Polyethylene glycol: Difference between revisions

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{{Chembox new
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| ImageFile = Polyethylene glycol chemical structure.png
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|   CASNo = 25322-68-3
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|   SMILES =  
 
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| Section2 = {{Chembox Properties
|aOrAn=
|   Formula = C<sub>2n</sub>H<sub>4n+2</sub>O<sub>n+1</sub>
 
|   MolarMass = depends on ''n''
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=====Condition1=====
 
* Dosing Information
 
:* Dosage
 
=====Condition2=====
 
* Dosing Information
 
:* Dosage
 
=====Condition3=====
 
* Dosing Information
 
:* Dosage
 
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* Dosing Information
 
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=====Condition1=====
 
* Developed by:
 
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* Strength of Evidence:
 
* Dosing Information
 
:* Dosage
 
=====Condition2=====
 
There is limited information regarding <i>Off-Label Guideline-Supported Use</i> of {{PAGENAME}} in adult patients.
 
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|offLabelAdultNoGuideSupport=
 
=====Condition1=====
 
* Dosing Information
 
:* Dosage
 
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There is limited information regarding <i>Off-Label Non–Guideline-Supported Use</i> of {{PAGENAME}} in adult patients.
 
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<!--FDA-Labeled Indications and Dosage (Pediatric)-->
 
|fdaLIADPed=
 
=====Condition1=====
 
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There is limited information regarding <i>FDA-Labeled Use</i> of {{PAGENAME}} in pediatric patients.
 
<!--Off-Label Use and Dosage (Pediatric)-->
 
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|offLabelPedGuideSupport=
 
=====Condition1=====
 
* Developed by:
 
* Class of Recommendation:
 
* Strength of Evidence:
 
* Dosing Information
 
:* Dosage
 
=====Condition2=====
 
There is limited information regarding <i>Off-Label Guideline-Supported Use</i> of {{PAGENAME}} in pediatric patients.
 
<!--Non–Guideline-Supported Use (Pediatric)-->
 
|offLabelPedNoGuideSupport=
 
=====Condition1=====
 
* Dosing Information
 
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There is limited information regarding <i>Off-Label Non–Guideline-Supported Use</i> of {{PAGENAME}} in pediatric patients.
 
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=====Cardiovascular=====
 
 
 
=====Digestive=====
 
 
 
=====Endocrine=====
 
 
 
=====Hematologic and Lymphatic=====
 
 
 
=====Metabolic and Nutritional=====
 
 
 
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=====Neurologic=====
 
 
 
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|useInPregnancyFDA=
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|useInPregnancyAUS=
* '''Australian Drug Evaluation Committee (ADEC) Pregnancy Category'''
 
There is no Australian Drug Evaluation Committee (ADEC) guidance on usage of {{PAGENAME}} in women who are pregnant.
 
|useInLaborDelivery=
There is no FDA guidance on use of {{PAGENAME}} during labor and delivery.
 
|useInNursing=
There is no FDA guidance on the use of {{PAGENAME}} with respect to nursing mothers.
 
|useInPed=
There is no FDA guidance on the use of {{PAGENAME}} with respect to pediatric patients.
 
|useInGeri=
There is no FDA guidance on the use of {{PAGENAME}} with respect to geriatric patients.
 
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There is no FDA guidance on the use of {{PAGENAME}} with respect to specific gender populations.
 
|useInRace=
There is no FDA guidance on the use of {{PAGENAME}} with respect to specific racial populations.
 
|useInRenalImpair=
There is no FDA guidance on the use of {{PAGENAME}} in patients with renal impairment.
 
|useInHepaticImpair=
There is no FDA guidance on the use of {{PAGENAME}} in patients with hepatic impairment.
 
|useInReproPotential=
There is no FDA guidance on the use of {{PAGENAME}} in women of reproductive potentials and males.
 
|useInImmunocomp=
There is no FDA guidance one the use of {{PAGENAME}} in patients who are immunocompromised.
 
<!--Administration and Monitoring-->
 
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* Oral
 
* Intravenous
 
|monitoring=
 
There is limited information regarding <i>Monitoring</i> of {{PAGENAME}} in the drug label.
 
