Micralax Micro-enema is a UK Pharmacy (P) medicine providing a small-volume single-dose rectal enema (5ml per tube) for short-term constipation relief and pre-procedure rectal evacuation.
Each tube combines sodium citrate (osmotic), sodium lauryl sulfoacetate (surfactant), sorbic acid, sorbitol, and glycerol to soften, lubricate, and evacuate stool from the rectum within 5 to 15 minutes.
Available in packs of 12 tubes from Courier Pharmacy under pharmacist supervision.
Micralax Micro-enema is a UK Pharmacy (P) medicine for short-term constipation relief. It comes as a single-dose 5ml tube with an integrated nozzle. Because it works in the rectum, it can help when you need results quickly.
Supplied by: Courier Pharmacy (UK GPhC-registered) with pharmacist support
Suitable for: adults and children (children should follow GP/prescriber advice)
What Micralax is used for
Micralax helps relieve constipation when stool sits low down in the bowel. It can also help empty the rectum before certain procedures. For many people, it’s a useful “get things moving” option when oral laxatives feel too slow.
How Micralax works
Micralax combines ingredients that draw water into the bowel and soften the stool. It also lubricates the area. As a result, the rectum fills slightly and triggers the natural urge to open your bowels.
Here’s what the ingredients do, in plain English:
Sodium citrate and sorbitol pull water into the bowel
Sodium lauryl sulfoacetate helps soften and spread the stool
Glycerol lubricates and supports the softening effect
Sorbic acid helps preserve the solution
How quickly does it work?
Micralax usually works within 5 to 15 minutes. Therefore, it can suit people who need fast relief. In contrast, oral laxatives often take longer. Some take hours, while others can take a day or two.
When Micralax may be a good option
Micralax can help in a few common situations, such as:
Acute constipation with hard stool in the rectum
When oral laxatives feel unsuitable, for example with nausea, vomiting, or swallowing difficulties
Before procedures where a clear rectum helps the exam
When someone is frail or less mobile and needs quicker relief
As an occasional rescue option alongside a longer-term bowel routine
When to consider other options
Micralax is not usually the best choice for ongoing constipation. Repeated rectal treatments can feel uncomfortable. They can also mask the cause of the problem. If you need Micralax often, speak to a pharmacist or GP. They can help you build a plan that prevents constipation in the first place.
Micralax from Courier Pharmacy
Courier Pharmacy supplies Micralax from a UK-registered pharmacy with pharmacist support. You do not need a prescription because it is a Pharmacy (P) medicine. However, we will still check it suits your symptoms. If needed, we can also suggest other options.
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When oral laxatives haven’t worked, when constipation has progressed to faecal loading in the rectum that needs more direct treatment, or when rectal evacuation is needed before a procedure like sigmoidoscopy, a small-volume rectal enema is one of the established options. Micralax is the UK pharmacy-supply micro-enema that has been used for decades for exactly these situations: a 5ml single-dose tube delivering a combination of osmotic and surfactant ingredients to produce a bowel movement within 5 to 15 minutes.
At Courier Pharmacy, we believe healthcare should suit the person, not the marketing budget. Constipation is one of those conditions where the right answer depends on the pattern: lifestyle changes and oral laxatives for most chronic constipation, rectal preparations for stubborn rectal loading, and proper investigation when something doesn’t fit the standard picture. This page covers where Micralax fits, how to use it well, and when other options might suit you better.
