• PO: Treatment of constipation associated with dry, hard stools and decreased intestinal motility.
• Prevention of opioid-induced constipation.

Contraindicated in:

• Hypersensitivity
• Abdominal pain, nausea, or vomiting, especially when associated with fever or other signs of an acute abdomen
• Concomitant use of mineral oil.

Use Cautiously in:

• Excessive or prolonged use may lead to dependence, fluid and electrolyte imbalance, and vitamin and mineral deficiencies.

F and E: electrolyte imbalances, dehydration.

GI: abdominal cramps, nausea, vomiting, diarrhea.

Derm: rashes.

GU: urine discoloration.

Drug-Drug:

• None significant.

• Tablets: Docusate sodium 50 mg and sennosides 8.6 mg^OTC;

• PO (Adults and Children >12 yr): 2 tablets once daily at bedtime; maximum 4 tablets twice daily.
• PO (Children 6–12 yr): 1 tablet once daily at bedtime; maximum: 2 tablets twice daily.
• PO (Children 2–6 yr): 1/2 tablet once daily at bedtime; maximum: 1 tablet twice daily.

Peri-Colace, Senna Plus, Senokot-S

• Senna's metabolite acts as a local irritant on the colon stimulating peristalsis.
• Docusate promotes incorporation of water into stool, resulting in softer fecal mass.

• Softening and passage of stool.

Therapeutic Classification: laxatives

Pharmacologic Classification: stimulant laxatives, stool softeners

Absorption: Docusate: small amounts may be absorbed from the small intestine after oral administration.

Distribution: Unknown.

Metabolism/Excretion: Senna: metabolized in the liver and eliminated in bile and urine. Docusate: eliminated in bile.

Half-life: Unknown.

(softening of stool)

• 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.

DOK-yoo-sate SOE-dee-um SEN-na