Docusate Salts
Class: Cathartics and Laxatives
ATC Class: A06AA
VA Class: GA205
CAS Number: 128-49-4
Brands: Colace, Correctol, Diocto, Docusoft S, DOK, DOS, Ex-Lax Stool Softener, Fleet Sof-Lax, Phillips’, Surfak, Therevac S.B. Enema
Introduction
Stool softeners (emollients); anionic, surface-active agents (surfactants) that have emulsifying and wetting properties.
Uses for Docusate Salts
Constipation
Used as stool softeners (emollients) to relieve occasional constipation.
Preferred to bulk-forming laxatives to ease evacuation of feces in constipation associated with hard, dry stools.
Considered the treatment of choice by many clinicians for childhood constipation associated with hard, dry stools and to be safer and more efficacious than mineral oil for conditions in which straining at defecation is to be avoided.
Particularly useful prophylactically for softening stools and preventing painful defecation in patients who have or are about to undergo hemorrhoid surgery or who have other anorectal disorders or when it is desirable to avoid straining at defecation (e.g., following abdominal surgery, recent rectal surgery, or myocardial infarction; in patients with vascular diseases, diseases of the anus or rectum, or hernias; immediately postpartum).
Used as stool softeners for constipation associated with stricture of the colon.
Used to soften fecal impactions. Safer and more efficacious than mineral oil. After softening the impacted feces with a stool softener, stimulant or saline laxatives may be administered rectally to evacuate the impacted colon.
Used in combination with stimulant laxatives (e.g., senna, bisacodyl) for long-term management of opiate-induced constipation.
Docusate Salts Dosage and Administration
Administration
Docusate salts are administered orally and the sodium salt also is administered rectally.
Adequate fluid intake facilitates stool softening.
Oral Administration
Administer orally.
Dilution
Oral liquids (not syrups) of docusate sodium should be diluted with 120 mL of milk, fruit juice, or infant formula to mask their bitter taste.
Rectal Administration
The sodium salt of docusate may be administered rectally.
Dosage
Administered in doses only large enough to produce softening of the stools.
Oral dosage varies widely according to the severity of the condition and the response of the patient and should be adjusted to individual response.
Pediatric Patients
Constipation
May be administered in divided doses, but usually one bedtime dose is sufficient.
Initially, doses at the higher end of the dosage ranges may be required.
Oral
Children <2 years of age: Usually, 25 mg (range: 20–50 mg) daily.
Children 2–12 years of age: Usually, 50–150 mg daily.
Children >12 years of age: Usually, 50–360 mg daily.
Oral, Alternative Dosing (e.g., Liquid Formulations)
Children <3 years of age: 10–40 mg daily.
Children 3–6 years of age: 20–60 mg daily.
Children 6–12 years of age: 40–150 mg daily.
Rectal
Add 50–100 mg of docusate sodium as an oral liquid (not syrup) to saline or oil retention enemas for rectal use.
Adults
Constipation
Oral
Usually, 50–360 mg daily.
