Emollient Laxative

Aka: Emollient Laxative, Stool Softener, Docusate, Colace, Mineral Oil, Glycerin

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II. Mechanism

  1. Theoretically softens stool
    1. Allow water and fat to penetrate the fecal mass
  2. Effect probably due to induced Secretory Diarrhea
  3. Slow onset of action (24 to 48 hours)

III. Precautions

  1. Do not use longterm
  2. Docusate enhances intestinal Mineral Oil absorption
    1. Do not use Docusate with Mineral Oil preparations
  3. Docusate liquid formulations were recalled in 2016 due to Bacterial contamination
    1. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm511528.htm
  4. May also increase absorption of other medications
  5. Risk of hepatotoxicity

IV. Efficacy

  1. Some studies suggest no greater effect than Placebo, especially for Docusate (Colace)

V. Preparations Docusate

  1. Other agents are preferred in most cases (low efficacy)
  2. Docusate Sodium or Dioctyl sulfosuccinate (Colace)
    1. Onset of action within 24-72 hours
    2. Adult
      1. Twice daily: 100 mg PO bid
      2. Once daily: 200 mg PO qhs
      3. Maximum daily total dose: 400 mg
    3. Pediatric
      1. Age <3 years: 10-40 mg per dose
      2. Age 3-6 years: 20-60 mg per dose
  3. Docusate Calcium (Surfak)
    1. Adult: 240 mg PO qd
    2. Child: 50-150 mg qd

VI. Preparations: Non-Docusate agents

  1. Mineral Oil (use caution due to aspiration risk)
    1. Contraindications
      1. Risk of Aspiration Pneumonia (lipoid Pneumonia)
      2. Risk of malabsorption
    2. General dosing
      1. Give chilled in juice to maximize tolerability
      2. Coadminister Multivitamin daily if used chronically
    3. Child Dose (over 18 months of age)
      1. Low: 1-3 cc/kg/day divided daily to twice daily
        1. Used in maintenance of bowel regimen
      2. High dose: 15-30 ml per age in years up to 240 ml
        1. Used in acute disimpaction
        2. May repeat daily for 3-4 days
    4. Adult Dose: 5-45 ml PO qhs
  2. Glycerin Suppository
    1. One Suppository (Adult or Pediatric) PR prn
    2. Indicated in Constipation in Infants

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Related Studies

Cost: Medications

stool softener (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
STOOL SOFTENER 100 MG SOFTGEL Generic OTC $0.02 each
STOOL SOFTENER 250 MG SOFTGEL Generic OTC $0.05 each
STOOL SOFTENER-STIM LAX SOFTGL Generic OTC $0.06 each
STOOL SOFTENER-STIM LAX TABLET Generic OTC $0.03 each
docusate (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
DOCUSATE CAL 240 MG SOFTGEL Generic OTC $0.06 each
DOCUSATE SODIUM 100 MG SOFTGEL Generic OTC $0.02 each
DOCUSATE SODIUM 100 MG TABLET Generic OTC $0.03 each
DOCUSATE SODIUM 250 MG SOFTGEL Generic OTC $0.05 each
DOCUSATE SODIUM 50 MG/5 ML LIQ Generic OTC $0.01 per ml
colace (on 10/1/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
COLACE 100 MG CAPSULE Generic OTC $0.02 each
COLACE 2-IN-1 TABLET Generic OTC $0.03 each
COLACE-T 100 MG CAPSULE Generic OTC $0.02 each
mineral oil (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
MINERAL OIL Generic OTC $0.01 per ml
FPNotebook does not benefit financially from showing this medication data or their pharmacy links. This information is provided only to help medical providers and their patients see relative costs. Insurance plans negotiate lower medication prices with suppliers. Prices shown here are out of pocket, non-negotiated rates. See Needy Meds for financial assistance information. GoodRx is another tool for finding lower drug prices.

Related Topics in Pharmacology

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