Package leaflet: Information for the user

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Package leaflet: Information for the user 6.9 g, powder for oral solution Macrogol 3350, sodium chloride, sodium hydrogen carbonate, potassium chloride Read all of this leaflet carefully before you give this medicine to your child because it contains important information for you. - Keep this leaflet. You may need to read it again. - If you have any further questions, ask your doctor or pharmacist. - This medicine has been prescribed for your child. Do not pass it on to others. It may harm them, even if their symptoms are the same as your childs. - If you or your child notice any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. See section 4. What is in this leaflet 1. What is and what it is used for 2. What you need to know before you give 3. How to use 4. Possible side effects 5. How to store 6. Contents of the pack and other information 1. What is and what it is used for is a laxative. This medicine is used to: - treat chronic constipation in children aged 2-11 years. - treat impaction in children from 5 years. Impaction is persistent constipation, where a large volume of stools cause a blockage of the rectum and / or colon. A medicine with a higher dose is recommended for children over the age of. 2. What you need to know before you give Do not give to your child if your doctor has told you that: - your child is allergic to Macrogol 3350, sodium chloride, sodium hydrogen carbonate, potassium chloride, or any of the other ingredients in this medicine (listed in section 6). - your child has a blockage in their intestine. - your child has a perforated gut wall. - your child has a severe inflammatory bowel disease like ulcerative colitis, Crohn's disease or toxic megacolon. Warnings and precautions If your child has heart or kidney problems, an impaired gag reflex or suffers from heart-burn, talk to your doctor before giving. Other medicines and Some medicines, such as medicines for epilepsy, may be less effective during use of CosmoCol Paediatric. Tell your doctor about any other medicines that your child is taking. Do not give your child other medicines within one hour of giving.

Giving with food and drink This medicine can be given at any time with or without food or drink. Pregnancy and breast-feeding can be used during pregnancy and breastfeeding. contains sodium. Each sachet contains 93.87 mg of sodium. To be taken into consideration by patients on a sodium controlled diet. contains sorbitol (E420). If you have been told by your doctor that your child has an intolerance to some sugars, contact your doctor before giving this medicine to your child. 3. How to give Always follow your doctor s instructions when giving this medicine to your child. Check with your doctor or pharmacist if you are not sure. Chronic Constipation: The recommended dose depends on your child s age and their response to treatment. - For children aged 2 to 6 years, start with a dose of 1 sachet each day. - For children aged 7 to 11 years, start with a dose of 2 each day. Your doctor may tell you to increase the number of taken until your child has a soft bowel movement. If the dose needs increasing, do this every other day. Normally, no more than 4 are needed each day. Your child does not need to drink the whole dose at once. If your child prefers, half the dose can be drunk in the morning and half in the evening. Your child will need treatment over a long period of time, at least 6 months. Faecal impaction: Before your child takes for faecal impaction, your doctor must check to confirm that your child has this condition. A treatment course for faecal impaction lasts up to 7 days. The recommended dose is: Age Day 1 Day 2 Day 3 Day 4 Day 5 Day 6 Day 7 5-11 years 4 6 8 10 On each day, doses can be spread out over hours (e.g. 8am 8pm). You will know the medicine has worked when your child passes large volumes of stools and / or watery diarrhoea. Once the medicine has worked, treatment can be stopped. To prevent further problems from faecal impaction, your doctor may advise that you continue to give this medicine to your child. You should give the dose for treating chronic constipation. How to mix - Tear open the sachet and pour the contents into a glass. - Add water until the glass is about a quarter full. - Stir until all the powder has dissolved and the solution is clear or slightly hazy, then give it to your child to drink. Duration of treatment

Chronic constipation: Treatment needs to be for a prolonged period of time, at least 6 months. Faecal impaction: Treatment can be for up to 7 days. If your child takes more than they should Your child may develop excessive diarrhoea. If this occurs, stop your child taking CosmoCol Paediatric and make sure they drink plenty of fluids. If you are worried contact your doctor or pharmacist. If you forget to give Give the dose as soon as you remember. 4. Possible side effects Like all medicines, this medicine can cause side effects, although not everybody gets them. Tell your doctor immediately and stop giving if your child has a serious allergic reaction which causes difficulty in breathing or swelling of the face, lips, tongue or throat. Very common side effects (more than 1 person in 10) stomach pains rumbling stomach Common side effects (more than 1 in 100 but less than 1 in 10 people): diarrhoea feeling sick or being sick pain or discomfort around the bottom If your child is being treated for chronic constipation, diarrhoea will usually improve when the dose is reduced. Uncommon side effects (more than 1 in 1000 but less than 1 in 100 people) feeling bloated wind Rare side effects (less than 1 person in 1000) allergic reactions, which may include, breathlessness or difficulty in breathing. Other side effects reported include: Skin rash (hives), itching, reddening of the skin or a nettle rash, swollen hands, feet or ankles, headaches, indigestion, high or low levels of potassium in the blood. Reporting of side effects If your child gets 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: Malta ADR Report Website: www.medicinesauthority.gov.mt/adrportal United Kingdom Yellow Card Scheme Website: www.mhra.gov.uk/yellowcard

By reporting side effects you can help provide more information on the safety of this medicine. 5. How to store Keep this medicine out of the sight and reach of children. Do not use this medicine after the expiry date which is stated on the sachet and carton. The expiry date refers to the last day of the month. Do not store your above 25 C. Once you have made up in water, if your child cannot drink it straight away, keep it covered and in the fridge (2 8 C). Throw away any solution not used within 24 hours. Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment. 6. Contents of the pack and other information What contains One sachet of contains the following active ingredients: - Macrogol 3350, 6.563 g - Sodium chloride, 0.1754 g - Sodium hydrogen carbonate, 0.0893 g - Potassium chloride, 0.0233 g When the sachet contents are dissolved in quarter of a glass of water, each sachet gives the equivalent of: - Sodium 65 millimoles/litre - Chloride 53 millimoles/litre - Hydrogen carbonate 17 millimoles/litre - Potassium 5.0 millimoles/litre This medicinal product contains sodium, equivalent to 93.87 mg per sachet. The other ingredients are colloidal anhydrous silica, saccharin sodium, orange flavour, and lemon lime flavour. The flavorings contain sorbitol (E420) and alpha-tocopherol (E307). What looks like and contents of the pack is a white powder which comes in a sachet. Boxes of 30, 40, 50, 60 or 100 are available. Marketing Authorisation Holder and Manufacturer Marketing Authorisation Holder: Stirling Anglian Pharmaceuticals Limited Hillington Park Innovation Centre, 1 Ainslie Road, Hillington, Glasgow G52 4RU, United Kingdom Manufacturer: Klocke Pharma-Service GmbH Max-Becker Strasse 6, 76356 Weingarten, Germany

For any information about this medicine, please contact the Marketing Authorisation Holder. This medicinal product is authorised in the Member States of the EEA under the following names: Ireland Iceland Malta United Kingdom Wecol Paediatric This leaflet was last revised in /2015.