Fleet Enema

Fleet Enema is an Over-the-Counter (OTC) rectal solution containing monobasic sodium phosphate and dibasic sodium phosphate as its active ingredients, supplied as a ready-to-use, pre-lubricated single-dose bottle. It belongs to the saline/osmotic laxative class of products and is intended for adults and children aged 12 years and above; a separate, lower-strength formulation (“Fleet Enema for Children”) is sold specifically for younger children.

As an OTC product, Fleet Enema is available at pharmacies and through online pharmacies serving Malaysia and Singapore without needing a doctor’s prescription, though it should still be used carefully and only occasionally. Sodium phosphate enemas are well established products, but they are also associated with a genuine, well-documented risk of serious electrolyte disturbance if overused or used in patients who are more vulnerable to this effect, which is why the directions on dose frequency and the precautions below should be followed closely rather than treated as optional.

Fleet Enema is supplied as a single bottle (approximately 133ml, delivering around 118ml of solution) with an attached, pre-lubricated applicator tip. The exact bottle volume, batch number, and expiry date are printed on the packaging and should be checked at the time of purchase.

• Remove the protective cap from the applicator tip; the tip is pre-lubricated, but extra water-based lubricant may be applied if needed.
• Lie on your left side with your knees bent towards your chest.
• Gently insert the tip into the rectum with a slight side-to-side motion — do not force it.
• Slowly squeeze the bottle until most of the liquid has been delivered, then withdraw the tip.
• Try to hold the solution for a few minutes before going to the toilet, if you are able to.
• Do not use a second bottle within the same 24-hour period unless a doctor has told you to.

For adults and children aged 12 years and above, the usual dose is one bottle (approximately 118ml) used as a single rectal dose. This product is not intended for children under 12 years — a separate, lower-strength Fleet Enema for Children product exists for that age group and should be used instead, under the guidance on that product’s own label. Do not use more than one enema in any 24-hour period, and do not use for more than a few days in a row, unless specifically directed by a doctor, because repeated or excessive use of sodium phosphate enemas is linked to a real risk of serious electrolyte disturbance (see Contraindications and Relevant Information).

Store at room temperature, below 25°C, away from direct sunlight and out of the reach and sight of children. Do not use if the seal is broken or damaged before first use.

• Common: Mild abdominal cramping or a feeling of fullness.
• Common: Temporary bloating or gas.
• Common: Mild rectal irritation or discomfort during use.
• Uncommon: Loose stools after the bowel motion.
• Rare/Serious: Signs of an electrolyte disturbance — such as unusual weakness, confusion, muscle cramps or twitching, an irregular heartbeat, marked swelling, or a significant reduction in urination — which require urgent medical attention, particularly in a young child, an elderly person, or anyone with kidney disease.
• Rare/Serious: Rectal bleeding or severe, persistent abdominal pain after use, which should be reported to a doctor promptly.

• Known or suspected bowel obstruction, blockage, or significant narrowing of the bowel.
• Active inflammatory bowel disease (such as ulcerative colitis or Crohn’s disease) or unexplained rectal bleeding.
• Congestive heart failure.
• Moderate to severe kidney (renal) impairment.
• Dehydration, or a diet that severely restricts sodium.
• Known hypersensitivity (allergy) to any ingredient in this product.
• Children under 12 years of age — use the dedicated Fleet Enema for Children product instead, under medical guidance.

• Using this enema together with other laxatives, diuretics (“water tablets”), or medicines that affect kidney function or electrolyte levels can increase the risk of an electrolyte disturbance; tell a doctor or pharmacist about all other medicines being taken before use.
• Repeated or combined use with other phosphate-containing products (including some other bowel-preparation products) should be avoided unless specifically directed by a doctor, as this increases the phosphate load on the body.
• No specific food interactions are known, though drinking plenty of clear fluids after use is generally advisable unless a doctor has advised fluid restriction.

• Read the full directions on the pack before use, even if you have used a similar product before.
• Never use more than one enema in a 24-hour period unless a doctor has told you to.
• Do not use this adult-strength product on a child under 12 years — use the specific children’s version instead.
• Have a toilet nearby and accessible before starting.
• Drink plenty of clear fluids afterwards unless you have been told to limit fluids.
• Contact a doctor if you need to use a laxative product repeatedly over more than a few days, rather than continuing to self-treat.

Precautions: Sodium phosphate enemas such as Fleet Enema have a well-documented risk of serious, and in rare cases fatal, electrolyte disturbance (including low blood sodium, high blood phosphate, and low blood calcium) when overused, used more frequently than directed, or used in patients who are more vulnerable to this effect — particularly young children, elderly or frail patients, anyone with reduced kidney function, anyone who is dehydrated, and anyone taking diuretics or other medicines that affect electrolytes. Never exceed the stated dose or frequency, never force the applicator, and never use this adult-strength product on a child under 12 years. Use in pregnancy or breastfeeding should only be on a doctor’s advice.

When to See a Doctor or Pharmacist: Stop use and seek medical advice if there is no bowel motion within the expected timeframe, if you experience severe or worsening abdominal pain, rectal bleeding, or signs of an electrolyte disturbance (weakness, confusion, muscle cramps, irregular heartbeat, marked swelling, or reduced urination), or if you find yourself needing to use a laxative repeatedly over several days.