Five key takeaways
Micralax Micro-enema is a UK Pharmacy (P) medicine containing sodium citrate, sodium lauryl sulfoacetate, sorbic acid, sorbitol, and glycerol in a 5ml single-dose tube for rectal administration
It works within 5 to 15 minutes through a combination of osmotic effect (drawing water into the rectum) and surfactant action (softening and lubricating the stool)
The main licensed uses are short-term relief of constipation when oral laxatives are unsuitable or have not worked, and evacuation of the rectum before sigmoidoscopy or rectal surgery
Micralax is not a first-line treatment for chronic constipation. Lifestyle measures (fibre, hydration, exercise) and oral laxatives (bulk-forming, osmotic, or stimulant) are usually the appropriate starting point. Micralax has a specific place when these are not enough or when faster, more direct rectal evacuation is needed
It is generally well-tolerated, with the main considerations being correct technique, avoidance of over-use, and recognition that recurrent need for enemas in adult constipation usually means the underlying constipation pattern needs assessment rather than repeated rescue treatment
Why choose Courier Pharmacy for Micralax Micro-enema
At Courier Pharmacy, our whole approach is built around the idea that healthcare should fit the person. For Micralax specifically, that means honest framing: it’s a useful product when used in the right situation, but it’s not the answer to chronic constipation and we’d rather have the conversation about that than sell you a pack of enemas every month. Our service is shaped by the philosophy of Dr Ada Jex-Cori, our brand pharmacist, who has built her practice around accessible, honest, personalised care. Her view is straightforward: you are not broken. The system is the problem. We are here to change that.
Honest framing of where Micralax fits
For patients with acute constipation, faecal loading in the rectum, or specific situations where oral laxatives are unsuitable, Micralax is a genuinely useful product. For pre-procedure rectal evacuation, it is the established UK option. For patients managing occasional constipation episodes alongside good lifestyle and oral medicine, it is a sensible rescue option.
For patients with chronic constipation needing repeated rectal preparations, the conversation needs to be different. Repeated enema use is uncomfortable, undignified, and bypasses the underlying causes. We’d rather work with you on the wider picture (lifestyle, oral medicines, addressing contributing factors, considering whether specialist review is appropriate) than supply enemas indefinitely.
Pharmacist support before and after purchase
Because Micralax is a Pharmacy (P) medicine, you don’t need a prescription, but you do benefit from pharmacist support. Our pharmacist can help with questions about:
Whether Micralax is the right option for your situation, or whether another approach would suit you better
Correct technique for first-time users
Managing side effects or unexpected responses
The wider stepped approach to constipation if you’re dealing with an ongoing pattern
Whether your symptoms warrant GP review
This is free and available before and after purchase. Get in touch if you have any questions.
Care for specific patient groups
We are happy to provide tailored support for:
Patients with limited mobility managing constipation at home or in domiciliary care
Older patients where the safer profile of Micralax compared to phosphate enemas matters
Patients on opioid pain relief where constipation is a recurrent challenge, where we can discuss the wider opioid-induced constipation approach
Patients preparing for sigmoidoscopy or rectal procedures where Micralax has a specific role
Patients with conditions like Crohn’s disease, ulcerative colitis, or after rectal surgery who need particular care; we will be honest if Micralax isn’t the right option and signpost appropriate alternatives
Coordination with your GP and other care
If you have a GP, district nurse, or other healthcare professional involved in your care, we are happy to coordinate. For patients with chronic constipation, a joined-up approach across primary care, pharmacy, and (when needed) gastroenterology produces better outcomes than fragmented care.
Trust earned, not claimed
We are GPhC-regulated, we ground our content in NHS, NICE, BNF, and EMC guidance, and we will tell you honestly if Micralax isn’t the right answer for your situation. We’d rather give you the right advice than a quick sale.
How to buy Micralax Micro-enema from Courier Pharmacy
Micralax Micro-enema is a Pharmacy (P) medicine. Supply through Courier Pharmacy does not require a prescription but is overseen by our pharmacist to ensure the use is appropriate for your situation.
