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Docusate Sodium (Dioctyl Sodium Sulfosuccinate; DSS)
Colace, Diocto, Docu, D.O.S, D-S-S, ex-lax Stool Softener, Genasoft, Modane Soft, Non-Habit Forming Stool Softener, Phillips’ Liqui-Gels, Regulax SS, Silace, Stool Softener, PMS-Docusate Sodium, Regulex, Selax, Soflax
Docusate Calcium (Dioctyl Calcium Sulfosuccinate)
DC Softgels, Stool Softener, Stool Softener DC, Surfak Liquigels, Albert Docusate, PMS-Docusate Calcium, Surfak
Docusate Potassium (Dioctyle Potassium Sulfosuccinate)
Dialose, Diocto-K, Kasof, Perestan
Class: Laxative/Fecal softener

 Action Facilitates stool softening by detergent activity.

 Indications Short-term treatment of constipation; prophylaxis in patients who should not strain during defecation (eg, after anorectal surgery, myocardial infarction); evaquate 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; co-administration with mineral oil.

 Route/Dosage

DOCUSATE SODIUM

ADULTS & CHILDREN > 12 YR: PO 50 to 500 mg. CHILDREN 6 to 12 YR: PO 40 to 120 mg. CHILDREN 3 to 6 YR: PO 20 to 60 mg. CHILDREN < 3 YR: PO 10 to 40 mg.

DOCUSATE CALCIUM

ADULTS: PO 240 mg. CHILDREN ³ 6 YR & Adults With MINIMAL NEEDS: PO 50 to 150 mg.

DOCUSATE POTASSIUM

ADULTS: PO 100 to 300 mg. CHILDREN ³ 6 YR: PO 100 mg at bedtime.

 Interactions

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

 Lab Test Interferences None well documented.

 Adverse Reactions

CV: Palpitations. CNS: Dizziness; fainting. GI: Excessive bowel activity (griping, diarrhea, nausea, vomiting); perianal irritation; bloating; flatulence; abdominal cramping. OTHER: Sweating; weakness.

 Precautions

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 CARE CONSIDERATIONS

 Administration/Storage

  • Administer each dose with full glass of water.
  • Do not open or otherwise alter capsules.
  • Do not give within 1 hr of other drugs or antacids, milk or histamine H2 blockers.
  • Do not administer for > 1 wk without follow-up evaluation.
  • Store capsules at room temperature. Protect liquid preparations from light.

 Assessment/Interventions

  • Obtain patient history, including drug history and any known allergies.
  • Assess patient’s bowel regimen to determine nonpharmacologic interventions for bowel evacuation.
  • Review patient’s diet history for medical restriction of sodium. If sodium restriction is present, docusate sodium should not be used.
  • Document daily I&O.
  • Evaluate and document patient’s response to stool softener, noting and reporting any adverse reactions such as nausea, vomiting, abdominal cramping or diarrhea.
  • Monitor patient frequently for signs and symptoms of dehydration and electrolyte imbalance such as weakness, dizziness, confusion, palpitations, thirst or decreased urine output.

 Patient/Family Education

  • 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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