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Medical history: Existing conditions like diabetes, heart disease, or gastrointestinal disorders influence dosing decisions

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NICE Clinical Knowledge Summary (CKS) on constipation in adults recommends a stepwise approach, typically starting with bulk-forming laxatives (such as ispaghula husk) for many adults, with osmotic laxatives (such as macrogol) added or substituted if response is inadequate or stools remain hard

Regardless of which storage method you choose after the first dose, the pen must be used or disposed of within 56 days