PRODUCT INFORMATION

Enemeez® contains a delivered dose of 283mg of docusate sodium. This non-irritating formula provides fast, predictable constipation relief typically within 2-15 minutes.1 Enemeez® products have shown to be effective for bowel care needs associated with spinal cord injury or disease and general constipation. Please see label for complete information.

Enemeez® Plus includes 20mg of benzocaine, assisting in the anesthetization of the rectum and lower bowel. The formulation was developed for patients who experience painful bowel movements.

• Fast, predictable results typically in 2-15 minutes.
• Can assist in reducing time spent with patient for dressing/redressing due to episodes of incontinence or fecal discharge.
• Can virtually eliminate episodes of incontinence.3 No mucosal discharge4; helps to maintain healthy skin integrity
• Non-irritating formula. No after-burn.
• Easy rectal usage for patients with reflux issues or nausea.

DOSAGE

Adults and children 12 years of age and older (with adult supervision), one to three units daily. Children under 12 years of age, consult a physician prior to use. Enemeez® is to be used as an enema. Product is not a suppository. Do not take orally.

POSITIONING

• • For best results, lay on left side with knees bent.

Alternate position:

• Administer while seated on the toilet.
• Kneel, then lower head and chest forward until side of face is resting on the surface.

HOW SUPPLIED

Enemeez® and Enemeez® Plus are available in bottles of 30 single use 5mL tubes.

PATIENT COST

• Medicaid coverage: Enemeez® is covered in 78% of the United States by Medicaid, requiring little to no out-of-pocket cost to the patient.
• Private insurance: Many private insurance plans cover the cost of Enemeez®. We recommend that individuals contact their insurance companies and inquire if Enemeez® is on their formulary plan. If it is not, request a prior authorization form, which should be completed and submitted to the insurance company by the prescribing physician. If your insurance company will not cover the Enemeez® products, please phone Enemeez® customer service in regards to entering our patient assistance program.
• VA Federal Supply Schedule: Enemeez® is listed on the VA Federal Supply Schedule and must be requested by brand name. Please consult your healthcare provider.
• Patient Assistance Program: Patients experiencing financial hardship may qualify for our Patient Assistance Program. Please contact Alliance Labs for details.
• Direct Purchase: Contact Alliance Labs at 888.273.9734 or visit www.enemeez.com

WHEN SWITCHING TO ENEMEEZ®

If you have been using a bisacodyl product, please keep in mind that bisacodyl is a stimulant laxative, which irritates the rectal mucosa. Neutrophils can persist in the mucosa for up to 30 hours after insertion of the bisacodyl,5 possibly leading to inflamed rectal mucosa, producing a mucousal discharge. Mucosal discharge may occur up to three (3) days after discontinuing bisacodyl. You should allow time for your body to heal from the use of the bisacodyl product in order to produce an improved bowel movement with the Enemeez® product. With older post injury patients, please allow at least five (5) or more bowel care sessions for the body to acclimate to Enemeez®. If you do not experience an improvement, please phone your physician.

Diet and fluid intake will play an important part in improving your bowel care program with Enemeez®.

FOODS THAT CAN KEEP STOOL SOLID BUT SOFT

Foods that are higher in fiber can absorb liquids, which help make your stool solid, but soft and easy to pass. Examples of high-fiber foods are fresh fruits, vegetables, dried peas, beans, whole grain cereals, and breads. It’s best to get the dietary fiber you need from a variety of food sources. A starting goal of at least 15 grams of fiber each day is recommended as part of a healthy diet.

An increase of fiber is recommended only if it isnecessary to produce a soft-formed stool. It’s a good idea to increase this amount gradually over a 6 week period to prevent a bloated feeling and too much gas. If you can’t eat as much fiber as your healthcare professional suggests, you may want to try fiber supplements or natural vegetable powders, such as psyllium. Remember, if you use fiber to vary the consistency of your stool, you will have more total stool and may need to perform bowel care more often.

DIARRHEA

There are no foods that cause diarrhea in everyone. Some people find fatty, spicy, or greasy foods correlate with diarrhea. Other people report that caffeine found in coffee, tea, cocoa, chocolate, and many soft drinks appear to cause diarrhea. Diarrhea-causing bacteria can contaminate different foods as well. If you have episodes of diarrhea, keep a food record of what you eat and drink to help you identify what you are sensitive to.

IMPORTANT

Not everyone will benefit from a high-fiber diet. You need to recall how much fiber you had in your diet before your injury or disease versus how much you eat now. Speak with your healthcare professional.

ADMINISTRATION

1. Twist off and remove tip.
2. Lubricate tip prior to insertion. Place a few drops of the tube’s liquid content on the shaft prior to insertion.
3. Also apply liquid content or lubricant to the anus before inserting the mini-enema.
4. With steady pressure, gently insert the tube into the rectum with care to prevent damage to the rectal wall. Insert up to the shoulder of the tube.
5. Squeeze to empty the contents.
6. Keep the tube squeezed until it is removed from the rectum.
7. After the contents have been emptied, remove the disposable tube and discard. A small amount of liquid may remain in the unit after use.

WARNINGS

For rectal use only. Drug Interaction Precaution: Do not take this product if you are presently taking mineral oil, unless directed by a doctor.

• Laxative products when abdominal pain, nausea or vomiting are present.
• Laxative products for a period longer than 1 week unless directed by a doctor.

Stop use and ask a physician if you have:

• Rectal bleeding.
• Noticed a sudden change in bowel habits that persist over a period of 2 weeks.
• Failed to have a bowel movement after use. This may indicate a serious condition.

Pregnant or Lactating Women, ask a health professional before use.

Keep out of reach of children. In case of accidental ingestion, get medical help or contact a Poison Control Center immediately.

Diet and Fluid Intake Recommendations

HOW MUCH SHOULD I DRINK EVERYDAY?

You should drink plenty of fluids everyday to keep your body hydrated and stool soft to prevent constipation. A good guideline is 64 ounces everyday (drinks with alcohol or caffeine do not count). If you exercise a lot or the weather is hot, increase fluid intake. Some people may need to limit how much they drink because of their bladder program. Talk with your healthcare provider about a good daily fluid goal that will work for both your bladder program and your bowel care program. Consult your physician regarding your individual needs.

IMPORTANT

Drinks such as coffee, tea, cocoa, and soft drinks contain caffeine, which is a diuretic. Diuretics can cause you to lose more fluid than you drink. Caffeine is also a stimulant. Consider keeping caffeine drinks to a minimum per day.

PREVENTING BOWEL PROBLEMS

• Pay attention to your body, your stool, and your bowel care routine. You know yourself best; you’ll be the first to notice changes that may be important.
• When switching to Enemeez®, change only one component at a time. Give yourself plenty of time to decide if the change has helped. A good rule to follow is to allow at least two weeks with your new bowel care regimen.
• Check-ups are recommended at least once a year. Bring a completed copy of the Bowel Care Record from this guide and review it with your healthcare professional.

WHAT IS A BOWEL CARE RECORD?

A Bowel Care Record helps you and your healthcare professional decide whether your bowel program is working. Every time you do bowel care, write down the results. A bowel care record is included on the reverse side of this information sheet

When making a change to your bowel care program, medical professionals recommend changing one thing at a time and maintaining that change for at least a two week period. The following chart is to help you evaluate your change and to help identify the most appropriate bowel care regimen to maximize your quality of life and minimize the time spent on bowel care.