Docusate

Docusate (pronounced /ˈdɒkjuːseɪt/) is the generic name of a surfactant used as a laxative and stool softener, which is sold in the U.S. under multiple brand names: Aqualax, Calube, Colace, Colace Micro-Enema, Correctol Softgel Extra Gentle, DC-240, Dialose, Diocto, Dioctocal, Dioctosoftez, Dioctyn, Dionex, Doc-Q-Lace, Docu Soft, Docucal, Doculax, Docusoft S, DOK, DOS, Doss-Relief, DSS, Dulcolax, Ex-Lax Stool Softener, Fleet Sof-Lax, Genasoft, Kasof, Laxa-basic, Modane Soft, Octycine-100, Regulax SS, Sulfalax Calcium, Sur-Q-Lax, Surfak Stool Softener and Therevac-SB.

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Docusate is also any of a group of anionic surfactants widely used as emulsifying, wetting, and dispersing agents.

Clinical use

Docusate is given to make stools softer and easier to pass. It is used to treat constipation due to hard stools, in painful anorectal conditions such as hemorrhoids, and for people who should avoid straining during bowel movements. Of note is that the effect of docusate may not necessarily be all due to its surfactant properties. Perfusion studies suggest that docusates inhibit fluid absorption or stimulate secretion in jejunum.

While the use of docusate is widespread, the data to support its efficacy in treating chronic constipation is actually lacking. Also, although more research is needed, long term use of docusate seems to decrease levels of magnesium and potassium in the blood.

Docusate should not be used in addition to mineral oil as the emulsifier will result in mineral oil being absorbed rather than functioning as a lubricant for the bowel walls.

Presentations

• Docusate is available in tablet, capsule, liquid, and rectal enema.
• Docusate calcium [USP] and docusate potassium [USP] are anionic surfactants used as stool softeners and are administered orally.
• Docusate sodium [USP] is anionic surfactant used as a stool softener and is administered orally or rectally; as a tablet disintegrant or as an emulsifier and dispersant in topical preparations. When sold as Colace, it is docusate sodium, or sodium salt of dioctyl sodium sulfosuccinate (DSS). Some metabolism studies show that DSS is absorbed by the body from the gastrointestinal tract, undergoing extensive metabolism. In humans, the main way DSS metabolites are excreted is via the feces.

Docusate sodium may be used in a daily regimine in persons who are undergoing narcotic pain medication therapy to reduce the effects of chronic constipation or hardened stools which can cause severe straining, impaction, and torn rectal tissues.

Effect

• The effect on stools is seen 1 to 3 days after the first dose.