Castor Oil

Drug class: Antineoplastic Agents

Usage of Castor Oil

Constipation

Has been used as a stimulant laxative to relieve occasional constipation. However, castor oil usually is avoided for simple constipation because it produces violent purgation.

Use of stimulant laxatives for simple constipation is seldom necessary or desirable.

If a stimulant laxative is used, senna derivatives are preferred.

Stimulant laxatives have been used to treat constipation that occurs following prolonged bed rest or hospitalization.

Stimulant laxatives have been used to treat constipation resulting from diminished colonic motor response in geriatric patients but, because this type of constipation is frequently due to psychological or physical laxative dependence, the Bulk-Forming Laxatives are preferred.

Stimulant laxatives are used to treat constipation occurring secondary to idiopathic slowing of transit time, to constipating drugs, or to irritable bowel or spastic colon syndrome.

Stimulant laxatives have been used to treat constipation in patients with neurologic constipation.

Colonic Evacuation

Used orally to empty the bowel prior to surgery or radiologic, proctoscopic, or sigmoidoscopic procedures, when thorough evacuation is essential.

Usually supplemented with administration of rectal evacuants, such as saline, stimulant, or soapsuds enemas, immediately before radiologic procedures.

Relate drugs

How to use Castor Oil

Administration

Oral Administration

Administer orally.

Emulsions or aromatic or flavored preparations somewhat mask the disagreeable taste of castor oil.

Containers of the emulsion should be shaken before using, and the emulsion may be mixed with 120–240 mL of water, milk, fruit juice, or soft drink before administration.

Dosage

Usually reserved for total colonic evacuation, such as prior to surgery or radiologic, sigmoidoscopic, or proctoscopic procedures.

Pediatric Patients

Constipation

Use in children for occasional constipation generally is avoided.

Colonic Evacuation

To prepare for colonic surgery or radiologic, sigmoidoscopic, or proctoscopic procedures, the patient should receive a residue-free diet 1 day before the surgery or procedure and a cleansing rectal enema (e.g., tap water, soap suds, saline laxative, bisacodyl) on the day of the examination.

Additionally, standardized senna fruit extract may be administered 4 hours after castor oil.

Oral

Administer as a single dose about 16 hours before surgery or procedure.

Children <2 Years of Age: 1–5 mL.

Children 2–11 Years of Age: 5–15 mL for children.

Children ≥12 years of Age: Usually, 15–60 mL.

Adults

Constipation Oral

15 mL, but rarely indicated for occasional constipation.

Colonic Evacuation

To prepare for colonic surgery or radiologic, sigmoidoscopic, or proctoscopic procedures, the patient should receive a residue-free diet 1 day before the surgery or procedure and a cleansing rectal enema (e.g., tap water, soap suds, saline laxative, bisacodyl) on the day of the examination.

Additionally, standardized senna fruit extract may be administered 4 hours after castor oil.

Oral

Administer as a single dose about 16 hours before the surgery or procedure.

15–60 mL.

Special Populations

Hepatic Impairment

No specific dosage recommendations for hepatic impairment.

Renal Impairment

No specific dosage recommendations for renal impairment.

Geriatric Patients

No specific geriatric dosage recommendations.

Warnings

Contraindications

  • In acute abdominal pain, nausea, vomiting, or other symptoms of appendicitis or undiagnosed abdominal pain or rectal bleeding.
  • Intestinal obstruction.
  • Pregnancy or menstruation.

    • Warnings/Precautions

    Warnings

    Chronic Use or Overdosage

    Chronic use or overdosage may produce persistent diarrhea, hypokalemia, loss of essential nutritional factors, and dehydration.

    Factitious diarrhea (i.e., severe, chronic, watery diarrhea, frequently occurring at night and accompanied by abdominal pain, weight loss, nausea, and vomiting).

    Electrolyte disturbances including hypokalemia, hypocalcemia, metabolic acidosis or alkalosis, abdominal pain, diarrhea, malabsorption, weight loss, and protein-losing enteropathy may occur. May require immediate medical intervention with appropriate fluid and electrolyte replacement.

    Electrolyte disturbances may produce vomiting and muscle weakness; rarely, osteomalacia, secondary aldosteronism, and tetany may occur.

    Pathologic changes including structural damage to the myenteric plexus, severe and permanent interference with colonic motility, and hypertrophy of the muscularis mucosae may occur with chronic use.

    Protein-losing enteropathy and steatorrhea can occur.

    “Cathartic colon” with atony and dilation of the colon, especially of the right side, has occurred with habitual use (often for several years) and often resembles ulcerative colitis.

    Specific Populations

    Pregnancy

    Category X.

    Lactation

    Not known whether castor oil or ricinoleic acid is distributed into milk.

    Pediatric Use

    Stimulant laxatives generally avoided in children younger than 6–10 years of age for occasional constipation.

    Used in all age groups for colonic evacuation.

    Common Adverse Effects

    Abdominal discomfort, nausea, cramps, griping, and/or faintness.

    Even at therapeutic doses, excessive irritation of the colon and violent purgation.

    Diarrhea, GI irritation, and fluid and electrolyte depletion.

    May rarely cause pelvic congestion.

    What other drugs will affect Castor Oil

    GI Drug Absorption

    By increasing intestinal motility, can potentially decrease transit time of concomitantly administered oral drugs and thereby decrease their absorption.

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