Here is how our service works:
Add Micralax Micro-enema to your basket and complete a quick questionnaire about your symptoms, what you’ve already tried, any current medicines, and any relevant medical conditions
Our pharmacist reviews your answers to confirm Micralax is suitable for you. Where the pharmacist needs to ask additional questions or recommend alternatives, we will do so before completing the supply
Once approved, your order is prepared and dispatched discreetly to your door
Free pharmacist support is available before and after your purchase for any questions
If Micralax isn’t the right product for your situation, we will explain why and suggest alternatives. That might be:
Lifestyle and oral measures if you’ve not yet had a fair trial of these
Bulk-forming laxatives (ispaghula husk) if regular fibre supplementation hasn’t been tried
Stimulant laxatives (senna, bisacodyl) if your motility is the issue
Glycerol suppositories if you want a gentler rectal option for occasional use
A GP appointment if your constipation has red flags (new onset over 50, weight loss, blood in stool, significant change in bowel habit, severe abdominal pain) or if it’s not fitting the standard picture
A different approach entirely if your symptoms suggest IBS, inflammatory bowel disease, or other underlying conditions that need assessment
Our free fortnightly drop-in clinics at Insomnia, Derby run every other week from 12 to 1pm. Bowel health, constipation, IBS, IBD, haemorrhoids, anal fissures, MCAS, hair loss, men’s health, weight management, and the broader conversations about wellbeing are all topics we cover regularly at these sessions. No appointment needed, no charge, no pressure.
Active ingredients in Micralax Microenema
Micralax Micro-enema contains a blend of ingredients that work together in the rectum to soften stool and support a bowel movement. Each single-dose 5ml tube includes sodium citrate and sorbitol, which help draw water into the bowel to soften hard, dry stool. It also contains sodium lauryl sulfoacetate, which helps the liquid spread and lubricate the stool so it passes more comfortably. Glycerol adds further lubrication and a mild water?drawing effect. Micralax also contains sorbic acid, which acts as a preservative to keep the product stable.
What are Micralax microenemas used for?
Where Micralax fits in constipation treatment
Constipation is common, affecting around 10 to 20% of the UK adult population at any given time and a higher proportion at some point during their lifetime. It affects women more than men, and the prevalence increases with age. In care home populations the prevalence reaches 50% or higher.
The treatment of constipation in modern UK practice follows a clear stepped approach, with most patients responding to early-stage interventions and only a minority needing rectal preparations or specialist input.
First-line: lifestyle measures
The foundation of constipation treatment, and the foundation of constipation prevention, is lifestyle. The components that matter most:
Fibre intake: aim for around 30g per day, ideally from food sources. Wholegrain bread, oats, brown rice, beans, lentils, fruit (with skin where appropriate), vegetables, nuts, and seeds are all good sources. Increase gradually rather than suddenly to avoid bloating and wind.
Hydration: 1.5 to 2 litres of fluid per day for most adults, more in hot weather or with heavy exercise. Water is ideal but most non-alcoholic, non-strongly-caffeinated fluids contribute.
Physical activity: regular movement helps bowel motility. Even a 20 to 30 minute walk most days makes a real difference.
Toilet habits: respond to the urge promptly rather than delaying. Use a slightly squatting position (feet on a low footstool) to align the anorectal angle. Keep toilet time short and focused rather than spending extended periods straining.
Address contributing medicines: opioid painkillers, iron supplements, calcium channel blockers, some antidepressants, anticholinergic medicines, and some chemotherapy agents all cause or worsen constipation. If you are on these and constipation is a problem, discuss with the prescriber whether alternatives are appropriate.
For around half of patients with mild to moderate chronic constipation, getting the lifestyle foundation right is enough.
Second-line: bulk-forming laxatives
If lifestyle measures alone are not enough, the first medicine option is usually a bulk-forming laxative. These work by absorbing water and adding bulk to stool, mimicking the effect of dietary fibre.
Ispaghula husk (Fybogel sachets, Ispagel): the most widely used bulk-forming laxative in UK practice
Methylcellulose (Celevac): an alternative bulk-forming option
Bulk-forming laxatives work over days rather than hours. They are not suitable for acute constipation where rapid relief is needed, nor for patients with significant dehydration or bowel obstruction. They need to be taken with plenty of water.
Third-line: osmotic laxatives
If bulk-forming laxatives are not enough or not tolerated, osmotic laxatives are the next step.
