CLISMALAX*1 ENEMAS 133ML

Clisma lax, rectal solution
Anhydrous monobasic sodium phosphate, dibasic sodium phosphate

What it is and what it is used for
Clisma lax contains the active ingredients anhydrous monobasic sodium phosphate and dibasic sodium phosphate, which belong to a group of medicines called osmotic laxatives.

Clisma lax is a highly concentrated rectal solution that works by drawing water into the site of administration, thereby increasing the volume of intestinal contents. This stimulates peristaltic movements in the intestine, thus facilitating the elimination of faeces.

Clisma lax is used for the short-term treatment of occasional constipation.

Consult your doctor if you do not notice any improvement or if your symptoms worsen after 7 days.

What you need to know before taking the medicine
Do not use Clisma lax:
- if you are allergic to sodium phosphate or any of the other ingredients of this medicine (listed in section 6)
- if you have acute abdominal pain or any pain of unknown origin
- if you have nausea or vomiting
- if you have an intestinal or ano-rectal obstruction or narrowing (stenosis)
- if you have an intestinal blockage due to a real obstruction (mechanical ileus) or only partial (sub-occlusion intestinal)
- if you have an intestinal blockage or a defect in normal intestinal emptying (paralytic ileus)
- if you suffer from inflammatory bowel disorders and other conditions that may increase the absorption of the medicine
- if you have a perforation of the anal wall
- if you suffer from particular bowel problems (colon abnormalities such as Hirschsprung's disease or congenital or acquired megacolon)
- if you suffer from rectal bleeding of unknown cause
- if you have an acute haemorrhoidal crisis with pain and bleeding
- if you are severely dehydrated
- if you suffer from heart disorders or problems
- if you have severe kidney problems (severe renal failure) or high levels of phosphate in your blood (hyperphosphataemia)
- in children under 12 years of age
- if you are taking other medicines containing sodium phosphate (such as oral solutions or tablets)

Warnings and precautions
Consult your doctor or pharmacist before using Clisma lax:
- if the need for a laxative arises from a sudden change in previous bowel habits (frequency and characteristics of bowel movements) that has lasted for more than two weeks or when the use of the laxative fails to produce effects
- if you are elderly or in poor health
- if you suffer from high blood pressure, heart problems, an increase in the volume of abdominal fluid (ascites) or ulcers and fissures of the rectal mucosa
- if you often have problems with bowel movements or if you suffer from chronic constipation.

What you need to know about laxatives:
- prolonged use of a laxative for the treatment of constipation is not recommended
- to treat constipation, medicines should only be an aid to hygiene-dietary treatment (e.g., increased vegetable fibre and fluids in the diet, regular physical activity)
- you should drink at least 6-8 glasses of water, or other liquids, during treatment with laxatives to help soften the faeces
- it is advisable to correct your eating habits by supplementing your diet with more fibre and water during episodes of constipation.

The abuse of laxatives (frequent or prolonged use or excessive doses) can cause:
- persistent diarrhoea with consequent loss of water, mineral salts and other essential substances
- in more severe cases, dehydration or a severe decrease in potassium in the blood may occur, which can lead to heart or nerve and muscle dysfunctions, especially if you are simultaneously taking heart medicines (digitalis), medicines to increase urine production (diuretics) or cortisone (anti-inflammatories)
- a state of dehydration, especially if you are simultaneously taking medicines that modify renal filtration such as diuretics, ACE inhibitors and sartans (drugs for reducing hypertension that act on angiotensin) or NSAIDs (anti-inflammatories)
- an alteration of the levels of some mineral salts in the blood which can manifest with severe kidney problems (renal failure) and muscle stiffness (tetany)
- the need to progressively increase the dosage (dependence)
- chronic constipation
- loss of normal bowel functions (decrease in bowel tone).

Health education notes
First of all, it should be kept in mind that in most cases, a balanced diet rich in water and fibre (bran, vegetables and fruit) can permanently solve the problem of constipation.
Many people think they suffer from constipation if they cannot have a bowel movement every day. This is a misconception, as this situation is completely normal for a large number of individuals.
Instead, constipation occurs when bowel movements are reduced compared to one's personal habits and are associated with the emission of hard faeces.
Consult your doctor if episodes of constipation occur repeatedly.

Children
Do not use Clisma lax in children under 12 years of age.

Possible side effects
Like all medicines, this medicine can cause side effects, although not everybody gets them.

The side effects that may occur with the use of Clisma lax are:
- cramp-like abdominal pains (isolated)
- non-continuous abdominal pain (abdominal colic)
- diarrhoea with loss of fluids and salts, more frequent in cases of severe constipation (difficulty in having a bowel movement)
- redness with burning or pain (irritation) at the rectal level
- nausea and vomiting
- hypersensitivity reactions (e.g. urticaria)
- blisters, itching and burning of the skin

The following side effects occur rarely:
- high levels of phosphate in the blood (hyperphosphataemia)
- high levels of sodium in the blood (hypernatraemia)
- low levels of calcium in the blood (hypocalcaemia)
- low levels of potassium in the blood (hypokalaemia)
- accumulation of calcium (calcification) in the tissues

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 national reporting system at: https://www.aifa.gov.it/content/segnalazionireazioni-avverse.
By reporting side effects you can help provide more information on the safety of this medicine.