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Golytely vs Magnesium Citrate
Introduction
For patients needing to cleanse the bowel before a colonoscopy or other medical procedure, certain drugs that help evacuate the bowels can be prescribed. Golytely and Magnesium Citrate are two such solutions often used for this purpose. Both work by increasing fluid in the small intestine which helps to stimulate bowel movements, thus aiding in clearing out the intestines.
Golytely is a polyethylene glycol-electrolyte solution that not only increases fluid but also maintains important electrolytes within your body, preventing dehydration during the process of cleansing. On the other hand, Magnesium Citrate is an osmotic laxative that pulls water into your intestines from surrounding tissues providing a softer stool and stimulating intestinal motility.
Golytely vs Magnesium Citrate Side By Side
| Attribute | Golytely | Magnesium citrate |
|---|---|---|
| Brand Name | Golytely | Magnesium Citrate |
| Contraindications | Kidney disease, bowel obstruction or perforation, gastrointestinal disorder, heart disease including congestive heart failure (CHF) | Kidney disease, long-term daily use not recommended due to potential magnesium imbalance or dependency for bowel function |
| Cost | $40-$50 for a single package | $2-$6 for a 10 oz bottle |
| Generic Name | Polyethylene Glycol 3350 | Magnesium Citrate |
| Most Serious Side Effect | Severe stomach pain or bloating, trouble swallowing, irregular heartbeats or feeling faint, dehydration signs, electrolyte imbalance indications | Blood in stools or rectal bleeding, unusually fast heartbeat, severe nausea or vomiting, dizziness or fainting, mood changes such as confusion |
| Severe Drug Interactions | Not specifically mentioned in the article | Not specifically mentioned in the article |
| Typical Dose | 240 mL every 10 minutes until the rectal output is clear or 4 liters are consumed | 240 ml (about 10 fluid ounces) in the evening, not to exceed 480 ml per day |
What is Golytely?
Polyethylene Glycol 3350 (the generic name for Golytely) is a type of osmotic laxative that supports bowel clearance, particularly used before colonoscopies. First approved by the FDA in 1981, it works by retaining water in the stool to soften it and increase the number of bowel movements. On the other hand, Magnesium Citrate is another form of osmotic laxative but also contains magnesium which naturally increases water in the intestines. Although both are used for similar purposes such as constipation relief or preparation for surgical procedures like colonoscopy, their effectiveness and side effects can vary. While Golytely has a wider influence on bowel movement with only minor influence on electrolyte balance, it results in having fewer side effects than Magnesium Citrate which may cause electrolyte imbalances if not properly administered.
What conditions is Golytely approved to treat?
Golytely is approved for the treatment of the following conditions:
- Bowel cleansing prior to colonoscopy
- Constipation
On the other hand, Magnesium Citrate is used in treating:
- Occasional constipation
- Preparing bowel for a medical procedure.
How does Golytely help with these illnesses?
Golytely aids in colon cleansing by increasing the amount of water in the intestinal tract. It does this by drawing water into the bowel, so stool can be softened and easily excreted for longer periods of time. Water is a vital component in our body that plays an important role not only in digestion but also maintaining body temperature, lubricating joints and preserving skin health amongst other things. People preparing for a colonoscopy often have to ensure their colon is thoroughly cleansed. Therefore, by drawing more water into the bowel, Golytely facilitates this process making it easier to remove fecal matter from the body and prepare patients for their procedure.
What is Magnesium Citrate?
Magnesium Citrate is a saline laxative that is thought to work by increasing fluid in the small intestine. It usually results in a bowel movement within 30 minutes to 3 hours. Magnesium citrate, which was first approved by the FDA in the early 1900s, is often used as a short-term solution for constipation or as preparation for certain medical procedures like colonoscopies. Because magnesium citrate does not produce its effects through impacting serotonin reuptake, it has a different side-effect profile than drugs such as Golytely (a polyethylene glycol-based medication). Notably, magnesium citrate doesn't cause cramping and bloating commonly associated with Golytely intake due to its osmotic effect on the intestines. Magnesium Citrate may be more appropriate for patients seeking quick relief from temporary constipation or those who need an easily accessible over-the-counter option.