* Description
 
<!--IV Compatibility-->
 
|IVCompat=
 
There is limited information regarding <i>IV Compatibility</i> of {{PAGENAME}} in the drug label.
 
<!--Overdosage-->
 
|overdose=
 
===Acute Overdose===
 
====Signs and Symptoms====
 
* Description
 
====Management====
 
* Description
 
===Chronic Overdose===
 
There is limited information regarding <i>Chronic Overdose</i> of {{PAGENAME}} in the drug label.
 
<!--Pharmacology-->
 
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: [[File:{{PAGENAME}}01.png|thumb|none|600px|This image is provided by the National Library of Medicine.]]
 
<!--Pharmacodynamics-->
 
|PD=
 
There is limited information regarding <i>Pharmacodynamics</i> of {{PAGENAME}} in the drug label.
 
<!--Pharmacokinetics-->
 
|PK=
 
There is limited information regarding <i>Pharmacokinetics</i> of {{PAGENAME}} in the drug label.
 
<!--Nonclinical Toxicology-->


==Overview==
|nonClinToxic=
'''Polyethylene glycol''' (PEG) and '''polyethylene oxide''' (PEO) are [[polymer]]s composed of repeating subunits of identical structure, called [[monomers]], and are the most commercially important [[Ether|polyethers]].  Poly ([[ethylene glycol]]) or poly ([[ethylene oxide]]) refers to an [[oligomer]] or polymer of ethylene oxide.  The two names are chemically synonymous, but historically PEG has tended to refer to shorter polymers, PEO to longer.<ref>For example, in the online catalog[http://www.scientificpolymer.com/utils/search.asp] of Scientific Polymer Products, Inc., poly(ethylene glycol) molecular weights run up to about 20,000, while those of poly(ethylene oxide) have 6 or 7 digits.</ref> PEG and PEO are liquids or low-melting solids, depending on their [[molecular weight]]s.  Both are prepared by polymerization of [[ethylene oxide]].  While PEG and PEO with different molecular weights find use in different applications and have different physical properties (e.g. [[viscosity]]) due to chain length effects, their chemical properties are nearly identical.  Derivatives of PEG and PEO are in common use, the most common derivative being the methyl ether (methoxypoly (ethylene glycol)), abbreviated mPEG.


Their melting points vary depending on the Formula Weight of the polymer. PEG or PEO has the following structure:
There is limited information regarding <i>Nonclinical Toxicology</i> of {{PAGENAME}} in the drug label.


:HO-(CH<sub>2</sub>-CH<sub>2</sub>-O)<sub>n</sub>-H
<!--Clinical Studies-->


The numbers that are often included in the names of PEGs and PEOs indicate their average molecular weights, e.g. a PEG with n=80 would have an average molecular weight of approximately 3500 daltons and would be labeled PEG 3500.  Most PEGs and PEOs include molecules with a distribution of molecular weights, i.e. they are polydisperse.  The size distribution can be characterized statistically by its [[weight average molecular weight]] (Mw) and its [[number average molecular weight]] (Mn), the ratio of which is called the [[polydispersity index]] (Mw/Mn).  Mw and Mn can be measured by [[mass spectroscopy]].
|clinicalStudies=


[[PEGylation]] is the act of covalently coupling a PEG structure to another larger [[molecule]], for example, a [[therapeutic protein]] (which is then referred to as '''PEGylated'''). [[PEGylated interferon alfa-2a]] or -2b is a commonly used injectable treatment for [[Hepatitis C]] infection.
There is limited information regarding <i>Clinical Studies</i> of {{PAGENAME}} in the drug label.


PEG is soluble in [[water]], [[methanol]], [[benzene]], [[dichloromethane]] and is insoluble in [[diethyl ether]] and [[hexane]]. It is coupled to hydrophobic molecules to produce non-ionic [[surfactant]]s.
<!--How Supplied-->


==Production==
|howSupplied=
Poly (ethylene glycol) is produced by the interaction of [[ethylene oxide]] with water, [[ethylene glycol]] or ethylene glycol oligomers.[http://chemindustry.ru/Polyethylene_Glycol.php] The reaction is catalyzed by acidic or basic catalysts. Ethylene glycol and its oligomers are preferable as a starting material instead of water, because it allows the creation of polymers with a low [[polydispersity]] (narrow molecular weight distribution). Polymer chain length depends on the ratio of reactants.


