docusate

Therapeutic Classification: laxatives

Pharmacologic Classification: stool softeners

Indications ⬆ ⬇

REMS

PO: Prevention of constipation (in patients who should avoid straining, such as after MI or rectal surgery).
Used as enema to soften fecal impaction.

Action ⬆ ⬇

Promotes incorporation of water into stool, resulting in softer fecal mass.
May also promote electrolyte and water secretion into the colon.

Therapeutic effects:

Softening and passage of stool.

Pharmacokinetics ⬆ ⬇

Absorption: Small amounts may be absorbed from the small intestine after oral administration. Absorption from the rectum is not known.

Distribution: Unknown.

Metabolism/Excretion: Amounts absorbed after oral administration are eliminated in bile.

Half-Life: Unknown.

Time/Action Profile ⬆ ⬇

(softening of stool)

ROUTE	ONSET	PEAK	DURATION
PO	12–72 hr	unknown	unknown
Rectal	2–15 min	unknown	unknown

Contraind./Precautions ⬆ ⬇

Contraindicated in:

Hypersensitivity;
Abdominal pain, nausea, or vomiting, especially when associated with fever or other signs of an acute abdomen.

Use Cautiously in:

Excessive or prolonged use may lead to dependence;
Should not be used if prompt results are desired;
OB: Has been used safely.

Adv. Reactions/Side Effects ⬆ ⬇

Derm: rash

EENT: throat irritation

GI: diarrhea, mild cramps

Interactions ⬆ ⬇

Drug-drug:

None significant.

Route/Dosage ⬆ ⬇

Docusate Calcium

PO (Adults ): 240 mg once daily.

Docusate Sodium

PO (Adults and Children >12 yr): 50–400 mg in 1–4 divided doses.
PO (Children 6–12 yr): 40–150 mg in 1–4 divided doses.
PO (Children 3–6 yr): 20–60 mg in 1–4 divided doses.
PO (Children <3 yr): 10–40 mg in 1–4 divided doses.
PO (Infants ): 5 mg/kg/day in 1–4 divided doses.
(Adults ): 50–100 mg or 1 unit containing 283 mg docusate sodium, soft soap, and glycerin.

Availability ⬆ ⬇

(Generic available)

Docusate Calcium

Capsules: 240 mg^OTC

Docusate Sodium

(Generic available)

Tablets: 100 mg^OTC
Capsules: 100 mg^OTC; 250 mg^OTC
Syrup: 60 mg/15 mL^OTC
Liquid: 50 mg/5 mL^OTC; 100 mg/10 mL^OTC
Enema: 283 mg/5 mL^OTC
In combination with: stimulant laxativesOTC. See Appendix [not included in this PDA edition].

Assessment ⬆ ⬇

Assess for abdominal distention, presence of bowel sounds, and usual pattern of bowel function.
Assess color, consistency, and amount of stool produced.

Implementation ⬆ ⬇

Do not confuse Colace with Cozaar. Do not confuse Dulcolax (docusate sodium) with Dulcolax (bisacodyl).
This medication does not stimulate intestinal peristalsis; stimulant laxative may be required for constipation.
PO: Administer with a full glass of water or juice. May be administered on an empty stomach for more rapid results.
- Oral solution may be diluted in milk, infant formula, or fruit juice to decrease bitter taste.
- Do not administer within 2 hr of other laxatives, especially mineral oil. May cause increased absorption.
Administer as a retention or flushing enema.

Patient/Family Teaching ⬆ ⬇

Advise patients that laxatives should be used only for short-term therapy. Long-term therapy may cause electrolyte imbalance and dependence.
Encourage patients to use other forms of bowel regulation, such as increasing bulk in the diet, increasing fluid intake (6–8 full glasses/day), and increasing mobility. Normal bowel habits are variable and may vary from 3 times/day to 3 times/wk.
Instruct patients with cardiac disease to avoid straining during bowel movements (Valsalva maneuver).
Advise patient not to use laxatives when abdominal pain, nausea, vomiting, or fever is present.
Advise patient not to take docusate within 2 hr of other laxatives.
Rep: Advise females of reproductive potential to notify health care professional is pregnancy is planned or suspected or if breastfeeding.

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Pronunciation ⬇

Classifications ⬆ ⬇