They’re not all the same, and the FDA has some advice that could help avoid side effects.
The FDA says over-the-counter (OTC) laxative drug products that contain granular dosage forms of bulk-forming psyllium ingredients are not safe in light of reports of esophageal obstruction associated with their use.
Not all psyllium products are unsafe. But the FDA advisory does include products in the form of granules that are swallowed dry before drinking liquid; dispersed, suspended, or partially dissolved in liquid prior to swallowing; chewed, partially chewed, or unchewed, and then washed down (or swallowed) with liquid; or sprinkled over food.
Avoid the following forms of psyllium.
Psyllium hydrophilic mucilloid
Psyllium seed (blond)
Psyllium seed husks
Plantago ovata husks (see photo)
The FDA advisory does not apply to psyllium laxatives in nongranular dosage forms, such as powders, tablets, or wafers.
John Russo, Jr., PharmD, is president of The MedCom Resource, Inc. Previously, he was senior vice president of medical communications at www.Vicus.com, a complementary and alternative medicine website.