Miralax (polyethylene glycol) alternatives: What can I take instead of Miralax?

Compare Miralax alternatives | Citroma | Milk of Magnesia | Dulcolax | Citrucel | Colace | Natural alternatives | How to switch meds

Constipation is a widespread condition that may impact one’s quality of life. According to the American Gastroenterological Association, approximately 16% of U.S. adults (and 33% of those older than 60 years) experience symptoms of constipation, including infrequent bowel movements, difficulty in passing stools, straining to pass stools, or the feeling of an incomplete bowel movement. 

Miralax (generic name polyethylene glycol 3350 or PEG 3350), an osmotic laxative, treats occasional constipation by attracting water into the colon to ease, hydrate, and soften the stool. For adults, 17 years and older, 17 grams (one capful or one packet) is dissolved into four to eight ounces of water or any hot or cold beverage once daily for up to seven days. Children 16 years or under should consult a primary physician or gastroenterologist for dosing instructions. Miralax typically produces a bowel movement in one to three days without causing gas, bloating, cramping, or sudden urgency, like some laxatives. However, it may result in loose, watery, or more frequent stools.

Miralax was initially approved as a prescription-only medication by the U.S. Food and Drug Administration (FDA) in 1999 and moved to over-the-counter (OTC) status in 2006. It is proven safe and effective in adults aged 17 years and older, including older adults. Miralax should not be used by those allergic to the active ingredient polyethylene glycol and should only be used under the guidance of a healthcare professional for those under age 17, those with kidney disease, or pregnant or breastfeeding women.

What can I take in place of Miralax?

While Miralax may be a good choice for many people, many safe and effective OTC laxatives are available to treat occasional constipation. Laxatives work in different ways, and the effectiveness of each type may vary from person to person. There are four general categories of oral laxatives based on how they relieve constipation symptoms:

• Osmotic agents (such as Miralax) draw water into the colon to help eliminate stool
• Bulk-forming agents (also known as fiber supplements) absorb water to form a soft, bulky stool
• Emollient agents (also known as stool softeners), which wetten and soften the stool to make it easier to eliminate
• Stimulant agents, which trigger contractions of intestinal muscles to eliminate the stool

The following chart provides some examples of these different categories of oral laxatives. Because many over-the-counter laxatives are available (including non-oral preparations such as enemas or rectal suppositories), it’s best to talk to a pharmacist or other healthcare provider about which may be best for each individual.

RELATED: The lowdown on laxatives

Savings on OTC medications require a prescription from your doctor or healthcare provider.

Other alternatives to Miralax

The preceding chart lists the brand names of the most commonly used OTC laxatives. Thousands of generic versions are available for these branded products with various dosage forms (such as tablets, capsules, liquids, powders, etc.)  typically priced much less than the branded versions. Using a SingleCare prescription discount card can help bring costs down even more. For sufferers of chronic constipation, talking to a healthcare professional can help determine the cause of constipation.

Top 5 Miralax alternatives

The following are some of the most common alternatives to Miralax.

1. Citroma (magnesium citrate)

Citroma is an osmotic laxative that treats constipation by increasing fluid in the intestines (similar to Miralax). It comes as a liquid in a ten-ounce bottle, and it is recommended to chill it before drinking to improve the taste. The occasional constipation dosage is typically one bottle as a single dose or in divided doses in 24 hours. The dose may be adjusted based on age, other medical conditions, or response to treatment. Because it is a saline laxative, Citroma usually results in a bowel movement within 30 minutes to three hours. Drinking a full glass of water after taking it is recommended to help prevent side effects such as dehydration. Mild abdominal discomfort, cramps, gas, or nausea may occur when taking Citroma. 

As with other types of laxatives, If Citroma is used too often, it may cause laxative dependence, i.e., reliance on continuing to take a laxative to have a bowel movement. If symptoms of overuse occur (diarrhea, abdominal pain, decreased weight, or weakness), contact a healthcare professional. Citroma should be taken two hours before or two hours after other medicines. 

2. Milk of Magnesia

Milk of Magnesia is another osmotic laxative that works for occasional constipation by drawing water into the intestines. Milk of Magnesia, also known as magnesium hydroxide, may be used to treat the symptoms of heartburn, upset stomach, or indigestion by lowering the amount of acid in the stomach. It comes in several dosage forms: a liquid suspension, tablets, chewable tablets, and liquid-filled gel capsules. The dose is based on age, the medical condition being treated, and the response to treatment. The chewable form should be thoroughly chewed before swallowing. Because it is a suspension, the liquid form should be shaken well before each dose and carefully measured using an accurate measuring cup or spoon. A full glass of water should follow each dose when taking Milk of Magnesia for constipation. Since it is a saline laxative, a bowel movement should be expected sooner than with Miralax – usually within thirty minutes to six hours.