Macrogol (Movicol, Laxido, CosmoCol): polyethylene glycol with electrolytes. Generally well-tolerated and effective. Works over 1 to 3 days.
Lactulose (Duphalac, Laevolac): a synthetic sugar that draws water into the bowel and is also fermented by colonic bacteria. Can cause bloating and wind, which limits its tolerance for some patients.
Magnesium hydroxide (Milk of Magnesia): older but still used; caution in renal impairment.
Fourth-line: stimulant laxatives
If osmotic laxatives alone are insufficient, stimulant laxatives can be added or substituted. They work by stimulating colonic motility, typically producing a bowel movement within 6 to 12 hours.
Senna (Senokot): plant-derived, widely used
Bisacodyl (Dulcolax tablets or suppositories): synthetic stimulant
Sodium picosulfate (Dulcolax Pico, Laxoberal): typically used overnight for morning effect
Stimulant laxatives are generally for short-term use rather than continuous daily use, although in specific situations (opioid-induced constipation, longstanding refractory constipation under specialist care) longer-term use is sometimes appropriate.
Specific situations: rectal preparations
For situations where the constipation has progressed to faecal loading in the rectum, where oral medicines are unsuitable or have not worked quickly enough, or where rapid evacuation is needed, rectal preparations come into play.
The options include:
Glycerol suppositories: small, bullet-shaped suppositories that act through osmotic and lubricant effect. Gentle, suitable for many patients including children and pregnancy.
Bisacodyl suppositories: stimulant suppositories with faster, more vigorous action than glycerol. Useful when faster effect is needed.
Micralax Micro-enema (this product): small-volume enema with osmotic and surfactant action. Sits between suppositories (which work more locally on the lower rectum) and larger-volume enemas (which work higher into the colon).
Sodium phosphate enemas (Fleet ready-to-use enema): larger volume enemas with strong osmotic effect. Effective but require caution in older patients, patients with cardiovascular disease, and patients with renal impairment because of phosphate absorption.
Tap water or soap suds enemas: used in some inpatient settings but not standard home practice in the UK
Within the rectal preparations, Micralax has a particular place. It is more substantial than a glycerol or bisacodyl suppository (delivering 5ml of active liquid that can reach further into the rectum), but smaller and gentler than a phosphate enema. The dual osmotic-plus-surfactant mechanism produces effective evacuation without the larger volumes or stronger osmotic pull of phosphate enemas. This makes Micralax a sensible middle-ground choice for many patients with rectal-loading-type constipation.
When specialist input is appropriate
A small proportion of patients have constipation that does not respond well to standard stepped treatment. Refractory constipation may warrant assessment for:
Underlying causes such as hypothyroidism, hypercalcaemia, diabetes, neurological conditions, or pelvic floor dysfunction
Slow-transit constipation, where colonic motility is the dominant problem
Outlet dysfunction (functional defaecation disorders), where the problem is at the pelvic floor and anorectal coordination
Newer prescription agents like prucalopride (a 5-HT4 receptor agonist), linaclotide (a guanylate cyclase-C agonist), or lubiprostone (a chloride channel activator), which are used under specialist guidance
Bowel cancer or other structural pathology, particularly if constipation is new, associated with weight loss, bleeding, or significant change in bowel habit, or in patients over 50
If your constipation pattern doesn't fit, or if it's not responding to sensible stepped treatment, ask for a review rather than continuing to escalate rectal preparations.
How Micralax works
Micralax produces its effect through several complementary mechanisms acting together in the rectum and lower bowel.
Sodium citrate is an osmotic agent. After administration, it draws water from the surrounding tissues into the rectum, increasing the water content of the stool and softening it. The water draws softening effect happens over minutes rather than hours, which is part of why Micralax works quickly.
Sodium lauryl sulfoacetate is a surfactant. Surfactants reduce the surface tension between water and the stool, which allows water to penetrate hard stool more easily and produces a softening and lubricating effect. This is particularly useful when the stool has become hard and dry from prolonged retention.
Sorbitol and glycerol add to the osmotic effect, drawing more water into the rectum, and provide additional lubrication.