What conditions is Magnesium Citrate approved to treat?
Magnesium Citrate, a saline laxative, is approved for the treatment of:
- Occasional constipation
- Bowel cleansing before medical procedures such as colonoscopy.
It works by drawing water into the intestines, which helps to produce a bowel movement. It's important to stay well hydrated while using this medication due to its diuretic effect.
How does Magnesium Citrate help with these illnesses?
Magnesium Citrate is a saline laxative that is thought to work by increasing fluid in the small intestine, which can help induce bowel movements and cleanse the colon. It is usually used as a preparation for diagnostic procedures or surgical interventions such as colonoscopy. The action of magnesium citrate not only stimulates water retention within the intestines but also promotes peristalsis, the coordinated rhythmic muscle contractions that move food through the digestive tract, thereby helping to increase bowel motility. Its mechanism of action may be more tolerable for some patients compared to osmotic laxatives like Golytely, which require large volume intake and can cause bloating and discomfort due to their mode of operation. However, while Magnesium Citrate could be a preferable choice for certain cases due its lower volume requirement and fewer side effects, it's important to remember individual response varies greatly from person to person when it comes to gastrointestinal medications.
How effective are both Golytely and Magnesium Citrate?
Both polyethylene glycol-electrolyte solution (GoLYTELY) and magnesium citrate have proven efficacy in bowel preparation before diagnostic procedures, such as colonoscopy. These two laxatives were both approved by the FDA during the 1980s. Since they act through different physiological mechanisms to induce bowel movements, their use may differ based on patients' health status and the specific requirements of the procedure.
The effectiveness of GoLYTELY and magnesium citrate was directly studied in a randomized clinical trial in 2003; both drugs exhibited similar efficacy for bowel cleansing prior to colonoscopy with comparable safety profiles. In this study, no significant differences were found between patients receiving GoLYTELY or magnesium citrate regarding completion rates of colonoscopies or need for repeat procedures due to inadequate cleansing.
A 2012 review indicated that GoLYTELY is effective from the first dose and its side effect profile compares favorably with other strong laxatives used for medical procedures. The same study reports that GoLytely has become one of the most commonly prescribed solutions worldwide for gut cleansing ahead of diagnostics or therapy. As it was among the first balanced electrolyte lavage solutions developed, there is considerable history studying its effectiveness.
A 2015 meta-analysis concluded that while magnesium citrate appears less effective than polyethylene glycol-based preparations overall at achieving optimal colonic cleansing, it remains a viable alternative due to its lower cost and easier administration process. Nonetheless, like all osmotic laxatives, excessive use can lead to dehydration or mineral imbalances if not properly managed.
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At what dose is Golytely typically prescribed?
Oral dosages of Golytely are typically around 240 mL every 10 minutes until the rectal output is clear or 4 liters are consumed. This large volume ensures a complete colon cleanse before medical procedures like a colonoscopy. Magnesium Citrate, on the other hand, usually requires a dose of 240 mL for adults and children over 12 years old taken orally once, followed by plenty of water. For children between ages six to eleven, the dosage can be reduced to half (120mL). Dosage can be adjusted as needed but should never exceed recommended amounts unless supervised by a healthcare provider. Effective results for both medications largely depend on individual response and tolerability.
At what dose is Magnesium Citrate typically prescribed?
Magnesium Citrate administration typically begins with a dosage of 240 ml (about 10 fluid ounces) in the evening. This can then be adjusted according to individual response, but should not exceed a maximum dose of 480 ml per day. Doses are ideally spaced out by at least four hours and are usually taken with an ample amount of water or juice to assist bowel clearance. If there is no noticeable effect after one use, it may be advisable to repeat the dose; however, long-term daily use is not recommended due to potential magnesium imbalance or dependency for bowel function.
What are the most common side effects for Golytely?
Common side effects of Golytely may include:
- Bloating
- Nausea and vomiting
- Stomach cramps
- Anal irritation
- Thirst or general discomfort
Whereas Magnesium Citrate may cause the following side effects:
- Diarrhea, stomach discomfort or pain, nausea and sometimes vomiting
- Electrolyte imbalance (symptoms can include weakness, irregular heartbeat)
- Dehydration symptoms such as extreme thirst, decreased urination, muscle cramping or feeling dizzy upon standing up.
