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