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Active substance(s): MACROGOL 4000

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Dulcobalance – Patient Information Leaflet - Text Version

10 g powder for oral solution in sachet
macrogol 4000

Package Leaflet: Information for the patient
Read all of this leaflet carefully before you start taking this medicine because it contains important
information for you.
• Keep this leaflet. You may need to read it again
• If you have any further questions, ask your pharmacist or doctor
• Talk to your pharmacist or doctor if your symptoms worsen or do not improve
• If a side effect occurs and gets troublesome, or seems serious to you, or if you experience a side
effect not listed in this leaflet, please tell your pharmacist or doctor.
What is in this leaflet:
1. What Dulcobalance® is and what it is used for
2. What you need to know before you take Dulcobalance®
3. How to take Dulcobalance®
4. Possible side effects
5. How to store Dulcobalance®
6. Contents of the pack and other information
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

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
Other medicines and Dulcobalance®
Tell your pharmacist or doctor if you are taking or have recently taken any other medicines,
including medicines obtained without a prescription.
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
Dulcobalance® does not affect your ability to drive or use machines.

Important information about some of the ingredients of Dulcobalance®
If you have been told by your doctor that you have an intolerance to some sugars (sorbitol), contact
your doctor before taking this medicine. This medicine contains a small amount of a sugar called
sorbitol, which is converted to fructose. 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.
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
• 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) pain
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
• Low blood levels of sodium which can cause tiredness and confusion, muscle twitching, fits and
• 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 at 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 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
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
Ipsen Ltd., 190 Bath Road, Slough, Berkshire, SL1 3XE, UK.
Beaufour Ipsen 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, Latvia, Lithuania, Luxemburg, Poland,
Portugal, Slovakia, and The Netherlands; Dulcolax M Balance in Germany, Tanilas 10g in Greece,
Idrolax in Ireland, Paxabel 10g in Italy, and Dulcobalance in the United Kingdom.
This leaflet was last revised in June 2016.
® Registered trade mark

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