Posted by Pharmacist Nguyễn Thu Giang – Clinical Pharmacist – Pharmacy Department – Vinmec Times City International General Hospital.
Fortrans is a powdered medication that is mixed with water to create a drinking solution, commonly used for colon cleansing. To ensure effective treatment, patients should follow the instructions provided by their doctor or pharmacist.
1. What is Fortrans?
Fortrans is a powdered medication that is mixed with water to create a drinking solution, commonly used for colon cleansing. The ingredients of the medication include Macrogol 4000 (mainly polyethylene glycol 4000), anhydrous sodium sulfate, sodium bicarbonate, potassium chloride, and sodium saccharin. Macrogol 4000, in particular, is a long, linear polymer that is linked to water molecules by hydrogen bonds. When taken, it increases the fluid volume in the intestines. This fluid is not absorbed but is expelled from the body through the digestive system, thus having a laxative effect. Fortrans is classified as an osmotic laxative.
2. Indications for using Fortrans
Fortrans is indicated for colon cleansing before procedures such as colonoscopy, X-ray imaging, and colon surgery.
However, the medication should not be used in the following cases: dehydration, severe heart failure, advanced colon cancer, or other colon diseases that cause excessive damage to the intestinal lining. It is also contraindicated in patients with or suspected of having intestinal obstruction or paralytic ileus, children under 15 years old due to insufficient clinical data, and in cases of gastrointestinal perforation or a risk of perforation.
3. How to use Fortrans
To ensure the medication works effectively and minimize side effects, patients should use it correctly: dissolve 1 sachet in 1 liter of water, stir thoroughly, and drink. The average dosage is 3-4 liters of the prepared solution. The medication can be taken in one dose or divided into several doses to ensure the required amount of solution:
Dose adjustment: You can drink 2 liters the night before the procedure and 2 liters on the morning of the procedure, or drink 3 liters the night before and 1 liter on the morning of the procedure. The patient should finish drinking the solution 3-4 hours before the procedure. For a single dose: drink 4 liters the night before the procedure, and rest for 1 hour after drinking 2 liters. The recommended drinking pace is 1 - 1.5 liters per hour (i.e., 250ml every 10-15 minutes). However, the doctor may adjust the drinking pace depending on the patient’s clinical condition and any associated diseases.
4. Side effects of using Fortrans
When using the medication, patients may experience some side effects such as nausea, vomiting, bloating. In rare cases, skin rash, hives, swelling, and anaphylaxis (very rare) may occur. Electrolyte imbalances can also occur due to the components of the medication, so great caution should be exercised when using the drug in patients with reduced kidney function, heart failure, or those on diuretics.
In particular, doctors must closely monitor patients who are bedridden, have trouble neurological, and/or movement disorders due to the risk of aspiration pneumonia. These patients should take the medication while sitting and via a gastrostomy tube. Patients with heart failure or kidney failure are at risk of acute pulmonary edema due to sodium overload (due to the sodium content in the medication).
Given these usage precautions, the medication should only be used as prescription and under the supervision of a doctor.
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