Ispaghula husk 3.5g / Mebeverine 135mg effervescent granules sachets sugar free

Background Constipation is a common problem among patients with advanced chronic kidney disease (CKD), leading to a loss of quality of life. Pharmacologic treatments are in common use, but whether lactulose and senna plus ispaghula husk is effecive to treat constipation among patients with pre-dialysis CKD remains unknown. Objective The aim of the study was to compare efficacy of lactulose and senna plus ispaghula husk to treat constipation among patients with pre-dialysis CKD. Methods A study was conducted among patients with pre-dialysis CKD receiving a diagnosis of constipation by ROME IV criteria. All subjects were randomly assigned to receive either lactulose or senna plus ispaghula husk daily for 14 days. After a 7-day washout period, the patients were switched to the other substance for another 14 days. Primary outcome was complete spontaneous bowel movement (CSBM) weekly, assessed using a stool diary after each laxative. Secondary outcome measure was the change of stool appearance using the Bristol stool form scale (BSFS). Results A total of 22 patients underwent randomization. Baseline CSBM and BSFS were 3.4 ± 1.4 and 2.3 ± 1.2 time/week, respectively. At the end of the study, the mean CSBM weekly increased in the lactulose group (mean difference 1.3 ± 1.6, P < 0.001) and the senna plus ispaghula husk group (mean difference 2.1 ± 2.1, P < 0.001) from baseline. Comparing CSBM between lactulose and senna plus ispaghula husk exhibited no significant difference (95% CI −1.2 to 0.06; P = 0.276). BSFS was significantly changed after using ispaghula husk with senna, the mean ± SD of BSFS changed to 1.7 ± 1.8 (p = 0.001) and after use lactulose, the mean ± SD of BSFS changed to 1.6 ± 1.8 (p = 0.001). No significant BSFS change was observed between groups regarding stool appearance. No serious adverse event in either group was found. Conclusion Lactulose and senna plus ispaghula husk were similar in efficacy to treat constipation among patients with pre-dialysis CKD. Trial Registration Thai Clinical Trials number is TCTR20200818006. Retrospectively Registered 18 August 2020.

Abstract licence: CC BY-NC 3.0

This comprehensive review provides an in-depth exploration of Ispaghula husk as a natural polymer in the pharmaceutical landscape. Beginning with an overview of natural polymers, emphasising their eco-friendly attributes, the article classifies and elucidates the significance of these polymers in pharmaceutical applications. Focused on the Ispaghula husk, the review delves into its properties, pharmaceutical applications and stability considerations. A key emphasis is placed on the importance of polymer modification in advancing formulation development, covering diverse methodologies applied to Ispaghula husk. The article elucidates various drug delivery systems formulated using this natural polymer, showcasing its adaptability in controlled-release formulations and mucoadhesive drug delivery. Recent patents on Ispaghula husk provide a contemporary perspective. The review concludes with forward-looking recommendations, positioning itself as a valuable resource for researchers and pharmaceutical professionals navigating the potential of Ispaghula husk as a natural polymer in pharmaceutical contexts. Major Findings: This review highlights Ispaghula husk as an eco-friendly and biocompatible natural polymer with significant pharmaceutical applications. It possesses excellent swelling, gel-forming, and bioadhesive properties, making it suitable for controlled-release and mucoadhesive drug delivery systems. Various chemical and physical modifications enhance its solubility, stability, and drug-carrying capacity. Recent patents demonstrate its growing importance in novel pharmaceutical formulations. Future research should focus on advanced modifications and expanding its role in innovative drug delivery platforms.

Abstract licence: CC BY-NC-ND 4.0