Can You Take Protonix With Miralax?

In our latest question and answer, the pharmacist discusses whether or not Protonix (pantoprazole) can be taken with Miralax.

Question

I take Miralax daily, first thing in the morning. I was prescribed Protonix and I'm supposed to take it 30-60 minutes before breakfast. Can I take Miralax before Protonix, at the same time, or should I take Protonix first? Thank you.

Asked by nick67 On Nov 19, 2022

Answered by
Medical Content Reviewed By HelloPharmacist Staff

Published Nov 22, 2022
Last updated Nov 22, 2022

Key points

  • Miralax doesn't have many listed drug interactions but as a general rule of thumb, it is recommended to separate the administration of other drugs and laxatives to avoid changes in drug absorption.
  • Proton pump inhibitors like Protonix (pantoprazole) should be dosed 30-60 minutes before food and other drugs for optimal absorption.

Answer

While there is no specific interaction between Miralax (polyethylene glycol) and Protonix (pantoprazole), it's generally a good idea to separate the administration of most drugs from laxative products.

Laxatives can sometimes decrease the absorption of other drugs simply based on how they work, which oftentimes includes speeding up how fast the contents of the gastrointestinal tract move, although Miralax is thought to only work by drawing water into the stool.

I couldn't find any documentation or studies that have shown that Miralax decreases the absorption of Protonix in particular, but again, a general rule of thumb is to not take other medications at the same time that you take laxatives.

Additionally, for optimal absorption, proton pump inhibitors, like Protonix, are recommended to be taken on an empty stomach, 30-60 minutes before meals. Therefore, if you are going to take Protonix and Miralax on the same day, I would recommend taking Protonix 30-60 minutes before dosing with Miralax.

How Does Miralax Work?

Miralax contains polyethylene glycol. It is an osmotic laxative that is essentially completely unabsorbed as it moves through the gastrointestinal tract.

Osmotic laxatives like Miralax work by drawing water into the gastrointestinal tract, and also help the stool retain water. This results in softened stool consistency and increased urgency to go to the bathroom.

One of the benefits of Miralax is that, unlike some other laxatives, it isn't thought to cause dependency (i.e., tachyphylaxis).

Miralax has very few reported drug interactions, but as mentioned, there is a chance it could affect the absorption of some drugs if taken at the same time as them. To avoid this potential interaction, you can separate the administration of Miralax by a couple of hours.

Final Words

In your question, it sounds like you will be taking Miralax and Protonix on a daily basis.

You have multiple ways to do this to avoid any sort of absorption issue, but the easiest way may be to take your Protonix first, on an empty stomach, and take your Miralax 30-60 minutes later with breakfast.

I hope this answer your question!

References

  • Protonix Prescribing Information, AccessFDA
  • Polyethylene Glycol, NIH

About the Pharmacist

Dr. Brian Staiger, PharmD

Dr. Brian has been practicing pharmacy for over 11 years and has wide-ranging experiences in many different areas of the profession. From retail, clinical and administrative responsibilities, he's your knowledgeable and go-to source for all your pharmacy and medication-related questions! Feel free to send him an email at Hello@HelloPharmacist.com! You can also connect with Dr. Brian Staiger on LinkedIn.

Recent Questions