'''HOCH<sub>2</sub>CH<sub>2</sub>OH + n(CH<sub>2</sub>CH<sub>2</sub>O) → HO(CH<sub>2</sub>CH<sub>2</sub>O)<sub>n+1</sub>H'''
*


Depending on the catalyst type, the mechanism of polymerization can be cationic or anionic. The anionic mechanism is preferable because it allows one to obtain PEG with a low [[polydispersity]]. [[Polymerization]] of ethylene oxide is an exothermic process. Overheating or contaminating ethylene oxide with catalysts such as alkalis or metal oxides can lead to runaway polymerization which can end with an explosion after few hours.
<!--Patient Counseling Information-->


Polyethylene oxide or high-molecular polyethylene glycol is synthesized by [[suspension polymerization]]. It is necessary to hold the growing polymer chain in solution in the course of the polycondensation process. The reaction is catalyzed by magnesium-, aluminium- or calcium-organoelement compounds. To prevent [[coagulation]] of polymer chains from solution, chelating additives such as [[dimethylglyoxime]] are used.
|fdaPatientInfo=


Alkali catalysts such as [[sodium hydroxide]] NaOH, [[potassium hydroxide]] KOH or [[sodium carbonate]] Na<sub>2</sub>CO<sub>3</sub> are used to prepare low-molecular polyethylene glycol.
There is limited information regarding <i>Patient Counseling Information</i> of {{PAGENAME}} in the drug label.


==Clinical uses== 
<!--Precautions with Alcohol-->
Polyethylene glycol has a low toxicity<ref>{{cite book | author = Victor O. Sheftel | title = Indirect Food Additives and Polymers: Migration and Toxicology | year = 2000 | pages = 1114-1116 | publisher = CRC | url = http://www.mindfully.org/Plastic/Polymers/Polyethylene-Glycols-PEGs.htm}}</ref> and is used in a variety of products. It is the basis of a number of [[laxative]]s (e.g. [[macrogol]]-containing products such as [[Movicol]] and polyethylene glycol 3350, or MiraLax or GlycoLax). It is the basis of many [[skin cream]]s, as ''cetomacrogol'', and [[sexual lubricant]]s, frequently combined with [[glycerin]]. [[Whole bowel irrigation]] (polyethylene glycol with added electrolytes) is used for bowel preparation before [[surgery]] or [[colonoscopy]] and drug overdoses.  It is sold under the brand names '''GoLYTELY''', '''GlycoLax''', '''Fortrans''', '''TriLyte''', and '''Colyte'''.  When attached to various protein [[medication]]s, polyethylene glycol allows a slowed clearance of the carried protein from the blood. This makes for a longer acting medicinal effect and reduces [[toxicity]], and it allows longer dosing intervals. Examples include PEG-[[interferon|interferon alpha]] which is used to treat [[hepatitis C]] and PEG-[[filgrastim]] (Neulasta®) which is used to treat [[neutropenia]].  It has been shown that polyethylene glycol can improve healing of [[vertebral column|spinal]] injuries in dogs.<ref>{{cite news | url = http://seattlepi.nwsource.com/health/202292_spinal04.html | date = 4 December 2004 | title = Study on dogs yields hope in human paralysis treatment | author = Lee Bowman | publisher = seattlepi.com}}</ref> One of the earlier findings that polyethylene glycol can aid in nerve repair came from the University of Texas (Krause and Bittner).<ref>{{cite journal | author = T. L. Krause and G. D. Bittner | title = Rapid Morphological Fusion of Severed Myelinated Axons by Polyethylene Glycol | year = 1990 | journal = [[PNAS]] | volume = 87 | issue = 4 | pages = 1471-1475 | url = http://www.pnas.org/cgi/content/abstract/87/4/1471}}</ref> Polyethylene glycol is commonly used to fuse B-cells with [[myeloma]] cells in [[monoclonal antibody]] production.PEG has recently been proved to give better results in constipation patients than tegaserod.<ref> Di Palma JA et al. Am J Gastroenterol 2007 Sep 102:1964 </ref>


