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All about: Docusate

Big Image Pronouncation: (DOCK-you-sate)
Class: Fecal softener, Sulfactant Docusate Sodium (Dioctyl Sodium Sulfosuccinate; DSS)

Trade Names:
Colace
- Capsules 50 mg
- Capsules 100 mg
- Liquid 150 mg/15 mL
- Syrup 60 mg/15 mL

Trade Names:
Diocto
- Liquid 150 mg/15 mL
- Syrup 60 mg/15 mL

Trade Names:
Docu
- Liquid 150 mg/15 mL
- Syrup 20mg/5 mL

Trade Names:
D.O.S
- Capsules, soft-gel 100 mg
- Capsules, soft-gel 250 mg

Trade Names:
D-S-S
- Capsules 100 mg

Trade Names:
ex-lax Stool Softener
- Tablets 100 mg

Trade Names:
Genasoft
- Capsules, soft-gel 100 mg

Trade Names:
Non-Habit Forming Stool Softener
- Capsules 100 mg

Trade Names:
Phillips' Liqui-Gels
- Capsules, soft-gel 100 mg

Trade Names:
Regulax SS
- Capsules 100 mg

Trade Names:
Silace
- Syrup 60 mg/15 mL

Trade Names:
Stool Softener
- Capsules 100 mg
- Capsules 250 mg

Selax (Canada)
Soflax (Canada)
ratio-Docusate Sodium (Canada)
Docusate Calcium (Dioctyl Calcium Sulfosuccinate)

Trade Names:
DC Softgels
- Capsules 240 mg

Trade Names:
Stool Softener
- Capsules 240 mg

Trade Names:
Stool Softener DC
- Capsules 240 mg

Trade Names:
Surfak Liquigels
- Capsules 240 mg

ratio-Docusate Calcium (Canada)

Mechanism of Action

Pharmacology

Facilitates stool softening by detergent activity.

Pharmacokinetics

Onset

12 to 72 h.

Indications and Usage

Short-term treatment of constipation; prophylaxis in patients who should not strain during defecation (eg, after anorectal surgery, MI); to evacuate the colon for rectal and bowel examinations; prevention of dry, hard stools.

Contraindications

Nausea, vomiting or other symptoms of appendicitis; acute surgical abdomen; fecal impaction; intestinal obstruction; undiagnosed abdominal pain; coadministration with mineral oil.

Dosage and Administration

Docusate Sodium
Adults and Children older than 12 yr of age

PO 50 to 500 mg.

Children 6 to 12 yr of age

PO 40 to 120 mg.

Children 3 to 6 yr of age

PO 20 to 60 mg.

Children younger than 3 yr of age

PO 10 to 40 mg.

Docusate Calcium
Adults

PO 240 mg.

Children 6 yr of age and older and Adults With Minimal Needs

PO 50 to 150 mg.

General Advice

  • Administer each dose with full glass of water.
  • Do not open or otherwise alter capsules.

Storage/Stability

Store capsules at room temperature. Protect liquid preparations from light.

Drug Interactions

Mineral oil

Docusate may increase absorption of mineral oil from GI tract, leading to toxicity.

Laboratory Test Interactions

None well documented.

Adverse Reactions

Cardiovascular

Palpitations.

CNS

Dizziness; fainting.

GI

Excessive bowel activity (griping, diarrhea, nausea, vomiting); perianal irritation; bloating; flatulence; abdominal cramping.

Miscellaneous

Sweating; weakness.

Precautions

Monitor

Evaluate and document patient's response to stool softener, noting any adverse reactions such as nausea, vomiting, abdominal cramping, or diarrhea.


Pregnancy

Category C .

Lactation

Undetermined.

Abuse/dependence

Long-term use may lead to laxative dependence, fluid and electrolyte imbalances, steatorrhea, osteomalacia, and vitamin and mineral deficiencies.

Fluid and electrolyte imbalance

Excessive laxative use may lead to significant fluid and electrolyte imbalance.

Rectal bleeding or failure to respond

May indicate serious condition that may require further medical attention.

Concomitant laxative use

Do not use other laxatives, especially during the initial phase of therapy for portal-systemic encephalopathy; the resulting loose stools may falsely suggest adequate lactulose dosage.

Patient Information

  • Tell patient to drink full glass of water with each dose.
  • Instruct patient to swallow tablets whole and not to chew them.
  • Instruct patient not to use mineral oil while taking this drug.
  • Teach patient other methods of stimulating regular bowel evacuation: attempt to evacuate bowels at same time each day; drink 6 to 8 full glasses of water; eat high-fiber diet; exercise daily; respond to urge for bowel movement as soon as possible.
  • Explain that liquid forms, excluding syrup, may be mixed with fruit juice or milk to mask unpleasant taste.

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