Action

Increases absorption of liquid into stool, resulting in softening of fecal mass. Also promotes electrolyte and water secretion into colon.

Availability

docusate calcium

Capsules: 240 mg

Capsules (soft gels): 240 mg

Rectal solution: 283 mg/5 ml

docusate sodium

Capsules: 50 mg, 100 mg, 250 mg

Capsules (soft gels): 100 mg, 250 mg

Liquid: 150 mg/15 ml

Syrup: 50 mg/15 ml, 60 mg/15 ml, 20 mg/5 ml, 100 mg/30 ml, 150 mg/15 ml

Tablets: 100 mg

Indications and dosages

➣ Stool softener

Adults and children older than age 12: 240 mg (docusate calcium) or 50 to 200 mg (docusate sodium) P.O. daily until bowel movements are normal

Children ages 6 to 12: 40 to 120 mg (docusate sodium) P.O. daily

Children ages 3 to 6: 20 to 60 mg (docusate sodium) P.O. daily

Contraindications

• Hypersensitivity to drug

• Abdominal pain, nausea, or vomiting

• Intestinal obstruction

Precautions

Use cautiously in:

• pregnant or breastfeeding patients.

Administration

• Give tablets and capsules with full glass of water.

• Give liquid solution with milk or fruit juice.

• Be aware that excessive or long-term use may lead to laxative dependence.

Adverse reactions

EENT: throat irritation

GI: nausea, diarrhea, mild cramps

Skin: rash

Other: bitter taste, decreased appetite, laxative dependence

Interactions

Drug-drug. Mineral oil: increased mineral oil absorption, causing toxicity

Warfarin: decreased warfarin effects (with high doses)

Patient monitoring

• If diarrhea occurs, withhold drug and notify prescriber.

• Know that therapeutic efficacy usually becomes apparent 1 to 3 days after first dose.

Patient teaching

• Instruct patient to drink sufficient fluids with each dose and to increase fluid intake during the day.

• Advise patient to prevent constipation by increasing fluids and consuming more dietary fiber (as in fruits and bran).

• Inform patient that excessive or prolonged use may lead to laxative dependence.

• As appropriate, review all other significant adverse reactions and interactions, especially those related to the drugs mentioned above.