Docusate sodium (pms-Docusate Sodium)

1. Health Canada Product Monograph — Docusate sodium

• Docusate sodium is used to manage and prevent constipation caused by hard, dry stools when straining during a bowel movement should be avoided.
• It is used in patients who should avoid straining during defecation, such as those recovering from an episiotomy, with painful thrombosed hemorrhoids, anal fissures, or perianal abscesses.
• It is also used in patients with a body wall or diaphragmatic hernia, anorectal stenosis, or recovering from a heart attack, where straining could be harmful.

• Docusate sodium should not be used during pregnancy unless directed by a physician, since safety data in pregnancy are limited.

• Docusate sodium should not be used while breastfeeding unless directed by a physician, since safety data during lactation are limited.

• Older adults often take docusate sodium for age-related constipation, but as with all patients, use should be limited to one week unless a physician advises otherwise.
• Older adults are more susceptible to electrolyte disturbances from any laxative, so extended use should be monitored by a healthcare provider.

• Docusate sodium should not be given to children up to 6 years of age unless prescribed by a physician.
• For children 6 to 12 years old, the usual dose is 100 mg per day.

• For adults and children 12 years and older, the usual dose is 100 to 200 mg per day, taken with a full glass (240 mL) of water or other liquid, adjusted for individual size and need.
• For children 6 to 12 years, the usual dose is 100 mg per day with a full glass of water or other liquid.
• Docusate sodium should not be taken within 2 hours of another medication, since it may reduce that medication's effectiveness.
• At least 6 to 8 full glasses (240 mL each) of fluid per day should be taken to help produce a soft stool and prevent dehydration.
• Effects on the stool are usually seen within 1 to 3 days of the first dose.
• Docusate sodium should not be used for more than 1 week unless directed by a physician, due to the risk of dependence for bowel function.

If overdose is suspected, seek emergency medical attention immediately or contact your regional Poison Control Centre without delay.

• No cases of docusate sodium overdose have been reported.
• Excess use can cause diarrhea and abdominal cramps, which can typically be controlled by lowering the dose.

• Mild stomach or intestinal cramping may occur.
• Throat irritation may occur with liquid formulations.

Serious side effects require immediate discussion with the prescriber or emergency care.

• An allergic skin rash may occur and should be reported to a healthcare provider.
• Extended or excessive use may lower serum potassium levels (hypokalemia), particularly with chronic use.
• Extended use may elevate blood glucose concentrations.
• Overdose has not been reported to cause serious harm; the main effects would be diarrhea and abdominal cramping, which typically resolve by reducing or stopping the dose.
• Seek medical attention if a rash, severe or persistent stomach pain, or signs of low potassium such as muscle weakness or irregular heartbeat occur.

• Use with caution in patients with congestive heart failure.
• Use with caution in patients with hypertension.
• Use with caution in patients taking potassium-sparing diuretics or potassium supplements, since chronic docusate use can lower serum potassium and interfere with these therapies.
• Use with caution with extended or repeated use, due to the risk of dependence for normal bowel function and electrolyte disturbances.
• Use with caution when self-treating constipation for more than one week without medical supervision, since persistent symptoms may indicate an underlying bowel disorder that needs evaluation.

• Do not use when abdominal pain, nausea, or vomiting is present.
• Contraindicated in appendicitis or symptoms suggestive of appendicitis.
• Contraindicated in rectal bleeding or undiagnosed bleeding.
• Contraindicated in fecal impaction.
• Contraindicated in intestinal obstruction.

• Chronic use or overuse with potassium-sparing diuretics or potassium supplements may reduce serum potassium levels and interfere with the potassium-retaining effect of these diuretics.
• Concurrent use with mineral oil, phenolphthalein, or danthron-type stimulant laxatives can increase systemic absorption of these agents, raising the risk of toxicity; liver injury has been reported when docusate is combined with danthron-type products.

• Docusate sodium can be taken with or without food; food does not significantly affect its stool-softening action.
• Taking each dose with a full glass of water or juice supports its softening effect.

• Docusate sodium can be taken at any time of day, with or without food.
• Avoid taking it within 2 hours of other medications, since it may reduce their effectiveness.

• Store between 15 and 30 degrees Celsius in a tight, light-resistant container in a dry area.
• Keep out of reach of children.

• Docusate sodium (pms-Docusate Sodium) is a stool softener that helps prevent straining during bowel movements by drawing more liquid into the stool.
• Drink plenty of fluids while taking it, and do not use it for more than one week without checking with a healthcare provider.
• Stop use and consult a healthcare provider if abdominal pain, rectal bleeding, or a rash develops.