It's important to note that these medications are used for bowel preparation before surgery or certain bowel procedures. Their purpose is to induce diarrhea in order to clean the intestines. Patients should consult with their healthcare provider if they experience persisting adverse reactions beyond what is expected from these medications' use.
Are there any potential serious side effects for Golytely?
While both Golytely and Magnesium Citrate are used to cleanse the bowels before a colonoscopy, they can have different side effects. Here's what you should watch for:
- Signs of an allergic reaction akin to hives, difficulty breathing, swelling in your face or throat
- Severe stomach pain or bloating
- Trouble swallowing
- Irregular heartbeats or feeling faint
- Dehydration signs: dizziness, decreased urination, dry mouth and throat
- Electrolyte imbalance indications: muscle cramps or weakness; mood changes; confusion; irregular heartbeat.
In rare cases with magnesium citrate usage specifically:
- Blood in stool or rectal bleeding
These side effects don't happen often but if they do occur it's important to stop using the drug immediately and seek medical attention. It is also essential that these medications be taken as directed by a healthcare professional due to their powerful bowel-cleansing abilities which can result in dehydration if not properly managed.
What are the most common side effects for Magnesium Citrate?
The use of Magnesium Citrate may lead to a variety of side effects, some of which include:
- Nausea and vomiting
- Stomach cramps or discomfort
- Diarrhea, often quite severe
- Sweating or feeling flushed
- Dizziness or faintness
- Increased thirst due to dehydration from diarrhea Muscle weakness if used in high doses for extended periods.
It's crucial to note that while Magnesium Citrate is generally well-tolerated, it should be taken with caution by individuals with kidney issues as it could potentially worsen their condition. Always consult your healthcare provider before starting any new medication regimen.
Are there any potential serious side effects for Magnesium Citrate?
Like any medication, Magnesium Citrate can occasionally have adverse effects. Certain serious reactions may require immediate medical attention:
- Signs of allergic reaction: hives, difficulty breathing, swelling in your face or throat
- Severe nausea or vomiting
- Dizziness or fainting
- Blood in stools or rectal bleeding
- Unusually fast heartbeat
- Difficulty swallowing
- Mood changes such as confusion
It's essential to stop using Magnesium Citrate and seek medical help immediately if you experience any of the above symptoms.
Contraindications for Golytely and Magnesium Citrate?
Both Golytely and Magnesium Citrate, like other laxatives, may cause side effects such as stomach pain or discomfort in some individuals. If your symptoms worsen or you experience severe nausea, vomiting, dizziness, fainting or rectal bleeding after taking these medications, please seek immediate medical attention.
Neither Golytely nor Magnesium Citrate should be taken if you are suffering from kidney disease without prior consultation with a healthcare provider. Always inform your doctor about any medications you are currently taking; certain drugs could interact negatively with Golytely and Magnesium Citrate.
Furthermore, if you have been diagnosed with a bowel obstruction or perforation, gastrointestinal disorder or heart disease including congestive heart failure (CHF), consult your physician before using either of these medications. These conditions might require close monitoring during the usage of both Golytely and Magnesium Citrate due to potential risk of fluid imbalance.
How much do Golytely and Magnesium Citrate cost?
For the brand name versions of these laxatives:
- A single package of Golytely, which contains enough for one bowel-cleaning dose, averages around $40-$50.
- In contrast, a bottle of Magnesium Citrate (10 oz), also typically used as a single-dose bowel cleanser, costs between $2 and $6.
This means that if you're preparing for a procedure like colonoscopy that requires thorough cleansing of your bowels, using brand-name Magnesium Citrate would be less expensive than using Golytely. However, cost should not be the only deciding factor. You need to consider tolerability and effectiveness as well when choosing between these two medications.
The generic versions are similar in price to their brand-name counterparts:
- Polyethylene Glycol 3350/Nulytely (generic version of Golytely) is available at an average cost ranging from $30 to $45 per dosage pack.
