Ispaghula Extract – Uses, Dosage, Side Effects, Interactions

Ispaghula Extract/Psyllium Husk is the husk of the dried ripe seeds of the Plantago psyllium, P. Indica, P. Ovata, and P. Arenaria plants with laxative and cholesterol-lowering activities. The husks contain mucilage that swells on exposure to water and provides an indigestible mucilaginous mass in the intestines, thereby causing lubrication, contraction of the smooth muscles of the intestinal walls, and thus stimulating bowel movement. Psyllium husk is rich in soluble fiber and has a cholesterol-lowering effect.

Synonyms of Psyllium Husk

  • Blond psyllium
  • Blonde psyllium
  • Indian plantain seed
  • Indian psyllium
  • Ispaghul
  • Ispaghula
  • Ispaghula extract
  • Ispaghula husk
  • Ispaghula seed
  • Plantaginis ovatae semen
  • Plantaginis ovatae testa
  • Plantago brunnea seed
  • Plantago fastigiata seed
  • Plantago gooddingii seed
  • Plantago insularis seed
  • Plantago minima seed
  • Psyllium seed, blonde

Mechanism of Action of Ispaghul

Psyllium seeds are comprised of dietary fibre which, when mixed with water forms a gel-like mass that works as a mild laxative. This gel-like mass subsequently moves down a patient’s digestive system and makes stools softer by increasing their water contents. At the same time, psyllium seed lubricates the intestine, which improves the transit of stools. Moreover, as the presence of the gel-like mass increases the stool bulk it also increases the tension and/or the stretch stimulus in the bowel wall which serves to trigger bowel movements.

The dietary fibre of which psyllium husk is comprised is fermented to various degrees by bacteria in the colon, resulting in the production of carbon dioxide, hydrogen, methane, water, and short-chain fatty acids, which are absorbed and brought into the hepatic circulation. In humans, such fiber reaches the large bowel in a highly polymerized form that is fermented to a limited extent, resulting in increased fecal concentration and excretion of short-chain fatty acids.

Indications of Ispaghul

  • Indications include the treatment of patients needing a high fibre regime, perhaps for: (a) the relief of constipation, including constipation in pregnancy and the maintenance of regularity; (b) the management of bowel function in patients with colostomy, ileostomy, hemorrhoids, anal fissure, chronic diarrhea with diverticular disease, irritable bowel syndrome, and ulcerative colitis.
  • Irritable Bowel Syndrome
  • Constipation
  • Dietary Fiber Supplementation
  • Preparations containing psyllium are sold under brand names such as Metamucil (in the US and elsewhere) and Fybogel (in the UK).
  • Psyllium is mainly used as a viscous, soluble dietary fiber, which is not absorbed by the small intestine. The purely mechanical action of psyllium mucilage is to absorb excess water while stimulating normal bowel elimination. Although its main use has been as a laxative, it is more appropriately termed a true dietary fiber and as such can help reduce the symptoms of both constipation and mild diarrhea. The laxative properties of psyllium are attributed to the fiber: it absorbs water and subsequently softens the stool. It does increase flatulence to some degree.

Contraindications of Psyllium Husk

  • are allergic to psyllium fiber or any ingredients of this medication
  • have a blocked intestine
  • have difficulty swallowing
  • have fecal impaction (a large, hard stool that cannot be passed)
  • have nausea, vomiting, fever, or abdominal pain
  • have undiagnosed bleeding from the rectum
  • blocked bowels with decreased peristaltic movement
  • stool blockage of the intestine
  • blockage of the stomach or intestine
  • Allergies to Psyllium

Dosage of Ispaghul

strengths: 3.5 g/3.7 g; 3.4 g/3.7 g; 3.3 g/7 g; 3.4 g/11 g; 4.03 g/6 g; 3.4 g/5.8 g; 3.4 g; 3.4 g/7 g


Daily fiber

  • Adults 19 to 50 years: Male: 38 g/day; Female: 25 g/day
  • Pregnancy: 28 g/day
  • Lactation: 29 g/day


  • 1 to 2 rounded teaspoonfuls, 1 to 2 packets, 1 to 2 wafers, or 5 to 6 capsules orally with 8 ounces of fluid 1 to 3 times a day

Irritable Bowel Syndrome

Daily fiber:

  • Adults 19 to 50 years: Male: 38 g/day; Female: 25 g/day
  • Pregnancy: 28 g/day
  • Lactation: 29 g/day


  • 1 to 2 rounded teaspoonfuls, 1 to 2 packets, 1 to 2 wafers, or 5 to 6 capsules orally with 8 ounces of fluid 1 to 3 times a day

Pediatric Dose for Constipation

Daily fiber

  • Children 1 to 3 years: 19 g/day
  • Children 4 to 8 years: 25 g/day
  • Children 9 to 13 years: Male: 31 g/day; Female: 26 g/day
  • Children 14 to 18 years: Male: 38 g/day; Female: 26 g/day


  • Children 6 to 11 years: 1.25 to 15 g orally per day in divided doses
  • Children greater than or equal to 12 years and adults: 2.5 to 30 g per day in divided doses

Side Effects of Ispaghula Extract

Fibre generally has few side effects.

  • Psyllium can cause bowel obstructions or bezoars if taken without an adequate amount of water.
  • Gas or stomach bloating may also occur.
  • Choking is a hazard if psyllium is taken without adequate water as it thickens in the throat.
  • Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
  • Trouble swallowing.
  • Stomach pain.
  • Bloating.
  • Stomach cramps.

Drug Interactions of Ispaghula Extract

Psyllium husk may interact with following drugs, supplements, & may change the efficacy of drugs

  • aspirin
  • diphenhydramine
  • Calcium 600 D (calcium / vitamin d)
  • CoQ10
  • duloxetine
  • Fish Oil (omega-3 polyunsaturated fatty acids)
  • Glucosamine & Chondroitin with MSM (chondroitin / glucosamine / methylsulfonylmethane)
  • atorvastatin
  • Metamucil (psyllium)
  • Metoprolol Succinate ER
  • polyethylene glycol 3350
  • Probiotic Formula (bifidobacterium infantis / lactobacillus acidophilus)
  • senna
  • montelukast
  • levothyroxine
  • acetaminophen
  • Vitamin B Complex 100 (multivitamin)
  • Vitamin B12 (cyanocobalamin)
  • Vitamin C (ascorbic acid)
  • Vitamin D3 (cholecalciferol)
  • Vitamins (multivitamin)
  • yogurt
  • cetirizine

Pregnancy Category Ispaghula Extract


This medication is considered safe to use during pregnancy.


It is not known if psyllium fibre passes into breast milk. However, this medication is considered safe to use for women who are breast-feeding. The safety and effectiveness of using this medication to lower cholesterol have not been established for children less than 6 years of age. Children 6 to 11 years of age should use the powder form of this medication.


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