THE PLAN

NONPHARMACOLOGIC TREATMENT PHARMACOLOGIC TREATMENT FOR THE PATIENT

FOR THE PATIENT
 Fruits
 Vegetables
 Drink more water per day (~2.7
liters/d)
 Exercise regularly
 Yoga
 Pilates If the patient prefers CRx C-lium Fibre, below is the dosage instructions:
Regular daily intake is recommended. Vitamin and mineral supplements
should be taken 2-3 hours before or after intake of C-Lium FIBRE.
Capsule: Take 5 capsules twice a day. Drink extra glass of water soon
after. Daily water intake should be at least 6-8 glasses per day.
Powder for oral liquid: Take once a day ideally during breakfast. Empty
one (1) sachet in a half glass of water or juice. Stir for 10 seconds only (it is
normal for C-Lium FIBRE powder not to dissolve completely). Drink
immediately and completely thereafter. Follow up with an extra glass of
water. Daily water intake should be at least 6-8 glasses per day.

If the patient prefers a generic psyllium fiber to save money (from

Ritemed), below is the dosage instructions:
Powder sachet: 1 sachet (5.4g) 1-3 times a day with meals. To be taken
immediately after reconstitution

If the patient prefers Methylcellulose (Citrucel caplets), below is the dosage

instructions:
Caplets: 2 caplets up to 6 times/day; not to exceed 12 caplets/day; follow
each dose with 8 oz of water.

Notes:
The patient is advised to take more water while supplementing with bulk-forming laxatives/agents to avoid
obstruction of the esophagus, stomach, small intestine, and colon. Before using this medications, tell your doctor
or pharmacist your medical history, especially of: stomach/intestinal blockage, difficulty swallowing, appendicitis
or symptoms of appendicitis (such as nausea/vomiting, sudden or unexplained stomach/abdominal pain), a
sudden change in bowel habits that lasts for longer than 2 weeks, bleeding from the rectum.
Long-term therapy of these fiber supplements is not a problem.
COMMON ADVERSE EFFECTS:
METHYLCELLULOSE
 Flatulence
 Impaction
 Excessive bowel activity
WARNINGS/PRECAUTIONS/CONTRAINDICATIONS:
METHYLCELLULOSE
 Contraindicated in Hypersensitivity,
bowel obstruction, symptoms of
appendicitis or acute surgical abdomen,
GI ulceration/adhesions, fecal impaction,
dysphagia, rectal bleeding
REFERENCES:
1. https://reference.medscape.com
2. https://www.mims.com/philippines
3. Basic and Clinical Pharmacology 14th Edition
4. Joseph T. DiPiro, Gary C. Yee, L. Michael Posey (editors) - Pharmacotherapy_ A Pathophysiologic Approach-
McGraw-Hill Education (2020)
PSYLLIUM FIBER
 Flatulence
 Abdominal bloating
 Distention
PSYLLIUM FIBER
 For adult use only. Not recommended for children,
pregnant and lactating women.
 Must be taken with at least a full glass of water or other
liquid (8 ounces/240 milliliters) so that it will not swell in
the throat, causing choking. Seek immediate medical
attention if after taking this product you have symptoms
of choking such as: chest pain, vomiting, difficulty
swallowing/breathing.