DOCUSATE CALCIUM (DIOCTYL CALCIUM SULFOSUCCINATE)

(dok'yoo-sate)
DCS, PMS-Docusate Calcium, Pro-Cal-Sof, Surfak
DOCUSATE POTASSIUM
Dialose, Diocto-K, Kasof
DOCUSATE SODIUM
Colace, Colace Enema, Dio-Sul, Disonate, DGSS, D-S-S, Duosol, Lax-gel, Laxinate 100, Modane Soft, Pro-Sof, Regulax

, Regutol, Therevac-Plus, Therevac-SB
Classifications: gastrointestinal agent; stool softener
Pregnancy Category: C

Availability

Docusate Calcium 50 mg, 240 mg capsules

Docusate Potassium 100 mg tablets; 240 mg capsules

Docusate Sodium 100 mg tablets; 50 mg, 100 mg, 240 mg, 250 mg capsules; 50 mg/15 mL 60 mg/15 mL, 150 mg/15 mL syrup

Actions

Anionic surface-active agent with emulsifying and wetting properties.

Therapeutic Effects

Detergent action lowers surface tension, permitting water and fats to penetrate and soften stools for easier passage.

Uses

Prophylactically in patients who should avoid straining during defecation and for treatment of constipation associated with hard, dry stools (e.g., following anorectal surgery, MI).

Contraindications

Atonic constipation, nausea, vomiting, abdominal pain, fecal impaction, structural anomalies of colon and rectum, intestinal obstruction or perforation; use of docusate sodium in patients on sodium restriction; use of docusate potassium in patients with renal dysfunction; concomitant use of mineral oil; pregnancy (category C).

Cautious Use

History of CHF, edema, diabetes melitus.

Route & Dosage

Stool Softener
Adult: PO 50–500 mg/d PR 50–100 mg added to enema fluid
Child: PO <3 y, 10–40 mg/d; 3–6 y, 20–60 mg/d; 6–12 y, 40–120 mg/d

Administration

Oral

Give with a full glass of water if allowed.
Store syrup formulations in tight, light-resistant containers at 15°–30° C (59°–86° F) unless directed otherwise.

Rectal

Microenema: Insert full length of nozzle (half length for children) into the rectum. Squeeze entire contents of tube and remove completely before releasing grip on tube.
Store in tightly covered containers.

Adverse Effects (1%)

GI: Occasional mild abdominal cramps, diarrhea, nausea, bitter taste. Other: Throat irritation (liquid preparation), rash.

Interactions

Drug: Docusate will increase systemic absorption of mineral oil.

Pharmacokinetics

Not studied.

Nursing Implications

Assessment & Drug Effects

Withhold drug if diarrhea develops and notify physician.
Therapeutic effectiveness: Usually apparent 1–3 d after first dose.

Patient & Family Education

Take sufficient liquid with each dose and increase fluid intake during the day, if allowed. Oral liquid (NOT syrup) may be administered in milk, fruit juice, or infant formula to mask bitter taste.
Do not take concomitantly with mineral oil.
Do not take for prolonged periods in lieu of proper dietary management or treatment of underlying causes of constipation.

Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; Canadian drug name; Prototype drug