Docusate

Pronunciation: (DOCK-you-sate)
Class: Fecal softener, Sulfactant Docusate Sodium (Dioctyl Sodium Sulfosuccinate; DSS)

Trade Names

Colace
- Capsules 50 mg
- Capsules 100 mg
- Liquid 150 mg/15 mL
- Syrup 60 mg/15 mL

Correctol Extra Gentle
- Capsules 100 mg

Diocto
- Liquid 150 mg/15 mL
- Syrup 60 mg/15 mL

Docu
- Liquid 150 mg/15 mL
- Syrup 20 mg/5 mL

Docusil
- Capsules 100 mg

DocuSol Mini-Enema
- Enema 283 mg

DOK
- Tablets 100 mg
- Capsules 100 mg
- Capsules 250 mg

D.O.S.
- Capsules, soft-gel 250 mg

Dulcolax Stool Softener
- Capsules 100 mg

Phillips' Liqui-Gels
- Capsules, soft-gel 100 mg

Silace
- Liquid 150 mg/15 mL
- Syrup 60 mg/15 mL

Apo-Docusate Sodium (Canada)
Selax (Canada)
Soflax (Canada)
ratio-Docusate Sodium (Canada)
Docusate Calcium (Dioctyl Calcium Sulfosuccinate)

Sur-Q-Lax
- Capsules 240 mg

Surfak
- Capsules 240 mg

ratio-Docusate Calcium (Canada)

Pharmacology

Facilitates stool softening by detergent activity.

Pharmacokinetics

Onset

12 to 72 h (oral); 2 to 15 min (enema).

Indications and Usage

Short-term treatment of constipation; prophylaxis in patients who should not strain during defecation (eg, after anorectal surgery, MI); to evacuate the colon for rectal and bowel examinations; prevention of dry, hard stools.

Contraindications

Nausea, vomiting or other symptoms of appendicitis; acute surgical abdomen; fecal impaction; intestinal obstruction; undiagnosed abdominal pain; coadministration with mineral oil; use longer than 1 wk unless directed by health care provider (enema).

Dosage and Administration

Docusate Sodium
Adults and Children older than 12 y

PO 50 to 500 mg. Rectal 1 to 3 units daily.

Children 6 to 12 y of age

PO 40 to 120 mg. Rectal 1 unit daily.

Children 3 to 6 y of age

PO 20 to 60 mg.

Children younger than 3 y

PO 10 to 40 mg.

Docusate Calcium
Adults

PO 240 mg.

Children 6 y and Older and Adults With Minimal Needs

PO 50 to 150 mg.

General Advice

• Administer each dose with full glass of water.
• Do not open or otherwise alter capsules.
• Enema is for rectal use only.
• Lubricate enema tip prior to insertion.

Storage/Stability

Store between 59° and 86°F. Protect liquid preparations from light. Discard enema unit after use.

Drug Interactions

Mineral oil

Docusate may increase absorption of mineral oil from GI tract, leading to toxicity.

Laboratory Test Interactions

None well documented.

Adverse Reactions

Cardiovascular

Palpitations.

CNS

Dizziness, fainting.

GI

Abdominal cramping, bloating, excessive bowel activity (eg, griping, diarrhea, nausea, vomiting), flatulence, perianal irritation.

Miscellaneous

Sweating, weakness.

Precautions

Monitor Evaluate and document patient's response to stool softener, noting any adverse reactions, such as nausea, vomiting, abdominal cramping, or diarrhea.

Pregnancy

Category C .

Lactation

Undetermined.

Children

Rectal

Consult a health care provider before use in children younger than 6 y.

Abuse/dependence

Long-term use may lead to laxative dependence, fluid and electrolyte imbalances, steatorrhea, osteomalacia, and vitamin and mineral deficiencies.

Concomitant laxative use

Do not use other laxatives, especially during the initial phase of therapy for portal-systemic encephalopathy; the resulting loose stools may falsely suggest adequate lactulose dosage.

Fluid and electrolyte imbalance

Excessive laxative use may lead to significant fluid and electrolyte imbalance.

Rectal bleeding or failure to respond

May indicate a serious condition that may require further medical attention.

Patient Information

• Tell patient to drink a full glass of water with each dose.
• Instruct patient to swallow tablets whole and not to chew them.
• Instruct patient not to use mineral oil while taking this drug.
• Teach patient other methods of stimulating regular bowel evacuation: attempt to evacuate bowels at same time each day; drink 6 to 8 full glasses of water; eat a high-fiber diet; exercise daily; respond to urge for bowel movement as soon as possible.
• Explain that liquid forms, excluding syrup, may be mixed with fruit juice or milk to mask unpleasant taste.
• Advise patient to lubricate enema tip prior to insertion with a few drops of water or of the product.
• Advise patients to consult their health care provider if, after using the enema, they fail to have a bowel movement or have rectal bleeding.

Copyright © 2009 Wolters Kluwer Health.