===Research for New Clinical Uses===
|alcohol=
* High-molecular weight PEG, e.g., PEG 8000, is a strikingly potent dietary preventive agent against [[colorectal cancer]] in animal models.<ref>{{cite journal | author = D. E. Corpet, G. Parnaud, M. Delverdier, G. Peiffer and S. Tache | title = Consistent and Fast Inhibition of Colon Carcinogenesis by Polyethylene Glycol in Mice and Rats Given Various Carcinogens | year = 2000 | journal = [[Cancer Res]] | volume = 60 | issue = 12 | pages = 3160-3164 | url = http://cancerres.aacrjournals.org/cgi/content/full/60/12/3160}}</ref>


The [http://www.inra.fr/reseau-nacre/sci-memb/corpet/indexan.html Chemoprevention Database] shows it is the most effective agent to suppress chemical carcinogenesis in rats. Cancer prevention in humans has not yet been tested in clinical trials.
* Alcohol-{{PAGENAME}} interaction has not been established. Talk to your doctor about the effects of taking alcohol with this medication.
* The injection of PEG 2000 into the bloodstream of guinea pigs after spinal cord injury leads to rapid recovery through molecular repair of nerve membranes.<ref>{{cite journal | author = R. B. Borgens and D. Bohnert | title = Rapid recovery from spinal cord injury after subcutaneously administered polyethylene glycol | year = 2001 | journal = [[Journal of Neuroscience Research]] | volume = 66 | issue = 6 | pages = 1179-1186 | doi = 10.1002/jnr.1254}}</ref> The effect of this treatment to prevent [[paraplegia]] in humans after an accident is not known yet.
* Research is being done in the use of PEG to mask antigens on red blood cells. Various research institutes have reported that using PEG can mask antigens without damaging the functions and shape of the cell.


==Other uses==
<!--Brand Names-->
PEG is used in a number of [[toothpaste]]s as a [[dispersant]]; it binds water and helps keep [[Xanthan gum|gum]] uniform throughout the toothpaste.  It is also under investigation for use in [[body armor]]<ref>{{Cite news | author = Tonya Johnson | publisher = [[Military.com]] | title = Army Scientists, Engineers develop Liquid Body Armor | url = http://www.military.com/NewsContent/0,13319,usa3_042104.00.html | date = 21 April 2004}}</ref> and [[tattoo]]s to monitor [[diabetes]].<ref>{{cite news | publisher = [[BBC News]] | date = 1 September 2002 | title = Tattoo to monitor diabetes | url = http://news.bbc.co.uk/2/hi/health/2225404.stm}}</ref> [[Functional group]]s of PEG give [[polyurethane]] [[elastomer]]s their "rubberiness", for applications such as [[foam]]s (foam rubber) and [[fiber]]s ([[spandex]]).  Its backbone structure is analogous to that of [[silicone]], another elastomer.


Since PEG is a flexible, water-soluble polymer, it can be used to create very high [[osmotic pressure]]s (tens of atmospheres).  It also is unlikely to have specific interactions with biological chemicals.  These properties make PEG one of the most useful molecules for applying osmotic pressure in [[biochemistry]] experiments, particularly when using the [[osmotic stress technique]].{{Fact|date=July 2007}}
|brandNames=


PEO (poly (ethylene oxide)) can serve as the separator and [[electrolyte]] [[solvent]] in [[lithium polymer cell]]s. Its low [[diffusion|diffusivity]] often requires high temperatures of operation, but its high viscosity even near its [[melting point]] allows very thin electrolyte layers.  While [[crystallization]] of the polymer can degrade performance, many of the salts used to carry charge can also serve as a [[kinetic barrier]] to the formation of crystals. Such batteries carry greater energy for their weight than other [[lithium ion battery]] technologies.
* ®<ref>{{Cite web | title = | url = }}</ref>


When working with [[phenol]] in a laboratory situation, PEG 300 can be used on phenol skin burns to deactivate any residual phenol.
<!--Look-Alike Drug Names-->


Poly (ethylene glycol) is also commonly used as a polar stationary phase for [[gas chromatography]], as well as a [[heat transfer fluid]] in electronic testers.
|lookAlike=


PEG is included in many or all formulations of the soft drink [[Dr Pepper]], purportedly as an anti-foaming agent.
* A® — B®<ref name="www.ismp.org">{{Cite web  | last =  | first =  | title = http://www.ismp.org | url = http://www.ismp.org | publisher =  | date =  }}</ref>


