Patient leaflet - Dulcobalance 10 g powder for oral solution in sachet
1. What Dulcobalance® is and what it is used for
Dulcobalance® contains the active substance macrogol 4000 and belongs to a group of medicines called osmotic laxatives.
Dulcobalance® carries water to your stool, which loosens and increases stool volume, helping to overcome sluggish bowels.
Dulcobalance® is not absorbed into the bloodstream or broken down in the body.
Dulcobalance® is used for the treatment of constipation in adults and children aged 8 years and over. Dulcobalance® is a powder that you dissolve in a glass of water (at least 50 ml) and then drink.
Dulcobalance® works gradually within 24 to 48 hours.
The treatment of constipation with any medicine should only be in addition to a healthy lifestyle and diet.
2. What you need to know before you take Dulcobalance®
Do not take Dulcobalance®:
- if you are allergic (hypersensitive) to macrogol (polyethylene glycol) or any of the other ingredients of this medicine (listed in section 6)
if you have an existing severe intestinal disease such as:
- inflammatory bowel disease (such as ulcerative colitis, Crohn’s disease, abnormal dilation of the bowel)
- perforation of the bowel or risk of perforation of the bowel
- ileus or suspicion of intestinal obstruction
- painful abdominal conditions of unknown cause
Do not take this medicine if any of the above applies to you. If you are not sure, talk to your pharmacist or doctor before taking the medicine.
Warnings and Precautions
Cases of allergic reactions involving rash and swelling of the face or throat (angioedema) have been reported in adults after taking products containing macrogol (polyethylene glycol). Isolated severe allergic reactions have been reported causing faintness, collapse or breathing difficulties and feeling generally unwell. If you experience any of these symptoms you should stop taking Dulcobalance® and seek medical help immediately.
As this medicine can sometimes cause diarrhoea, check with a doctor or pharmacist before taking this medicine if you:
- have impaired liver or kidney function
- are taking diuretics (water tablets) or are elderly as you may be at risk of low sodium (salt) or potassium levels in the blood
Before taking Dulcobalance, talk to your doctor or pharmacist if you know that you have a swallowing disorder.
Avoid mixing Dulcobalance - PEG laxative and starch-based food thickeners if you have difficulties with swallowing. This may result in a watery liquid which could get into your lungs and cause pneumonia if you can't swallow properly.
Other medicines and Dulcobalance®
There is a possibility that the absorption of other medicinal products could be transiently reduced during use with Dulcobalance, particularly medicinal products with a narrow therapeutic index or short half-life such as digoxin, anti-epileptics, coumarins and immunosuppressive agents, leading to decreased efficacy.
Tell your pharmacist or doctor if you are taking or have recently taken any other medicines, including medicines obtained without a prescription.
If you need to thicken fluids in order to swallow them safely, Dulcobalance may counteract the effect of the thickener.
Pregnancy and breast-feeding
Dulcobalance® can be used during pregnancy and breast-feeding. If you are pregnant, or breast-feeding, think you may be pregnant or are planning to have a baby, ask your pharmacist or doctor for advice before taking Dulcobalance®.
Driving and using machines
No studies on the effects on the ability to drive and /or use machines have been performed.
Important information about some of the ingredients of Dulcobalance®
This medicine contains 1.7 mg of sorbitol in each sachet.
Dulcobalance® can, however, be used if you are diabetic, or if you are on a galactose-free diet. Due to the presence of sulphur dioxide, Dulcobalance® may rarely cause severe hypersensitivity reactions and breathing difficulties.
This medicine contains less than 1 mmol sodium (23 mg) per sachet, that is to say essentially “sodium-free”.
3. How to take Dulcobalance®
Always take Dulcobalance® exactly as described in this leaflet or as your pharmacist or doctor has told you. Check with your doctor or pharmacist if you are not sure.
