Adult Dosing
Constipation
Preparation for rectal/bowel examination
Notes- To prepare for colonic surgery or radiologic, sigmoidoscopic, or proctoscopic procedures, patients must receive a residue-free diet one day before the surgery or procedure and a cleansing rectal enema. Standardized senna fruit extract may be given additionally 4 hours after castor oil
- Administer as a single dose about 16 hrs before the surgery or procedure; give chilled with other liquids
- Do not administer at bedtime
Pediatric Dosing
Constipation
- Use is generally avoided for occasional constipation in pediatric population less than 6-10 yrs of age
- Children >10 yrs: 15 mL PO qd
Preparation for rectal/bowel examination
- <2 yrs: 1-5 mL PO x 1
- 2-11 yrs: 5-15 mL PO x 1
12 yrs: 15-60 mL PO x 1
Notes- Patients undergoing colonic surgery or radiologic, sigmoidoscopic, or proctoscopic procedures must receive a residue-free diet one day before the surgery or procedure and a cleansing rectal enema. Standardized senna fruit extract may be given additionally 4 hours after castor oil
- Administer as a single dose about 16 hrs before the surgery or procedure; give chilled with other liquids
- Do not administer at bedtime
[Outline]
See Supplemental Patient Information
- Persistent diarrhea, hypokalemia, loss of essential nutritional factors, and dehydration may occur due to chronic use or overdosage
- Avoid castor oil for simple constipation as it may produce violent purgation
- Periodic and long-term use may cause laxative dependence, chronic constipation, and loss of normal bowel function
- Pathologic changes such as structural damage to the myenteric plexus, severe and permanent interference with colonic motility, and hypertrophy of the muscularis mucosae may occur with chronic use
- Chronic use may produce factitious diarrhea characterized by severe, chronic, watery diarrhea, frequently occurring at night and accompanied by abdominal pain, weight loss, nausea, and vomiting
- Incidences of electrolyte disturbances including hypokalemia, hypocalcemia, metabolic acidosis or alkalosis, abdominal pain, diarrhea, malabsorption, weight loss, and protein-losing enteropathy may occur during therapy; such patients may require immediate medical intervention with appropriate fluid and electrolyte replacement
- Electrolyte imbalance may cause vomiting and muscle weakness; rarely, osteomalacia, secondary aldosteronism, and tetany may occur
- Cathartic colon with atony and dilation of the colon, particularly of the right side, has been reported with habitual use (for several years) and often resembles ulcerative colitis
- Protein-losing enteropathy and steatorrhea may occur during chronic use
Caution: Use cautiously in
Supplemental Patient Information
- Advise patients not to receive the drug at bedtime
- Inform patients that long-term or chronic use may cause excessive loss of fluids, electrolytes, and nutrients
Pregnancy Category:X
Breastfeeding: Possibly unsafe.
