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docusate (Colace, DSS, Albert Docusate, Docusate Calcium, docusate sodium, DulcoEase, Phillips Liqui Gels, Silace, Soflax)

 

Classes: Laxatives, Stool Softener

Dosing and uses of Colace, DSS (docusate)

 

Adult dosage forms and strengths

capsule as sodium

  • 50mg
  • 100mg
  • 250mg

capsule as calcium

  • 240mg

tablet

  • 100mg

oral liquid

  • 10mg/mL
  • 50mg/15mL

syrup

  • 60mg/15mL

Enema, Rectal (Sodium)

  • 283 mg (5 mL)

 

Stool Softener

OraL

  • Docusate sodium: 50-300 mg PO once daily or divided doses
  • Docusate calcium: 240 mg PO qDay

RectaL

  • 283 mg/5mL (1 enema) PR once daily to three times daily

 

Pediatric dosage forms and strengths

capsule as sodium

  • 50mg
  • 100mg
  • 250mg

capsule as calcium

  • 240mg

oral liquid

  • 10mg/mL
  • 50mg/15mL

syrup

  • 60mg/15mL

Enema, Rectal (Sodium)

  • 100mg/5mL
  • 283 mg (5 mL)

 

Stool Softener

OraL

  • Docusate sodium
    • <2 years: Safety & efficacy not established
    • 2-12 years: 50-150 mg PO qDay or divided doses
    • >12 years: 50-300 mg PO once daily or divided doses
  • Docusate calcium
    • <12 years: Safety & efficacy not established
    • >12 years: 240 mg PO qDay

RectaL

  • <2 years: Safety & efficacy not established
  • 2-12 years: 100 mg/5 mL (1 enema) PR qDay; alternatively, 283 mg/5 mL (1 enema) PR qDay
  • >12 years: 283 mg/5mL (1 enema) PR once daily to three times daily

 

Colace, DSS (docusate) adverse (side) effects

Frequency not defined

Abdominal cramping

Diarrhea

Excessive bowel activity

Intestinal obstruction

Throat irritation

 

Warnings

Contraindications

Hypersensitivity

Intestinal obstruction, symptoms of appendicitis or acute abdominal pain, fecal impaction

Concomitant use of mineral oiL

Nausea or vomiting

Use for longer than 7 days when self-medicating

 

Cautions

Electrolyte imbalance may occur with excessive use

Excessive use may result in dependence

Enema is for rectal use only; lubricate prior to insertion; discontinue use and notify health care professional if irritation occurs around the anus/rectal or if resistance is encountered with insertion; injury or damage to the rectum can occur if tube forced

Prior to OTC use, patient should contact healthcare professional if stomach pain, nausea, or vomiting are present, or if a sudden change in bowel habits occurs and persists over 14 days

Patient should discontinue use and notify healthcare professional if bleeding occurs, if bowel movement fails to occur after use, or need to continue use after using for 7 days

 

Pregnancy and lactation

Pregnancy category: C

Lactation: Unknown whether drug is excreted in milk; compatible with nursing

 

Pregnancy categories

A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

NA: Information not available.

 

Pharmacology of Colace, DSS (docusate)

Mechanism of action

Surfactant laxative, reduces tension of oil-water interface of the stool; enhances incorporation of water and fat into stool, causing stool to soften

 

Absorption

Onset: 24-72 hr

 

Elimination

Excretion: Feces