating when they start this medication should reduce the amount they are taking and gradually increase their dose to what is recommended. If you are not sure how to do this, contact your doctor or pharmacist for advice.

Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important to take this medication exactly as prescribed by your doctor or recommended by your pharmacist. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature, keep the lid tightly closed (for powder) to protect from moisture, and keep it out of the reach of children.

Metamucil Original Texture, unflavoured powder
Each g of powder contains psyllium hydrophilic mucilloid 0.5 g. Nonmedicinal ingredient: sucrose.

Metamucil Smooth Texture, orange-flavoured powder
Each g of powder contains psyllium hydrophilic mucilloid 0.3 g. Nonmedicinal ingredients: citric acid, orange flavour, sucrose, and Sunset Yellow FCF.

Metamucil Smooth Texture, orange-flavoured, sugar-free
Each g of powder contains psyllium hydrophilic mucilloid 0.6 g. Nonmedicinal ingredients: acesulfame potassium, allura red AC, aspartame, citric acid, FD&C Blue No. 1, maltodextrin, orange flavour, Sunset Yellow FCF, and berry flavour blend.

Metamucil Smooth Texture, berry burst flavour, sugar-free
Each g of powder contains psyllium hydrophilic mucilloid 0.6 g. Nonmedicinal ingredients: aspartame, citric acid, malic acid, maltodextrin, FD&C Red No. 40, FD&C Blue No. 1, and natural and artificial flavour.

Metamucil Smooth Texture, unflavoured, sugar-free
Each g of powder contains psyllium hydrophilic mucilloid 0.6 g. Nonmedicinal ingredients: citric acid and maltodextrin.

Metamucil Smooth Texture pink lemonade flavour, sugar-free
Each g of powder contains psyllium husk (Plantago ovata) 0.6 g. Nonmedicinal ingredients: acesulfame potassium, aspartame, citric acid, FD&C Red No. 40, maltodextrin, and natural lemon flavour.

Metamucil Fibre Therapy Capsules
Each capsule contains psyllium husk (Plantago ovata) 525 mg. Nonmedicinal ingredients: caramel colour, FD&C Blue No. 1, FD&C Red No. 40 Aluminum Lake, FD&C Yellow No. 6 Lake, gelatin, and polysorbate 80.

Metamucil Fibre Wafers, cinnamon
Each wafer contains 1.7 g of psyllium hydrophilic mucilloid. Nonmedicinal ingredients: ascorbic acid, cinnamon, corn oil, fructose, soya lecithin, molasses, natural and artificial flavors, nutmeg, oat hull fibre, rolled oats, sodium bicarbonate, starch, sucrose, and wheat flour.

Metamucil Fibre Wafers, apple
Each wafer contains 1.7 g of psyllium hydrophilic mucilloid. Nonmedicinal ingredients: ascorbic acid, brown sugar, cinnamon, corn oil, corn starch, fructose, soy lecithin, molasses, natural and artificial flavors, oat hull fibre, sodium bicarbonate, soy lecithin, starch, sucrose, and wheat flour.

Do not take this medication if you:

• are allergic to psyllium fibre or any ingredients of this medication
• have a blocked intestine
• have difficulty swallowing
• have fecal impaction (a large, hard stool that cannot be passed)
• have nausea, vomiting, fever, or abdominal pain
• have undiagnosed bleeding from the rectum

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• bloating
• gas
• heartburn
• nausea
• vomiting

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• bleeding from rectum
• diarrhea
• sudden severe abdominal pain
• worsening or continued constipation

Stop taking the medication and seek immediate medical attention if any of the following occur:

• difficulty swallowing
• symptoms of a severe allergic reaction such as difficulty breathing, hives, or swelling of the face or throat

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Aspartame: Some forms of this medication contain aspartame and should not be taken by people who have phenylketonuria (PKU).

Difficulty swallowing: If you have difficulty swallowing or if there is a narrowing of your esophagus, do not take this medication. If you experience chest pain, vomiting, difficulty swallowing, or difficulty breathing after taking this medication, get immediate medical attention.

Fluids: It is important to take this medication with plenty of fluids (240 mL per dose). Not doing this can cause the medication to swell and block the throat or esophagus (the tube that connects the stomach to the mouth), causing choking.

Sudden change in bowel movements: If you are experiencing a sudden change in your bowel movements that has lasted more than 2 weeks, contact your doctor before using this medication. Your doctor will want to make sure that another medical condition is not causing your constipation.

Pregnancy: This medication is considered safe to use during pregnancy.

Breast-feeding: It is not known if psyllium fibre passes into breast milk. However, this medication is considered safe to use for women who are breast-feeding.

Children: The safety and effectiveness of using this medication to lower cholesterol have not been established for children less than 6 years of age. Children 6 to 11 years of age should use the powder form of this medication.

Psyllium fibre may interact with many medications by reducing the amount of other medications that is absorbed. Therefore it is recommended that other medications not be taken 2 hours before or after taking this medication.

Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications that you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.