FLEET ENEMA CHILDREN 66.6ML

Indications

Approved Uses

Relief of occasional constipation, bowel cleansing before rectal examination or procedures

Dosage & Administration

Dosing by Condition

Occasional constipation: administer rectally as a single dose per age/size product (one-half bottle for children 2 to under 5 years; one bottle for children 5 to 11 years) per product labeling; for bowel preparation use only as directed by a clinician. For children <2 years: do not use.

Initial Dose

Children 2-4 years: one-half bottle (approx. 33 mL); Children 5-11 years: one bottle (66 mL) as a single rectal dose

Maintenance Dose

Not applicable - for single-use, as-needed administration only

Maximum Dose

Maximum: 1 enema per 24 hours (do not repeat within 24 hours).

Children's Dosage

Children 5-11 years: one bottle (66 mL) rectally as a single dose or as directed by a doctor; Children 2 to under 5 years: one-half bottle (33 mL); Children under 2 years: not recommended.

Dose Adjustment Notes

Do not use more than 1 enema in 24 hours and do not use repeatedly/prolonged without medical advice; avoid or use extreme caution in renal impairment, dehydration, heart failure, or in patients on nephrotoxic/electrolyte-altering drugs due to risk of serious electrolyte disturbances and acute kidney injury.

How to Take

For rectal use only. Remove protective cap/shield from the tip (tip is pre-lubricated; add water-soluble lubricant if needed). Position child on left side with knees bent (or knee-chest). Gently insert tip into rectum pointing toward the navel. Squeeze bottle steadily until the recommended amount is given (often nearly all contents for a single-dose product). Remove tip and keep child in position until urge to evacuate; expect bowel movement within minutes. Do not force insertion and do not retain longer than necessary.

How to Prepare

Ready-to-use enema; no dilution or mixing. Remove protective cap, lubricate tip if needed, insert gently, and squeeze to administer; single-use only and discard after use.

Side Effects

Common Side Effects

Abdominal cramping, bloating, nausea, rectal irritation/discomfort or mild burning.

Safety & Warnings

Contraindications

Contraindicated in bowel obstruction/ileus or suspected obstruction, perforation, congenital megacolon (Hirschsprung disease), imperforate anus; severe renal impairment; dehydration; and clinically significant pre-existing electrolyte abnormalities (e.g., hyperphosphatemia, hypocalcemia, hypernatremia).

Warnings & Precautions

Do not use in children <2 years; do not exceed 1 dose in 24 hours; avoid use in dehydration, kidney disease/renal impairment, heart failure, or pre-existing electrolyte abnormalities; do not use with nausea/vomiting or severe abdominal pain (possible obstruction); stop and seek medical care if no bowel movement after use or if symptoms of dehydration/weakness occur.

Age Restriction

Not for use in children under 2 years of age.

Drug Interactions

Interaction Severity

MAJOR: Concomitant use with other sodium phosphate-containing laxatives/enemas (additive phosphate load → severe electrolyte disturbances/AKI). MODERATE: Diuretics, ACE inhibitors, ARBs, NSAIDs (increased risk of dehydration/renal impairment and electrolyte abnormalities).

Food Interaction

No clinically significant food interactions (not applicable for rectal single-dose use).

Special Populations

Children

Children 5-11 years: one bottle (66 mL) rectally as a single dose or as directed by a doctor; Children 2 to under 5 years: one-half bottle (33 mL); Children under 2 years: not recommended.

Storage & Patient Advice

Preparation Instructions

Ready-to-use enema; no dilution or mixing. Remove protective cap, lubricate tip if needed, insert gently, and squeeze to administer; single-use only and discard after use.

Missed Dose

Not applicable-used as a single, as-needed dose; do not repeat within 24 hours unless directed by a clinician.

Stopping the Medicine

Safe to stop anytime; intended for single-use as-needed administration only

Patient Counseling

Rectal use only; do not swallow. Use only as directed and do not use more than 1 enema in 24 hours. Age-appropriate use: do not use in children <2 years unless directed by a clinician. Insert applicator gently into rectum and squeeze bottle to deliver dose; expect bowel movement within minutes (typically 2-15 minutes). Stop and seek medical advice if no bowel movement occurs within 30 minutes, if rectal bleeding occurs, or if abdominal pain/nausea/vomiting develops. Do not use for more than 3 days unless advised by a clinician. Ensure adequate hydration; consult a clinician before use in dehydration, kidney disease, heart failure, or if the child is taking medicines that affect kidney function/electrolytes.

Monitoring Requirements

No routine monitoring for one-time occasional use in low-risk patients; in at-risk patients or with repeated/overuse, monitor renal function and serum electrolytes (phosphate, calcium, sodium, potassium) and hydration status.

Pharmacology

Mechanism of Action

Saline/osmotic action: sodium phosphate draws water into the colon, increasing intraluminal volume and softening stool, which stimulates colonic motility and promotes evacuation.

Onset of Action

Typically 1-5 minutes after rectal administration.

Duration of Effect

Intended to produce a single bowel movement; effect typically occurs and is completed within about 30 minutes.

Metabolism

No metabolism in the usual drug sense; phosphate and sodium are inorganic ions handled by physiologic distribution and renal regulation.

Excretion

Primarily eliminated in feces as unabsorbed phosphate/sodium; any absorbed phosphate and sodium are cleared predominantly by the kidneys (urinary excretion).

Protein Binding

Not applicable/none clinically relevant; inorganic phosphate and sodium are not meaningfully described by protein-binding parameters.

Product Information

Available Dosage Forms

Enema (rectal solution).

Composition per Dose

Each 66 mL bottle: Sodium phosphate monobasic 9.5g + Sodium phosphate dibasic heptahydrate 3.5g

OTC Alternatives

Glycerin suppositories (pediatric), polyethylene glycol/macrogol oral laxative, lactulose oral solution, bisacodyl suppositories; non-pharmacologic options include increased fluids/fiber and behavioral measures (age-appropriate).

Gi Condition

Constipation

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