VA Class:GA205

ATC Class:A06AA

AHFS Class:

• Cathartics and Laxatives 56:12

Generic Name(s):

• Docusate Calcium

• Docusate Sodium

The calcium and sodium salts of docusate are anionic, surface-active agents (surfactants) that have emulsifying and wetting properties and are used as stool softeners.

Administration

Docusate salts are administered orally. The sodium salt of docusate may be administered rectally. 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.

Dosage

Docusate salts should be administered in doses only large enough to produce softening of the stools. The oral dosage of the docusate salts varies widely according to the severity of the condition and the response of the patient and should be adjusted to individual response.

The usual oral dosage of docusate salts in adults and children older than 12 years of age is 50-360 mg daily. The usual oral dosage is 50-150 mg daily in children 2-12 years of age and 25 mg daily in children younger than 2 years of age. Alternatively, children 3-6 years of age may receive oral docusate sodium dosages of 20-60 mg daily and children younger than 3 years of age may receive 10-40 mg daily. Doses at the higher end of these dosage ranges may be required initially. The drugs may be administered in divided doses but usually one bedtime dose is sufficient. One manufacturer suggests adding 50-100 mg of docusate sodium as an oral liquid (not syrup) to saline or oil retention enemas for rectal use.

Pharmacokinetics

The extent to which orally administered docusate salts are absorbed has not been determined, but the drugs appear to be absorbed to some extent in the duodenum and jejunum and subsequently excreted in bile. The extent of absorption following rectal administration of docusate sodium is unknown.

Softening of the feces generally occurs within 1-3 days following initiation of oral docusate salt therapy.

Chemistry and Stability

Chemistry

The calcium and sodium salts of docusate are anionic, surface-active agents that have emulsifying and wetting properties. Docusate calcium occurs as a white, amorphous solid having the characteristic odor of octyl alcohol. The calcium salt is very slightly soluble in water and very soluble in alcohol. Docusate sodium occurs as a white, wax-like, plastic solid having a characteristic odor suggestive of octyl alcohol (but no odor of other solvents) and is sparingly soluble in water and freely soluble in alcohol. Solutions of the sodium salt are clear and have a bitter taste and characteristic odor.

Stability

Capsules of the docusate salts should be stored in tight containers at 15-30°C; docusate sodium solution should be stored in tight containers, and docusate sodium syrup should be stored in tight, light-resistant containers.

Additional Information

For further information on pharmacology, uses, cautions, drug interactions, and dosage and administration of the stool softeners, see the Cathartics and Laxatives General Statement 56:12.