Sorbitol

What is Sorbitol

Sorbitol (chemical designation D-glucitol) is a sugar alcohol found naturally in fruits. It is used as a low-calorie sweetener in some sugarless candies and gum and has been studied in the prevention of dental caries.

Similar to some other sugar alcohols, the FDA has approved the label ‘does not promote tooth decay’ for sugar-free foods that contain sorbitol.

Sorbitol  is used as a humectant in some saliva substitutes, as a genitourinary irrigant during transurethral surgical procedures, and as a laxative.

When used for constipation its hyperosmotic laxative effects are equivalent to lactulose, and it is a less expensive alternative; however, it is usually not first line treatment for constipation due to abdominal pain, cramping, and diarrhea.

Use in combination with sodium polystyrene sulfonate for hyperkalemia is not recommended due to reports of bowel necrosis.

It can be used with activated charcoal in some oral overdose or poison ingestions to facilitate the charcoal-toxin complex through the GI tract.

Sorbitol has been recognized by the FDA as GRAS (Generally Recognized As Safe). It was approved by the FDA as a topical bladder irrigant in May 1980. Numoisyn products (lozenges and oral solution) were approved by the FDA in 2006.

Brand Name

  • Numoisyn
  • Saliva Substitute

Indications & Dosage

  • constipation
  • transurethral surgery
  • urologic irrigation
  • xerostomia

Side Effects

  1. abdominal pain
  2. angina
  3. back pain
  4. blurred vision
  5. chills
  6. dehydration
  7. diarrhea
  8. diuresis
  9. dysgeusia
  10. dysphagia
  11. edema
  12. flatulence
  13. GI bleeding
  14. hyperglycemia
  15. hypotension
  16. metabolic acidosis
  17. nausea
  18. pruritus ani
  19. pulmonary edema
  20. rhinitis
  21. seizures
  22. sinus tachycardia
  23. urinary retention
  24. urticaria
  25. vertigo
  26. vomiting

Monitoring Parameters

  • serum electrolytes

Contraindications

  • anuria
  • breast-feeding
  • cardiac disease
  • children
  • Crohn’s disease
  • dehydration
  • diabetes mellitus
  • diverticulitis
  • electrolyte imbalance
  • geriatric
  • heart failure
  • hereditary fructose intolerance
  • hypernatremia
  • hyperosmolar hyperglycemic state (HHS)
  • hyponatremia
  • hypovolemia
  • infants
  • neonates
  • parenteral administration
  • pregnancy
  • pulmonary disease
  • renal disease
  • ulcerative colitis

Interactions

  • Abacavir; Dolutegravir; Lamivudine
  • Abacavir; Lamivudine, 3TC
  • Abacavir; Lamivudine, 3TC; Zidovudine, ZDV
  • Acetaminophen; Hydrocodone
  • Atropine; Difenoxin
  • Atropine; Diphenoxylate
  • Brompheniramine; Guaifenesin; Hydrocodone
  • Brompheniramine; Hydrocodone; Pseudoephedrine
  • Bumetanide
  • Carbinoxamine; Hydrocodone; Phenylephrine
  • Carbinoxamine; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Hydrocodone
  • Chlorpheniramine; Hydrocodone; Phenylephrine
  • Chlorpheniramine; Hydrocodone; Pseudoephedrine
  • Dichlorphenamide
  • Diphenhydramine; Hydrocodone; Phenylephrine
  • Dolutegravir; Lamivudine
  • Doravirine; Lamivudine; Tenofovir disoproxil fumarate
  • Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
  • Ethacrynic Acid
  • Furosemide
  • Guaifenesin; Hydrocodone
  • Guaifenesin; Hydrocodone; Pseudoephedrine
  • Homatropine; Hydrocodone
  • Hydrocodone
  • Hydrocodone; Ibuprofen
  • Hydrocodone; Phenylephrine
  • Hydrocodone; Potassium Guaiacolsulfonate
  • Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
  • Hydrocodone; Pseudoephedrine
  • Lamivudine, 3TC
  • Lamivudine, 3TC; Zidovudine, ZDV
  • Lamivudine; Tenofovir Disoproxil Fumarate
  • Loop diuretics
  • Sodium Polystyrene Sulfonate
  • Torsemide
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