Sorbic acid primarily acts as a preservative but also contributes mildly to the osmotic effect.
The combined effect: the stool in the rectum becomes softer, more lubricated, and surrounded by additional fluid. The increase in rectal volume stimulates the stretch receptors in the rectal wall, which trigger the rectal reflex (the urge to defecate). With the stool softened and lubricated, evacuation is much easier and less painful than passing the hardened stool alone would have been.
The effect is essentially local. The active ingredients are not significantly absorbed into the systemic circulation in clinically meaningful amounts, which means Micralax does not produce systemic effects and does not have the drug interactions that systemic laxatives sometimes have.
The onset is typically 5 to 15 minutes, with most patients producing a bowel movement within this time. The effect is single-dose: Micralax produces one bowel movement following administration and does not have a prolonged effect over the following hours. This is in contrast to oral osmotic or stimulant laxatives, which can produce effect over many hours.
How to use Micralax Micro-enema
The information below is a summary for reference. The definitive guide is the patient information leaflet supplied with the product. If you are unsure about any aspect of technique or timing, contact our pharmacist for support.
Preparing for use
Choose a time when you can be near a toilet for the next 30 minutes. Most patients produce a bowel movement within 5 to 15 minutes of administration, but allowing additional time avoids any pressure.
Wash your hands thoroughly with soap and water.
Take a single Micralax tube from the pack. Inspect the tube for any visible damage; do not use if the tube is damaged, leaking, or the seal is broken.
Twist off the cap from the nozzle, or break the seal as directed on the packaging.
A small amount of fluid can be gently squeezed onto the nozzle tip to lubricate the tip before insertion. This makes insertion more comfortable.
Administering the enema
There are two commonly recommended positions:
Lying on your side: lie on your left side with your knees drawn up towards your chest. This position is often the most comfortable and allows the enema to flow naturally into the rectum.
Standing or squatting: stand with one foot raised (on a stool or the edge of the bath) or squat down. This is faster and more convenient but can be less comfortable for some patients.
To administer:
Gently insert the nozzle into the rectum. The nozzle is designed to be inserted to its full length (around 5cm).
Squeeze the tube firmly and steadily to expel the contents into the rectum. Continue squeezing while withdrawing the tube to avoid drawing the fluid back out.
Withdraw the empty tube.
Remain in position (lying on your side or seated) for a few minutes if possible, to give the enema time to begin its effect before the urge to defecate becomes strong. This is not essential but often makes the effect more thorough.
After administration
The urge to defecate usually develops within 5 to 15 minutes. When the urge becomes strong, go to the toilet and pass the resulting bowel movement.
The bowel movement after Micralax is typically a single, complete evacuation. Some patients have a smaller second bowel movement within the next hour or so, but the dominant effect is the initial single evacuation. Micralax does not typically cause prolonged diarrhoea or repeated bowel movements over the following hours.
After the bowel movement, wash your hands thoroughly. Dispose of the used tube safely in household waste (it does not need special disposal).
Frequency and duration of use
For acute constipation: a single tube as needed. If the response is inadequate, a second tube can usually be used after an interval, but if two doses do not produce satisfactory effect, this suggests the cause needs further assessment rather than additional rectal preparations.
For pre-procedure preparation: one to two tubes typically used the day before or morning of the procedure, following the specific instructions from the clinical team.
Repeated use over consecutive days is not recommended without prescriber or pharmacist input. If you find yourself needing Micralax more than occasionally, this suggests the underlying constipation pattern needs review rather than more rectal preparation.
Use in children
Micralax is licensed for use in children, but paediatric use should be guided by a prescriber, GP, or pharmacist with paediatric experience. Childhood constipation often has different underlying drivers (dietary, behavioural, encopresis with overflow soiling, toilet training issues) and over-reliance on rectal preparations can be counterproductive. If you are considering Micralax for a child, contact our pharmacist or your GP for advice on whether it is appropriate and the right dose for the child's age.
