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Docusate

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Docusate, Colace

  • See Also
  1. Emollient Laxative
  2. Functional Constipation
  • Indications
  1. Functional Constipation
  2. Cerumen Impaction
  • Mechanism
  1. Emollient Laxative theoretically softens stool
    1. Allow water and fat to penetrate the fecal mass
  2. Effect probably due to induced Secretory Diarrhea
  3. Slow onset of action (24 to 48 hours)
  • Precautions
  1. Do not use longterm
  2. Docusate liquid formulations were recalled in 2016 due to Bacterial contamination
    1. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm511528.htm
  • Efficacy
  1. Some studies suggest Docusate has no greater effect than Placebo
  2. Other, more effective medications are recommended instead for Constipation
  • Dosing
  • Docusate Sodium or Dioctyl sulfosuccinate (Colace)
  1. Onset of action within 24-72 hours
  2. Oral liquid is bitter
    1. Mix with milk or fruit juice to mask taste
  3. Adult (or age >12 years)
    1. Twice daily: 100 mg orally twice daily
    2. Once daily: 200 mg orally at bedtime
    3. Maximum: 400 mg/day
  4. Pediatric
    1. Age <3 years: 10-40 mg/day divided up to four times daily
    2. Age 3 to 6 years: 20-60 mg/day divided up to four times daily
    3. Age 6 to 12 years: 40 to 150 mg/day divided up to four times daily
  1. Adult: 240 mg orally daily
  2. Child: 50-150 mg orally daily
  • Adverse Effects
  1. Risk of hepatotoxicity
  • Safety
  1. Pregnancy Category A
  2. Safe in Lactation
  • Drug Interactions
  1. May also increase absorption of other medications
  2. Mineral Oil
    1. Docusate enhances intestinal Mineral Oil absorption
    2. Do not use Docusate with Mineral Oil preparations
  • Resources
  1. Docusate Sodium (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=eb5e036b-dc1c-4a8d-b2c6-de1395384c57
  • References
  1. Olson (2020) Clinical Pharmacology, Medmaster Miami, p. 94
  2. (2023) Management of Constipation, Presc Lett, #390108