PEG has also been used to preserve objects which have been salvaged from underwater, as was the case with the warship [[Regalskeppet Vasa|Vasa]] in Stockholm.<ref>Lars-Åke Kvarning, Bengt Ohrelius (1998), ''The Vasa - The Royal Ship'', ISBN 91-7486-581-1, pp. 133-141</ref> It replaces water in wooden objects, which makes the wood dimensionally stable and prevents warping or shrinking of the wood.
<!--Drug Shortage Status-->


PEG is often seen (as a side effect) in mass spectrometry experiments with characteristic fragmentation patterns.
|drugShortage=
}}


In the field of [[microbiology]], PEG precipitation is used to concentrate viruses.
<!--Pill Image-->


PEG is also used in lubricant eye drops. PEG derivatives such as [[narrow range ethoxylate]]s are used as [[surfactant]]s.
{{PillImage
|fileName=No image.jpg|This image is provided by the National Library of Medicine.
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==References==
<!--Label Display Image-->
{{reflist|2}}


==External links==
{{LabelImage
* [http://chemindustry.ru/Polyethylene_Glycol.php polyethylene glycol - chemical product info: properties, production, applications.]
|fileName={{PAGENAME}}11.png|This image is provided by the National Library of Medicine.
}}
 
{{LabelImage
|fileName={{PAGENAME}}11.png|This image is provided by the National Library of Medicine.
}}


==See Also==
<!--Category-->
*[[PEGylation]]


[[Category:Polyethers]]
[[Category:Drug]]
[[Category:Laxatives]]
[[Category:Solvents]]
[[Category:Coolants]]

Revision as of 18:16, 21 April 2015

Polyethylene glycol
Black Box Warning
Adult Indications & Dosage
Pediatric Indications & Dosage
Contraindications
Warnings & Precautions
Adverse Reactions
Drug Interactions
Use in Specific Populations
Administration & Monitoring
Overdosage
Pharmacology
Clinical Studies
How Supplied
Images
Patient Counseling Information
Precautions with Alcohol
Brand Names
Look-Alike Names

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];

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Black Box Warning

Title
See full prescribing information for complete Boxed Warning.
ConditionName:
  • Content

Overview

Polyethylene glycol is a that is FDA approved for the {{{indicationType}}} of . There is a Black Box Warning for this drug as shown here. Common adverse reactions include .

Adult Indications and Dosage

FDA-Labeled Indications and Dosage (Adult)

Condition1
  • Dosing Information
  • Dosage
Condition2
  • Dosing Information
  • Dosage
Condition3
  • Dosing Information
  • Dosage
Condition4
  • Dosing Information
  • Dosage

Off-Label Use and Dosage (Adult)

Guideline-Supported Use

Condition1
  • Developed by:
  • Class of Recommendation:
  • Strength of Evidence:
  • Dosing Information
  • Dosage
Condition2

There is limited information regarding Off-Label Guideline-Supported Use of Polyethylene glycol in adult patients.

Non–Guideline-Supported Use

Condition1
  • Dosing Information
  • Dosage
Condition2

There is limited information regarding Off-Label Non–Guideline-Supported Use of Polyethylene glycol in adult patients.

Pediatric Indications and Dosage

FDA-Labeled Indications and Dosage (Pediatric)

Condition1
  • Dosing Information
  • Dosage
Condition2

There is limited information regarding FDA-Labeled Use of Polyethylene glycol in pediatric patients.

Off-Label Use and Dosage (Pediatric)

Guideline-Supported Use

Condition1
  • Developed by:
  • Class of Recommendation:
  • Strength of Evidence:
  • Dosing Information
  • Dosage
Condition2

There is limited information regarding Off-Label Guideline-Supported Use of Polyethylene glycol in pediatric patients.

Non–Guideline-Supported Use

Condition1
  • Dosing Information
  • Dosage
Condition2

There is limited information regarding Off-Label Non–Guideline-Supported Use of Polyethylene glycol in pediatric patients.