Adults and children over 8 years
- The recommended dose is one to two sachets per day, preferably taken as a single dose in the morning
- Start by taking one sachet each day and if needed increase to two sachets each day
- The daily dose can be adjusted according to the effect obtained and may range from one sachet every other day (especially in children) up to a maximum of two sachets per day
- Dissolve the contents of the sachets in a glass of water (at least 50 ml) immediately before use and drink the liquid
Please note:
- Dulcobalance® usually takes 24 to 48 hours to work
- In the management of children with constipation, the duration of treatment with Dulcobalance® should not exceed 3 months
- Improvement in the frequency of your bowel movements after taking Dulcobalance® can be maintained by keeping to a healthy lifestyle and diet
- Talk to your pharmacist or doctor if the symptoms worsen or do not improve
If you take more Dulcobalance® than you should
Taking too much Dulcobalance® may cause diarrhoea, stomach pains or vomiting. The diarrhoea usually disappears when treatment is stopped or the dose reduced.
If you suffer from severe diarrhoea or vomiting you should contact a doctor as soon as possible as you may require treatment to prevent loss of salts (electrolytes) due to fluid loss.
If you forget to take Dulcobalance®
Take the next dose as soon as you remember but do not take a double dose to make up for a forgotten dose.
4. Possible side effects
Like all medicines, Dulcobalance® can cause side effects, although not everybody gets them. The side effects that are usually mild and do not last long include:
In children:
Common (may affect up to 1 in 10 people)
- Abdominal (belly) pain
- Diarrhoea which may also cause soreness around the back passage (anus)
Uncommon (may affect up to 1 in 100 people)
- Nausea (feeling sick) or vomiting
- Abdominal (belly) bloating
Not known (frequency cannot be estimated from available data)
- Allergic (hypersensitivity) reactions (rash, hives (urticaria), swelling of the face or throat, breathing difficulties, faintness or collapse)
In adults:
Common (may affect up to 1 in 10 people)
- Abdominal (belly) pain
- Abdominal (belly) bloating
- Nausea (feeling sick)
- Diarrhoea
Uncommon (may affect up to 1 in 100 people)
- Vomiting
- Urgent need to go to the toilet
- Faecal incontinence
Not known (frequency cannot be estimated from available data)
- Low blood levels of potassium which can cause muscle weakness, twitching or abnormal heart rhythm
- Low blood levels of sodium which can cause tiredness and confusion, muscle twitching, fits and coma
- Dehydration caused by severe diarrhoea especially in the elderly
- Symptoms of an allergic reaction such as skin redness, rash, hives (urticaria), swelling of the face or throat, breathing difficulties, faintness or collapse.
Reporting of side effects
If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme.
Website: www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store.
By reporting side effects, you can help provide more information on the safety of this medicine.
5. How to store Dulcobalance®
Keep this medicine out of the sight and reach of children.
Do not take Dulcobalance® after the expiry date which is printed on the base of the carton. The expiry date refers to the last day of that month.
Dulcobalance® does not require any special storage conditions.
Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.
6. Contents of the pack and other information
What Dulcobalance® contains:
The active substance in each sachet is 10 grams of macrogol 4000.
The other ingredients are:
Saccharin sodium (E954) and orange-grapefruit flavour which contains orange and grapefruit essential oils, concentrated orange juice, citral, acetaldehyde, linalol, ethyl butyrate, alpha terpineol, octanal, beta and gamma hexenol, maltodextrin, gum arabic, sorbitol (E420), BHA (E320) and sulphur dioxide (E220).
What Dulcobalance® looks like and contents of the pack
Dulcobalance® is an almost white powder that smells and tastes of orange-grapefruit, for making up into a drink.
Dulcobalance® is available in packs of 10, 20, 50 and 100 sachets. Not all pack sizes may be marketed.
Marketing authorisation holder
MAYOLY PHARMA FRANCE
3 Place Renault
92500 Rueil-Malmaison
France
Manufacturer
MAYOLY INDUSTRIE,
Rue Ethe Virton, 28100 Dreux, France.
This medicinal product is authorised in the Member States of the EEA under the following names: Forlax 10g in Austria, Belgium, Czech Republic, Estonia, France, Germany, Latvia, Lithuania,
Luxemburg, Poland, Portugal, Slovakia, and The Netherlands; Tanilas 10g in Greece, Idrolax in Ireland, Paxabel 10g in Italy, and Dulcobalance in the United Kingdom.
This leaflet was last revised in February 2025.
® Registered trade mark