Docusate
Class: laxative – faecal softener
Indications: constipation
Contraindications/cautions: acute abdominal pain; appendicitis, undiagnosed rectal bleeding; intestinal obstruction
Adverse reactions: less common: abdominal cramps, atonic colon (on prolonged use), bitter taste, nausea, rash, diarrhoea
Metabolism/clearance: absorbed from the gastrointestinal tract and excreted mainly in the bile
Interactions:
- decreased clinical effect of antispasmodics (e.g. hyoscine butylbromide) may occur with concomitant docusate
| Dosing: | |
|---|---|
| oral: | Available as 50 mg or 120 mg tab. Adult: 100 to 150 mg twice daily or 240 mg at night – up to 480 mg daily in divided doses Also available as docusate with sennosides (Laxsol tabs) |
| subcut: | not available |
| rectal: | 1 suppository as required |
Syringe driver: not available
Mechanism of action: acts by lowering surface tension of the stool allowing water and salts into the hardened stool to soften it
Onset: oral 1 to 3 days
Notes:
- as docusate has some stimulant action it should be avoided in complete intestinal obstruction, as should all stimulant laxatives
- not laxative of choice in opioid induced constipation as a single agent but useful in combination with a stimulant (e.g. LaxsolTM) although giving a softener and a stimulant as separate tablets may be more effective