Contraindications

  • Condition1

Warnings

Title
See full prescribing information for complete Boxed Warning.
ConditionName:
  • Content
  • Description

Precautions

  • Description

Adverse Reactions

Clinical Trials Experience

There is limited information regarding Clinical Trial Experience of Polyethylene glycol in the drug label.

Body as a Whole
Cardiovascular
Digestive
Endocrine
Hematologic and Lymphatic
Metabolic and Nutritional
Musculoskeletal
Neurologic
Respiratory
Skin and Hypersensitivy Reactions
Special Senses
Urogenital
Miscellaneous

Postmarketing Experience

There is limited information regarding Postmarketing Experience of Polyethylene glycol in the drug label.

Body as a Whole
Cardiovascular
Digestive
Endocrine
Hematologic and Lymphatic
Metabolic and Nutritional
Musculoskeletal
Neurologic
Respiratory
Skin and Hypersensitivy Reactions
Special Senses
Urogenital
Miscellaneous

Drug Interactions

  • Drug
  • Description

Use in Specific Populations

Pregnancy

Pregnancy Category (FDA):

  • Pregnancy Category


Pregnancy Category (AUS):

  • Australian Drug Evaluation Committee (ADEC) Pregnancy Category

There is no Australian Drug Evaluation Committee (ADEC) guidance on usage of Polyethylene glycol in women who are pregnant.

Labor and Delivery

There is no FDA guidance on use of Polyethylene glycol during labor and delivery.

Nursing Mothers

There is no FDA guidance on the use of Polyethylene glycol with respect to nursing mothers.

Pediatric Use

There is no FDA guidance on the use of Polyethylene glycol with respect to pediatric patients.

Geriatic Use

There is no FDA guidance on the use of Polyethylene glycol with respect to geriatric patients.

Gender

There is no FDA guidance on the use of Polyethylene glycol with respect to specific gender populations.

Race

There is no FDA guidance on the use of Polyethylene glycol with respect to specific racial populations.

Renal Impairment

There is no FDA guidance on the use of Polyethylene glycol in patients with renal impairment.

Hepatic Impairment

There is no FDA guidance on the use of Polyethylene glycol in patients with hepatic impairment.

Females of Reproductive Potential and Males

There is no FDA guidance on the use of Polyethylene glycol in women of reproductive potentials and males.

Immunocompromised Patients

There is no FDA guidance one the use of Polyethylene glycol in patients who are immunocompromised.

Administration and Monitoring

Administration

  • Oral
  • Intravenous

Monitoring

There is limited information regarding Monitoring of Polyethylene glycol in the drug label.

  • Description

IV Compatibility

There is limited information regarding IV Compatibility of Polyethylene glycol in the drug label.

Overdosage

Acute Overdose

Signs and Symptoms

  • Description

Management

  • Description

Chronic Overdose

There is limited information regarding Chronic Overdose of Polyethylene glycol in the drug label.

Pharmacology

There is limited information regarding Polyethylene glycol Pharmacology in the drug label.

Mechanism of Action

Structure

File:Polyethylene glycol01.png
This image is provided by the National Library of Medicine.

Pharmacodynamics

There is limited information regarding Pharmacodynamics of Polyethylene glycol in the drug label.

Pharmacokinetics

There is limited information regarding Pharmacokinetics of Polyethylene glycol in the drug label.

Nonclinical Toxicology

There is limited information regarding Nonclinical Toxicology of Polyethylene glycol in the drug label.

Clinical Studies

There is limited information regarding Clinical Studies of Polyethylene glycol in the drug label.

How Supplied

Storage

There is limited information regarding Polyethylene glycol Storage in the drug label.

Images

Drug Images

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Package and Label Display Panel

{{#ask: Label Page::Polyethylene glycol |?Label Name |format=template |template=DrugLabelImages |mainlabel=- |sort=Label Page }}

Patient Counseling Information

There is limited information regarding Patient Counseling Information of Polyethylene glycol in the drug label.

Precautions with Alcohol

  • Alcohol-Polyethylene glycol interaction has not been established. Talk to your doctor about the effects of taking alcohol with this medication.

Brand Names

Look-Alike Drug Names

Drug Shortage Status

Price

References

The contents of this FDA label are provided by the National Library of Medicine.

  1. ↑ Empty citation (help)
  2. ↑ "http://www.ismp.org". External link in |title= (help)


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