Storage
Store at room temperature, below 25°C. Keep tubes in their original packaging until use. Keep out of sight and reach of children. Do not use after the expiry date printed on the pack.
Warnings and precautions
When not to use Micralax
Micralax should not be used in:
Patients with known hypersensitivity to any of the ingredients
Patients with significant rectal or anal pathology where rectal administration would be unsafe (recent rectal surgery, severe haemorrhoids with significant bleeding, severe anal fissure with severe pain, suspected or known rectal cancer requiring assessment, perianal abscess, severe inflammatory bowel disease affecting the rectum)
Patients with intestinal obstruction or suspected obstruction
Patients with severe abdominal pain of unclear cause (acute constipation with abdominal pain warrants medical assessment rather than home treatment)
Children under the age of supervised use without prescriber or GP guidance
When to seek assessment rather than self-treat
The use of Micralax for constipation assumes the constipation is straightforward and the cause is understood. Several patterns warrant medical assessment instead of (or before) home enema use:
Constipation that is new and persistent in a patient over 50, particularly with weight loss, blood in stool, or significant change in bowel habit (red flags for possible bowel cancer)
Constipation associated with significant abdominal pain, vomiting, or abdominal distension (possible obstruction)
Constipation in pregnancy that is not responding to lifestyle and gentle oral measures (specific considerations apply)
Constipation in patients with significant comorbidities including heart failure, kidney disease, liver disease, or active inflammatory bowel disease
Chronic constipation needing repeated rescue treatment (the pattern itself is the signal to assess rather than continue)
Constipation in young children, particularly with associated soiling, behavioural symptoms, or distress
Constipation in older or frail patients where the underlying causes and the safe treatment plan need consideration
If any of these apply, contact your GP or our pharmacist rather than reaching directly for Micralax.
Pregnancy and breastfeeding
The systemic absorption of Micralax is minimal, and the product is generally considered acceptable in pregnancy and breastfeeding when needed. Constipation is very common in pregnancy, and the first-line approach is lifestyle measures, hydration, and gentle oral options (bulk-forming laxatives, lactulose, or macrogol depending on stage and individual situation). Micralax can be used in pregnancy under prescriber or pharmacist guidance when oral options are not sufficient.
Older patients
Micralax is generally well-tolerated in older patients and is sometimes preferred to phosphate enemas because of the lower risk of electrolyte disturbance. Older patients with multiple medicines or significant comorbidities should discuss with the pharmacist before use.
Renal and hepatic impairment
The minimal systemic absorption means Micralax is generally safe in renal and hepatic impairment, in contrast to phosphate enemas which can cause clinically significant electrolyte disturbance in patients with renal impairment.
Sodium content
Each tube contains sodium as part of the active ingredients. The amount is small but is worth noting for patients on strict sodium-restricted diets or with severe heart failure where every milligram counts. For most patients this is not a clinically relevant consideration.
Anticoagulants and bleeding risk
The mechanical act of inserting the nozzle into the rectum carries a small risk of minor bleeding, particularly in patients with haemorrhoids or anal fissures. Patients on anticoagulants (warfarin, DOACs like apixaban, rivaroxaban, edoxaban, dabigatran) should administer with care and use lubrication generously. Significant bleeding is uncommon but contact your prescriber if it occurs.
Skin contact
If any of the solution contacts the skin, wash it off with water. Avoid contact with the eyes; if contact occurs, rinse thoroughly with water.
Side effects of Micralax Micro-enema
Micralax is generally well-tolerated when used appropriately. The side effect profile is mild and largely confined to the immediate area of administration.
