Macrogol 3350 (Molaxole) Powder: Supply issue

Affected product

Supply of the following product will be constrained until late May 2025. 

• Chemical: Macrogol 3350 with potassium chloride, sodium bicarbonate and sodium chloride
• Presentation: Powder for oral soln 13.125 g with potassium chloride 46.6 mg, sodium bicarbonate 178.5 mg and sodium chloride 350.7 mg
• Brand: Molaxole
• Pharmacode: 2519887 
• Subsidy: $8.50
• Measure / Qty: per 30

Alternative products

Prescribers, please consider prioritising supply of Molaxole for people taking clozapine, where constipation is a concern (especially for high-risk patients as per the Porirua Protocol). 

Other chemical alternatives

Where macrogol is not available, prescribers may want to consider the following alternatives (links to the NZ Formulary):

• Lactulose – Oral liquid 10g per 15ml(external link)
• Poloxamer – Oral drops 10%(external link)
• Docusate sodium + sennoside B tablets (Laxsol)(external link)
• Docusate sodium (Coloxyl)(external link)
• Sennoside B (Senna) part subsidy with restrictions(external link)
• Glycerol – suppositories 2.8/4.0g(external link)
• Phosphate sodium dibasic + phosphate sodium monobasic (Fleet enema)(external link)
• Sodium acid phosphate – enema 16% with sodium phosphate 8%(external link)
• Sodium citrate with sodium lauryl sulphoacetate(external link) – enema 90mg with sodium lauryl sulphoacetate 9mg per ml, 5ml i.e. Microlax

Alternative macrogol product (arrived mid-May 2025)

We listed an alternative product from 1 April 2025 so people can continue to access this treatment. It has the same active ingredients and flavour as the usual Molaxole brand. This arrived in New Zealand in mid-May 2025, it may take another 1 to 2 weeks to reach pharmacies.

• Brand: APO Health Macrogol
• Measure/Qty: 30 pack 
• Subsidy: $8.50
• Pharmacode: 2702215

This product is not Medsafe-registered. As such, it will need to be prescribed and dispensed in line with section 29 of the Medicines Act.

We have developed a flier to support pharmacists' conversations with affected people. 

Prescribing and supplying an unapproved medicine

Section 29 of the Medicines Act 1981 allows for medicines that are not Medsafe approved to be prescribed and supplied to people. The medicine must be prescribed by someone registered with the Medical Council of New Zealand – such as, a doctor. 

We know supplying a medicine under section 29 is not ideal. In this case, however, this will allow patients to be able to access an appropriate treatment. 

We apologise for any inconvenience this causes. 

Advice for prescribing under section 29 – BPAC website(external link) 

Prescriber and pharmacist requirements for section 29 medicines – Medsafe website (external link)

Medsafe’s section 29 Declaration / Notification Form [DOC](external link)

What patients need to know about unapproved medicines – Healthify website(external link)

Expected resupply

The supplier expects the next shipment of registered Molaxole to arrive by early June 2025. It may take another 1 to 2 weeks for the product to reach pharmacies around the motu.

Who to contact

If you have questions about this issue, email enquiry@pharmac.govt.nz

Please include as much information as you can about the product (presentation, brand, Pharmacode) and who your wholesaler is.

Sign up to our email list for regular emails about supply issues and more(external link)