Medications for the Management of Constipation | ||
INTERVENTION | DOSE | COMMENT |
---|---|---|
Stimulant laxatives | These agents directly stimulate peristalsis and may reduce colonic absorption of water. Work in 6-12 h. | |
Prune juice | 120-240 mL/d | |
Senna (Senokot) | 2-8 tablets PO bid | |
Bisacodyl | 5-15 mg/d PO, PR | |
Osmotic laxatives | These agents are not absorbed. They attract and retain water in the gastrointestinal tract. | |
Lactulose | 15-30 mL PO q4-8h | Lactulose may cause flatulence and bloating. |
Magnesium hydroxide (Milk of Magnesia) | 15-30 mL/d PO | Lactulose works in 1 day, magnesium products in 6 h. |
Magnesium citrate | 125-250 mL/d PO | |
Stool softeners | These agents work by increasing water secretion and as detergents, increasing water penetration into the stool. Work in 1-3 days. | |
Sodium docusate (Colace) | 300-600 mg/d PO | |
Calcium docusate | 300-600 mg/d PO | |
Suppositories and enemas | ||
Bisacodyl | 10-15 PR qd | |
Sodium phosphate enema | PR qd | Fixed dose, 4.5 oz, Fleet's. |