Common effects
Sensation of fullness, pressure, or mild discomfort in the rectum during administration and for a few minutes after
Urge to defecate developing within minutes of administration (this is the intended effect rather than a side effect)
Mild abdominal cramping at the time of bowel movement
Mild stinging or burning at the anal margin during or shortly after use, particularly if there are haemorrhoids or fissures present
Less common effects
Minor rectal or anal bleeding, usually small amounts on the toilet paper, more likely if there are pre-existing haemorrhoids or fissures
More substantial cramping in patients who are particularly sensitive
Local irritation of the perianal skin from the solution
Dehydration with repeated frequent use (uncommon with occasional use, more relevant if Micralax is used multiple times per day over consecutive days)
Rare but more significant effects
Allergic reactions to one of the ingredients (rare; would present with rash, itching, swelling around the area)
Rectal injury from inappropriate use of force during insertion (very rare with normal use)
Electrolyte disturbance is unlikely with Micralax because of its small volume and limited absorption (this is more a consideration with phosphate enemas)
Stop and seek advice if
You develop significant rectal bleeding beyond minor blood on the paper
You develop severe abdominal pain after administration
You develop signs of allergic reaction (significant rash, swelling, breathing difficulty)
The expected bowel movement does not happen and you develop signs of obstruction (severe pain, vomiting, abdominal distension)
You find yourself using Micralax repeatedly without resolution of the underlying problem
Yellow Card reporting
Suspected adverse reactions can be reported to the MHRA via the Yellow Card scheme at yellowcard.mhra.gov.uk. Reporting helps build the safety picture for everyone.
Drug interactions with Micralax
Because Micralax acts locally and is not significantly absorbed into the systemic circulation, it does not have clinically significant pharmacological drug interactions with other medicines. You can use Micralax alongside the medicines you are taking without concern for direct drug interaction.
The considerations that do exist are more practical than pharmacological:
Other rectal preparations: do not use Micralax at the same time as another rectal preparation (suppository or enema) without prescriber guidance, because the combined effect may be excessive
Oral laxatives: Micralax can be used alongside ongoing oral laxative treatment if needed, as the mechanisms and timing are different
Medicines causing constipation: opioid painkillers, iron supplements, calcium channel blockers, anticholinergic medicines, some antidepressants, and others contribute to constipation. Micralax addresses the symptom but does not address the underlying cause; if you are repeatedly constipated on these medicines, discuss with the prescriber whether alternatives are appropriate
Anticoagulants: as covered above, use with care because of the small risk of minor rectal bleeding from the mechanical insertion of the nozzle
Frequently asked questions about Micralax Micro-enema
How quickly does Micralax work?
Most patients produce a bowel movement within 5 to 15 minutes of administration. Some respond faster, some take a little longer. Stay near a toilet for the first 30 minutes after use.
Is it painful?
Insertion of the nozzle can feel slightly uncomfortable but should not be painful. If you have haemorrhoids, anal fissures, or other anal problems, there can be mild stinging or burning. Generous lubrication and gentle technique reduce discomfort.
Can I use Micralax instead of oral laxatives?
For chronic constipation, no. Oral laxatives and lifestyle measures should be the foundation. Micralax has a place for acute episodes, faecal loading, situations where oral medicines are unsuitable, and pre-procedure preparation, but is not a replacement for ongoing constipation management.
How often can I use Micralax?
For occasional use as needed. If you find yourself using Micralax more than occasionally, this suggests the underlying constipation pattern needs review rather than more frequent enemas.
Can I use two tubes if one doesn't work?
A second tube can be used after an interval if the response to the first is inadequate. If two doses do not produce satisfactory bowel movement, this suggests the cause needs further assessment rather than additional rectal preparations. Contact our pharmacist or your GP.
Is Micralax suitable for pregnancy?
Generally yes when needed, because the systemic absorption is minimal. The first-line approach to constipation in pregnancy is still lifestyle measures and gentle oral options. Discuss with your prescriber, midwife, or our pharmacist if you are pregnant.
Can children use Micralax?
Micralax is licensed for paediatric use but should be guided by a prescriber, GP, or pharmacist with paediatric experience. Childhood constipation has different drivers from adult constipation and over-reliance on rectal preparations can be counterproductive. Contact our pharmacist or your GP for advice.
Can I use Micralax if I have haemorrhoids?