- The generic form of Magnesium Citrate usually comes in bottles with prices around $1 - $4 each.
It's important to note that while both serve as effective laxatives for cleaning out the colon before medical procedures or treating constipation, they work differently and have different side effect profiles. Always consult with your healthcare provider about which option is best suited for you.
Popularity of Golytely and Magnesium Citrate
Polyethylene glycol-electrolyte solution (PEG-ES), known under the brand name Golytely, was estimated to have been prescribed to about 3.8 million people in the US in 2020. PEG-ES accounted for just over 15% of laxative prescriptions in the US and is commonly used as a bowel prep before colonoscopies due to its thoroughness and rapidity.
On the other hand, magnesium citrate was prescribed to approximately 2.7 million individuals within the same year. In terms of overall laxative prescriptions, magnesium citrate accounts for around 10%. It's often recommended as an over-the-counter option for occasional constipation relief or as part of a bowel cleansing regimen when less intensive cleaning is needed compared with procedures like colonoscopies.
The prevalence of both drugs has remained relatively stable over recent years; however, usage may vary based on individual patient needs and doctor recommendations.
Conclusion
Both Golytely (polyethylene glycol 3350 with electrolytes) and Magnesium Citrate have long-standing records of usage in patients for bowel preparation prior to procedures like colonoscopy. They are both backed by extensive clinical studies indicating their efficacy over placebo treatments. Due to their different mechanisms of action, they tend to be prescribed under varying circumstances. Golytely works by retaining water in the stool to stimulate bowel movements, while Magnesium Citrate acts as a saline laxative, increasing fluid in the small intestine.
Both drugs are available over-the-counter or via prescription, offering significant cost savings especially for patients who must pay out of pocket. Both Golytely and Magnesium Citrate require some time to work; effects may not be noticeable immediately after consumption but usually occur within several hours.
The side effect profile is similar between the two drugs—both can cause bloating, nausea or cramping—but magnesium citrate is more likely than Golytely to cause an electrolyte imbalance if used excessively due its mechanism of action that causes substantial water loss from your digestive system. Patients should closely monitor their response particularly when starting treatment and seek medical help immediately if severe pain or rectal bleeding occurs.
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Refrences
- BECK, D. E., HARFORD, F. J., DiPALMA, J. A., & BRADY, C. E., III. (1985, December). Bowel Cleansing With Polyethylene Glycol Electrolyte Lavage Solution. Southern Medical Journal. Southern Medical Association.http://doi.org/10.1097/00007611-198512000-00004
- Tomlinson, T., DiPalma, J., & Mangano, F. (1988, November 1). Comparison of a new colon lavage solution (Golytely-RSS) with a standard preparation for air-contrast barium enema. American Journal of Roentgenology. American Roentgen Ray Society.http://doi.org/10.2214/ajr.151.5.947
- Vilien, M., & Rytkønen, M. (1990, July). Golytely Preparation for Colonoscopy: 1.5 Liters is Enough for Outpatients. Endoscopy. Georg Thieme Verlag KG.http://doi.org/10.1055/s-2007-1012831
- Rex, D. K., DiPalma, J. A., McGowan, J., & Cleveland, M. vB. (2014, December). A comparison of oral sulfate solution with sodium picosulfate: magnesium citrate in split doses as bowel preparation for colonoscopy. Gastrointestinal Endoscopy. Elsevier BV.http://doi.org/10.1016/j.gie.2014.05.329
- Izzo, A. A., Gaginella, T. S., Mascolo, N., & Capasso, F. (1994, September). Nitric oxide as a mediator of the laxative action of magnesium sulphate. British Journal of Pharmacology. Wiley.http://doi.org/10.1111/j.1476-5381.1994.tb16198.x
- Enestvedt, B. K., Fennerty, M. B., & Eisen, G. M. (2010, October 25). Randomised clinical trial: MiraLAX vs. Golytely – a controlled study of efficacy and patient tolerability in bowel preparation for colonoscopy. Alimentary Pharmacology & Therapeutics. Wiley.http://doi.org/10.1111/j.1365-2036.2010.04493.x