A-3 Revised

1 What is A-3 Revised?

Brand: A-3 Revised, Alocass, Amitiza, Benefiber, Black-Draught, CeraLyte 70, Cholan-HMB, Citrate Of Magnesia, Citrucel, Colace, Colyte, Doc-Q-Lax, Docucal, Dulcolax, Fibercon, Fleet Mineral Oil, GaviLAX, GaviLyte-N with Flavor Pack, GlycoLax, Kristalose, Mag-Gel 600, Metamucil, Nulytely, Phillips Milk of Magnesia, Phospho-Soda, Prepopik, Purge, Reglan, Resource Benefiber, Rite Aid Senna, Senna-S, Senokot, Suprep Bowel Prep Kit, Unifiber

Generic: Oral laxatives

A-3 Revised is an oral laxative, which are drugs used for the relief of constipation by enhancing bowel movements.

These are also used to clean the bowel prior to any surgical procedure and used in conditions to avoid strain like hemorrhoids, fissure, stroke, hypertension etc.

Oral laxatives are present in many forms like solutions, pills, drops, syrups, chewable tablets and powder form. There are different kinds of laxatives based on their mechanism of action.

Bulk-forming laxatives, like polycarbophil and psyllium etc, as their name indicates, work by forming a bulk in the intestines.

They absorb water from the intestine and form a large bulk of waste and watery solution. The presence of bulk in the intestines stimulates the bowel movements.

As these laxatives absorb water and avoid its loss, a modified form of this drug can also be used in the treatment of diarrhea.

Hyperosmotic laxatives work by drawing water from surrounding tissues. This results in the formation of watery soft mass which can be removed with ease.

There are three types of hyperosmotic laxatives, namely polymer, saline, and lactulose.

  • Polymer type is a compound called polyethylene glycol which results in water retention in the stool and maintains its soft consistency.
  • The saline type laxatives result in the quicker emptying of small bowel and stomach
  • The lactulose type is much similar in action to saline one but slower in comparison.

Lubricants, like mineral oil, form a waterproof layer around the wall of the bowel. This avoids water absorption from the bowel and provides a smoother surface for passing for the bowel.

Stimulants are the much more commonly used compounds for self-medication. These drugs stimulate the muscle contraction of intestines and result in quick removal of stool.

Combination laxatives contain more than one type of laxative and provide quick effect. They are associated with more side effects as there are many drugs in these.

2 What to Know Before Using

Before using A-3 Revised, you must know all about the risks and complications associated with it. The decision of starting any new medication or any treatment method is done after the patient has informed the physician of any doubts in his/her mind, and has also been informed of all the details by the physician.

A-3 Revised should be used according to the complete plan by consulting a doctor. Some laxatives are non-prescription drugs and before using those, one should have a good assessment of his/her condition.

Detailed history of a patient is extremely important prior to any medical therapy and in this case it is preferred that a drug is started after it.

Allergies or any history of allergy to any drug, food, preservatives, dyes or animal products, history of drug usage, past medical or surgical procedure should also be kept in the record to predict any drug interaction.

Physical examination should be done before starting this drug so that any physiological or pathological condition with which this drug may interfere may be ruled out.

Age-specific assessment is very important for the safety of a patient. Laxatives should not be given to children younger than 6 years old unless recommended by a doctor.

Mineral oil and stimulants should be avoided as the former may lead to a type of pneumonia if inhaled by accident and the latter causes stomach irritation. 

Elderly, bedridden patients should not be given a mineral oil as it may lead to pneumonia, if inhaled. Stimulants should also be avoided as they cause weakness of bowel wall, dizziness, and lightheadedness, if taken too much.

Use of laxatives in pregnancy is very important as it helps control constipation and avoids unnecessary straining. Bulk-forming and stool softening laxatives are generally used during pregnancy. These compounds contain salts of sodium and other metals which may result in hypertension, so it is important to have regular checkups during their use.

Mineral oils and stimulants are contraindicated in pregnancy. Oils result in decreased absorption of the nutrients in bowel wall of mother and hence decrease the nutrition for the baby while stimulants may cause unwanted contractions in the mother’s uterus and cause discomfort to both baby and mother.

Breastfeeding mothers should also use laxatives with great caution and only after recommendation by the consulting doctor.

Drug interactions may occur when many drugs are used together. Other drugs may enhance or diminish effects of laxatives.

A consulting doctor should be well aware of the drug history of the patient and inform the patient about any possible drug interactions with other drugs.

The use of any antiviral like amantadine, antibiotic like sparfloxacin and histamine agonists may have serious interactions and doctors avoid their usage along with laxatives.

There may also be some drug interactions with anti-psychotics, anti-depressants, antibiotics, antifungals and antimetabolites and a doctor may advise you to use these at separate times than that of laxative.

Alcohol, tobacco and certain types of foods may also result in severe implications.

Other medical problems should be discussed with the doctor as these may interfere or affect the usage of laxatives.

These problems include inflammation in the bowel wall, heart disease, diabetes mellitus type 2, kidney disease, liver disease, rectal bleeding, intestinal blockage, colostomy or ileostomy, hypertension and swallowing difficulty.

3 Proper Usage

For effective and safe usage of A-3 Revised, it is important to follow doctor’s instructions or those printed on manufacturer’s label.

Use medications with water, except chewable tablets, for better working and drink lots of water later on.

Bulk-forming laxatives should be taken with lots of water to provide water for forming a bulk. Stool softening compounds and hyperosmotic laxatives can be taken with milk or juice to improve the flavor.

Saline laxatives show results in 30 minutes or an hour while the lactulose ones work in 24 to 48 hours and polymer compounds work in 2 to 4 days.

Mineral oils should be avoided within 2 hours of meals as they decrease absorption of nutrients and should only be taken at bedtime because they take 6 to 8 hours to work (with the exception of castor oil which works in 2 to 6 hours).

4 Precautions to Take

There are some precautions to provide best conditions for the working of A-3 Revised like:

  • Avoid its use if there is any inflammation in the bowel, for example, appendicitis.
  • Do not take mineral oils near or after a meal for at least two hours.
  • Take stimulants with an empty stomach for its better working.
  • Do not overuse laxatives, as it may lead to dependence on these drugs for bowel movements and may cause damage to muscles, nerves and other tissues of intestines.
  • Make sure that the contents of the laxative are not contraindicated to you. For example, sugar containing laxatives should not be used by diabetics.
  • Allergy to any drug should be revealed to the consulting physician.
  • Storage of drug in a dry environment at room temperature.
  • Keep it away from the reach of children.
  • Regular visits to the doctor should be made to see if the drug is working properly.
  • Consult the doctor if there is any question or any serious problem is suspected.

5 Potential Side Effects

Like any other drug, A-3 Revised is also associated with side effects.

These effects are based on the type of the drug and its other contents:

  • Salt and sugar containing drugs may aggravate hypertension and diabetes.
  • Mineral oils may build up gradually in body’s other tissues and also interfere with absorption of nutrients by the bowel wall.
  • Stimulant laxatives may be associated with dependence, skin rashes and intestinal cramping, belching and nausea.
  • Bulk-forming laxatives can cause intestinal blockage, skin rashes and difficulty in breathing.
  • Hyperosmotic compounds cause cramping, bloating, diarrhea, gas, nausea and increased thirst.
  • Lubricants cause irritation of the skin around the rectum.
  • Stool softeners cause stomach and intestinal cramping.
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