Docusate Salts

Drug class: Antineoplastic Agents

Usage of Docusate Salts

Constipation

Used as stool softeners (emollients) to relieve occasional constipation.

Preferred to bulk-forming laxatives to ease evacuation of feces in constipation associated with hard, dry stools.

Considered the treatment of choice by many clinicians for childhood constipation associated with hard, dry stools and to be safer and more efficacious than mineral oil for conditions in which straining at defecation is to be avoided.

Particularly useful prophylactically for softening stools and preventing painful defecation in patients who have or are about to undergo hemorrhoid surgery or who have other anorectal disorders or when it is desirable to avoid straining at defecation (e.g., following abdominal surgery, recent rectal surgery, or myocardial infarction; in patients with vascular diseases, diseases of the anus or rectum, or hernias; immediately postpartum).

Used as stool softeners for constipation associated with stricture of the colon.

Used to soften fecal impactions. Safer and more efficacious than mineral oil. After softening the impacted feces with a stool softener, stimulant or saline laxatives may be administered rectally to evacuate the impacted colon.

Used in combination with stimulant laxatives (e.g., senna, bisacodyl) for long-term management of opiate-induced constipation.

Relate drugs

How to use Docusate Salts

Administration

Docusate salts are administered orally and the sodium salt also is administered rectally.

Adequate fluid intake facilitates stool softening.

Oral Administration

Administer orally.

Dilution

Oral liquids (not syrups) of docusate sodium should be diluted with 120 mL of milk, fruit juice, or infant formula to mask their bitter taste.

Rectal Administration

The sodium salt of docusate may be administered rectally.

Dosage

Administered in doses only large enough to produce softening of the stools.

Oral dosage varies widely according to the severity of the condition and the response of the patient and should be adjusted to individual response.

Pediatric Patients

Constipation

May be administered in divided doses, but usually one bedtime dose is sufficient.

Initially, doses at the higher end of the dosage ranges may be required.

Oral

Children <2 years of age: Usually, 25 mg (range: 20–50 mg) daily.

Children 2–12 years of age: Usually, 50–150 mg daily.

Children >12 years of age: Usually, 50–360 mg daily.

Oral, Alternative Dosing (e.g., Liquid Formulations)

Children <3 years of age: 10–40 mg daily.

Children 3–6 years of age: 20–60 mg daily.

Children 6–12 years of age: 40–150 mg daily.

Rectal

Add 50–100 mg of docusate sodium as an oral liquid (not syrup) to saline or oil retention enemas for rectal use.

Adults

Constipation Oral

Usually, 50–360 mg daily.

Oral, Alternative Dosing (e.g., Liquid Formulations)

50–500 mg daily.

Rectal

Add 50–100 mg of docusate sodium as an oral liquid (not syrup) to saline or oil retention enemas for rectal use.

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.

    • Warnings/Precautions

    General Precautions

    Chronic Use or Overdosage

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

    Mainly associated with stimulant laxatives, but consider the possibility that laxative dependence, chronic constipation, and loss of normal bowel function could occur with any laxative during long-term use.

    Use of Fixed Combination

    When used in fixed combination with other agents, consider the cautions, precautions, and contraindications associated with the concomitant agents.

    Common Adverse Effects

    Adverse effects are rare. Occasionally, mild, transitory GI cramping pains, diarrhea, or rashes may occur. Irritation of the throat following oral administration of docusate sodium solutions.

    What other drugs will affect Docusate Salts

    GI Drug Absorption

    Docusate salts, which are surface-active agents (surfactants), theoretically may enhance the absorption of many orally administered drugs. The surfactant properties potentially could facilitate transport of other substances across cell walls.

    Some clinicians recommend that stool softeners not be administered concurrently with any oral drugs having low therapeutic indices.

    Specific Drugs

    Drug

    Interaction

    Comments

    Aspirin

    Potentiates aspirin-induced intestinal mucosal damage

    Use concomitantly with caution

    Mineral oil

    Increased GI absorption of mineral oil

    Avoid concomitant use

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