Abstract
On two groups of subjects, the side effects of constipation as a result of the administration of sevelamer hydrochloride (SV), and its prevention by the co-administration of laxatives were investigated. Patients in group 1 (n=8) were instructed to take a solution of D-sorbitol (SOR) on the first day of SV administration, and then, to take additional SOR depending on the nature of the feces produced. Patients in group 2 (n=7) were basically instructed to not take any laxatives, but on the first day of the appearance of constipation, they were instructed to take picosulfate at bedtime, using a self-conrolled the amount. In both groups, the total score for constipation by questionnaires based on Rome II showed a tendency toward improvement, and the total scores 3 months after administration of SV were significantly decreased, compared to data obtained before the administration of SV in group 1.
Furthermore, the solidity of feces was quantified using a visual analogue scale (VAS) measurement. Although VAS for the solidity of feces from 11 to 20 days, from 61 to 70 days, and from 81 to 90 days were significantly higher than that before taking SV in group 2, there was no change in VAS for the solidity of feces in group 1. However, VAS indicated a tendency for solidity to be markedly increased in group 2 before the beginning of SV to 20 days after its administration, after which VAS scores were slightly decreased from 21 to 30 days, finally reaching a steady state from 31 to 90 days. As a result, co-administration of SOR at the initiation of SV administration, then, taking a self-controlled dose of SOR appears to be effective in preventing constipation induced by SV.