In most cases yes, with care during insertion. Generous lubrication of the nozzle reduces discomfort. If your haemorrhoids are causing significant bleeding or are very painful, address the haemorrhoids first or discuss with our pharmacist whether a different option would suit better.
Can I use Micralax if I have an anal fissure?
The mechanical insertion can be uncomfortable with an anal fissure, and the goal of fissure treatment is keeping stool soft and bowel movements comfortable rather than using rectal preparations. Discuss with our pharmacist or your GP; usually softening oral laxatives and topical fissure treatments (GTN ointment or diltiazem cream) are the priority.
Can I use Micralax if I have inflammatory bowel disease?
Use with care and ideally under specialist guidance, particularly during active flares of ulcerative colitis or Crohn's disease affecting the rectum. The pharmacist or your gastroenterology team can advise.
Does Micralax cause dependency?
No. Micralax is for short-term use and does not cause dependency in the way that some stimulant laxatives can with very prolonged daily use. The concern is more about whether repeated use is masking a problem that needs assessment.
Does Micralax interact with my medicines?
No clinically significant pharmacological interactions because the active ingredients are not significantly absorbed. You can use Micralax alongside other medicines safely. The exceptions are practical: do not use Micralax at the same time as another rectal preparation, and exercise care if you are on anticoagulants because of the small risk of minor rectal bleeding from nozzle insertion.
What's the difference between Micralax and a phosphate enema (Fleet)?
Micralax is a small-volume enema (5ml) with mild osmotic and surfactant effect. Phosphate enemas (Fleet) are larger volume (typically 130ml) with strong osmotic effect from sodium phosphate. Phosphate enemas are more powerful but require more caution because of the risk of electrolyte disturbance, particularly in older patients, patients with cardiovascular disease, or patients with renal impairment. Micralax is generally the gentler option for routine use.
What's the difference between Micralax and glycerol suppositories?
Glycerol suppositories are smaller, solid suppositories that act on the lower rectum through osmotic and lubricant effect. Micralax delivers active liquid that reaches a little higher into the rectum and includes a surfactant for stool softening. Glycerol suppositories are gentler and often appropriate for the most distal constipation; Micralax is more substantial when there is more significant rectal loading.
Should I use Micralax for pre-procedure bowel preparation?
Yes, this is one of the licensed and established uses. Follow the specific instructions from the clinical team performing your sigmoidoscopy, proctoscopy, or rectal surgery, as the timing and number of tubes may vary by procedure.
How should I store Micralax?
Store at room temperature, below 25°C, in the original packaging. Keep out of sight and reach of children. Do not use after the expiry date printed on the pack.
How do I order Micralax from Courier Pharmacy?
Add the product to your basket on courierpharmacy.co.uk and complete the brief questionnaire. Our pharmacist will review your answers to confirm suitability and dispatch your order. Free pharmacist support is available before and after your order.
More than a prescription: our community
Healthcare shouldn't only happen when you're paying for it. Every fortnight we run free drop-in talks and clinics at Insomnia, Derby, from 12pm to 1pm. Bring a question, bring a friend, bring a stack of bewildering letters from another clinic; we'll sit with you. We cover bowel health, constipation, IBS, haemorrhoids, anal fissures, IBD, MCAS, hair loss, men's health, weight management, and whatever else people bring through the door. No appointment. No cost. No pressure. Learn more about our community talks.
Disclaimer: This article is for information only and isn't a substitute for personal medical advice. Always speak to a qualified prescriber before starting or changing treatment.
How this content was created
Written by the Courier Pharmacy editorial team and reviewed by a GPhC-registered pharmacist. Grounded in the latest NHS, NICE, BNF, EMC, and MHRA guidance, and the real questions patients bring to our drop-in clinics in Derby.
References
[1] Electronic Medicines Compendium (emc) (n.d.) [Title of SmPC as shown on page] – Summary of Product Characteristics (SmPC). Available at: https://www.medicines.org.uk/emc/product/9099/smpc (Accessed: 26 May 2026).