Extended use beyond one week or overuse of Milk of Magnesia may result in side effects such as laxative dependence, ongoing constipation, uncontrolled diarrhea, dehydration, and electrolyte imbalances. Those with kidney disease, a magnesium-restricted diet, or pregnant or breastfeeding women should consult a healthcare professional before using Milk of Magnesia. Because it may interact with certain prescription drugs, ask for a healthcare professional’s advice before taking Milk of Magnesia.

3. Dulcolax (bisacodyl)

Dulcolax is a stimulant laxative used to relieve occasional constipation. Unlike Miralax, It has a dual-action effect by which it hydrates the intestine to soften the stool and stimulates the bowel muscles to move the stool through the colon. Dulcolax is available as an oral tablet, and dosing for those twelve and older is one to three tablets with a full glass of water. Children six to under twelve can take one tablet daily with a full glass of water. Dulcolax generally produces a bowel movement in six to twelve hours

Stimulant laxatives such as Dulcolax may cause side effects, including intestinal straining, vomiting, abdominal discomfort, electrolyte imbalances, dehydration, and watery stools.  The tablets should not be chewed, crushed, or taken within one hour after taking an antacid or drinking milk. Stimulant laxatives are intended for short-term use, and use beyond one week is not recommended. Pregnant or breast-fed women should consult a healthcare professional before using Dulcolax.

An important note: The brand name “Dulcolax” is also used on other non-stimulant laxatives, so ensure the label contains the ingredient “bisacodyl” when looking for the product described in this section.

4. Citrucel (methylcellulose)

Citrucel is a bulk-forming fiber laxative used to treat occasional constipation. It works by increasing the bulk of the stool, which then increases the movement of the intestines. It also increases the water in the stool, making it softer and easier to pass. Citrucel is available as a water-soluble powder and as a tablet. Taking the powdered product without enough liquid (at least eight ounces) may cause choking. 

For those twelve years of age and over, start with two tablets or one heaping tablespoon mixed with at least eight ounces of water or other liquid. Children aged six to eleven years should start with one tablet or two and one-half teaspoons of powder in eight ounces of water or other liquid. The dose for both age groups can be repeated up to three times throughout the day. It may take one to three days before Citrucel starts working; therefore, taking this medication regularly for a few days may be necessary to get the most benefit. Do not take Citrucel for more than seven days unless directed by a healthcare professional, as adverse effects may occur. Citrucel may decrease the absorption of some medications, so it should be taken two hours before or two hours after other medicines. 

5. Colace (docusate)

Colace is an emollient laxative, also known as a stool softener, which allows water and fats to be absorbed into the stool, helping to soften and make it easier to pass. Stool softeners such as Colace, available as a tablet (regular strength or 100 mg) or capsule (half strength or 50 mg), are often the first medication healthcare professionals recommend for treating occasional constipation. 

The recommended dose for those twelve years of age and older, the recommended dose is one to three regular-strength tablets or one to six capsules taken as a single dose, usually at bedtime,  or in divided doses, with a full glass (eight ounces) of water or juice. Children two to under twelve years of age should take one tablet daily at bedtime or one to three capsules with a full glass of water or juice. Colace usually produces a bowel movement in one to three days. Stomach pain, diarrhea, cramping, or other side effects may occur when taking Colace, and women who are pregnant or breastfeeding should consult a healthcare professional before using.

Natural alternatives to Miralax

Natural laxatives and lifestyle changes can help digestive health by increasing stool frequency and consistency. Home treatments often help manage constipation:

1. Drink more water. Being dehydrated can make a person constipated; therefore, it is important to drink plenty of water to stay hydrated.
2. Eat more fiber. Increasing fiber intake increases the bulk and consistency of bowel movements, making them pass easier and faster.
3. Drink coffee, especially caffeinated coffee. For many, drinking coffee can increase the urge to go to the bathroom because coffee stimulates the muscles in the digestive system.
4. Eat probiotic foods, such as yogurt or sauerkraut, or take probiotic supplements, which help create a healthy environment in the gut.
5. Eat prunes. Prunes contain the sugar alcohol sorbitol, which has a laxative effect.
6. Take aloe vera. Aloe vera juice contains several compounds known to act as laxatives. 

How to switch to a Miralax alternative

Osmotic laxatives, such as Miralax, usually start to work in one to three days. Hence, it is best to be patient to determine if it will help. If there is no relief after three days, a different laxative may be tried, such as a bulk-forming or stimulant laxative. It is best to consult a healthcare professional before switching between different types of laxatives to avoid any interactions or complications. In most cases, a person should take only one type of laxative at a time. Only take two laxatives together on the medical advice of a healthcare professional, as there may be an increased risk of side effects.