Citrucel

THE SAFETY OF METHYLCELLULOSE FIBER DURING PREGNANCY OR BREASTFEEDING

The information provided below is for readers based in the United States of America. Readers outside of the United States of America should seek the information from local sources.

THIS MEDICATION IS UNLIKELY TO CAUSE HARM TO YOUR BABY:

The short-term use of methylcellulose fiber is expected to pose a low risk of harm to an infant. Although there is an absence of studies evaluating the safety of methylcellulose fiber during pregnancy, methylcellulose fiber is not absorbed into the body.

What is methylcellulose fiber?

Methylcellulose fiber is a synthetic, soluble fiber supplement or laxative. It is currently available as a generic or brand name medication (Citrucel™). Methylcellulose fiber is most often available as a powder or caplets. One tablespoon of the powder form of methylcellulose fiber is mixed with 8 ounces of water to drink according to the package instructions. For children, 2.5 teaspoons is mixed with 8 ounces of water. Methylcellulose fiber is administered in multiple doses (up to 3 doses) throughout the day for constipation. It is available over-the-counter. 

What is methylcellulose fiber used to treat?

Methylcellulose fiber is used as a daily fiber supplement or to treat occasional constipation lasting more than 1 week in children over 6 years old, adolescents, and adults. Constipation is common in pregnant women. Constipation is defined as having less than three bowel movements per week in addition to hard stool and abdominal bloating. Constipation during pregnancy is treated first by increasing fiber in the diet, moderate exercise, and increasing fluid intake. Bulk forming laxatives and probiotics may also be recommended by your doctor depending on the severity of the constipation and lack of response to first-line treatments. 

Constipation during pregnancy is caused by changes in hormone levels that decrease gastrointestinal movement and increase water absorption in the body. Constipation does not typically cause problems, but long-term constipation can lead to hemorrhoids, fecal impaction, rectal prolapse, and anal fissures. 

How does methylcellulose fiber work?

Methylcellulose fiber is known as a bulk-forming laxative that works by absorbing water in the colon, softening and enlarging the stool, to produce a bowel movement.

If I am using methylcellulose fiber can it harm my baby?

Methylcellulose fiber used for occasional constipation during pregnancy is not expected to pose a risk of harm to a baby. There no studies evaluating the safety of methylcellulose fiber use during pregnancy. However, methylcellulose fiber is not absorbed in the small intestine or into the body. 

Evidence from animal studies with methylcellulose fiber:

There are no studies evaluating the safety of methylcellulose fiber in animals.

Evidence for the risks of methylcellulose fiber in human babies:

Bulk-forming laxatives are not absorbed into the body and have not been associated with a risk of harm to the baby. There are no studies evaluating the safety of methylcellulose fiber in pregnant women. However, other bulk-forming laxatives such as psyllium have not been associated with adverse effects on the developing baby. 

The American College of Obstetricians and Gynecologists notes laxatives may be recommended to treat constipation during pregnancy. Bulk-forming laxatives are the preferred laxative to use in pregnant women. Bulk-forming laxatives may be associated with maternal bloating, gas, or cramping and they may take a few days to start working so they are not recommended for acute symptoms of constipation or fecal impaction. First-line options your doctor may recommend to treat constipation during pregnancy can include increasing fluid intake, exercising, and eating more high-fiber foods. 

Bottom line: There are no studies evaluating the safety of methylcellulose fiber in pregnant women. However, studies of other bulk-forming laxatives have not reported harmful effects on the developing baby. Because methylcellulose fiber is not absorbed into the body, it can used for occasional cases of constipation during pregnancy without posing a risk of harm to a baby.

If I am taking methylcellulose fiber and become pregnant, what should I do?

If you are taking methylcellulose fiber and become pregnant, you should contact your doctor immediately. Your doctor will determine if your medication is medically necessary, or if it should be discontinued until after the birth of your baby.

If I am taking methylcellulose fiber, can I safely breastfeed my baby?

There is no information available on the effects of methylcellulose fiber supplementation on the breastfed baby. Methylcellulose fiber is not absorbed from the gastrointestinal tract into the body, so it is expected to pose a low risk of harm to nursing infants.

Bottom line: Despite a lack of available safety information, methylcellulose fiber is not expected to pose a risk of harm to the nursing infant.

If I am taking methylcellulose fiber, will it be more difficult to get pregnant?

There is no information available on the effect of methylcellulose fiber on reproduction or fertility.

If I am taking methylcellulose fiber, what should I know?

The short-term use of methylcellulose fiber is expected to pose a low risk of harm to an infant. There have been no studies evaluating the safety of methylcellulose supplementation in pregnant and breastfeeding women.

If I am taking any medication, what should I know?

This report provides a summary of the available information about the use of methylcellulose fiber during pregnancy and breastfeeding. Content is from the product label unless otherwise indicated.

You may find Pregistry's expert report about constipation here, and reports about various other digestive health conditions as well as the individual medications used to treat digestive disorders here.   Additional information can also be found in the resources below. 

For more information about methylcellulose fiber during and after pregnancy, contact http://www.womenshealth.gov/ (800-994-9662 [TDD: 888-220-5446]) or check the following links:

GlaxoSmithKline: Citrucel

ACOG: Problems of the Digestive System

Read the whole report
General information

It is very common for women to worry about having a miscarriage or giving birth to a child with a birth defect while they are pregnant. Many decisions that women make about their health during pregnancy are made with these concerns in mind.

For many women these concerns are very real. As many as 1 in 5 pregnancies end in a miscarriage, and 1 in 33 babies are born with a birth defect. These rates are considered the background population risk, which means they do not take into consideration anything about the health of the mom, the medications she is taking, or the family history of the mom or the baby’s dad. A number of different things can increase these risks, including taking certain medications during pregnancy.

It is known that most medications, including over-the-counter medications, taken during pregnancy do get passed on to the baby. Fortunately, most medicines are not harmful to the baby and can be safely taken during pregnancy. But there are some that are known to be harmful to a baby’s normal development and growth, especially when they are taken during certain times of the pregnancy. Because of this, it is important to talk with your doctor or midwife about any medications you are taking, ideally before you even try to get pregnant.

If a doctor other than the one caring for your pregnancy recommends that you start a new medicine while you are pregnant, it is important that you let them know you are pregnant.

If you do need to take a new medication while pregnant, it is important to discuss the possible risks the medicine may pose on your pregnancy with your doctor or midwife. They can help you understand the benefits and the risks of taking the medicine.

Ultimately, the decision to start, stop, or change medications during pregnancy is up to you to make, along with input from your doctor or midwife. If you do take medications during pregnancy, be sure to keep track of all the medications you are taking.