sodium docusate (Colace, DOSS, DSS)

Introduction

Tradename: Colace. (a stool softener)

Indications

• relief of constipation
• softening of earwax (off label)

Contraindications

Pregnancy category :value +

Safety in lactation :value ?

Dosage

• 100 mg PO QD/BID.
• Pediatrics:
  • 10-400 mg/dose < 3 yr.
  • 20-60 mg/dose 3-6 yr
• Earwax: 1 mL liquid

Tabs: 50, 100, 240, 250 mg.

Liquid: 20 & 50 mg/5 mL.

Pharmacokinetics

• stool softening occurs in 1-3 days
• metabolized by liver

Adverse effects

• gastrointestinal (1-10%)
  • diarrhea
  • abdominal cramping
  • intestinal obstruction (rare)
• throat irritation

Drug interactions

• Colace causes increased systemic absorption of mineral oil leading to fatty liver infiltrates
• increased toxicity of phenolphthalein

Mechanism of action

• stool softener
• maintains stool hydration
• reduces surface tension of the oil-water interface of the stool, resulting in enhanced incorporation of water & fat allowing for stool softening
• the salts are interchangeable, i.e. the amount of cation Ca+2, K+, Na+ per unit dose is clinically insignificant

More general terms

• docusate

Component of

• casanthranol/sodium docusate
• alpha tocopherol/ascorbate/calcium phosphate/docosahexaenoate/ferrous fumarate/folic acid/pyridoxine/sodium docusate
• phenolphthalein/sodium docusate
• ferrous fumarate/sodium docusate
• benzocaine/sodium docusate
• ascorbate/carbonyl iron/cobalamin/folic acid/sodium docusate
• ascorbate/beta carotene/calcium carbonate/carbonyl iron/cholecalciferol/cobalamin/folic acid/magnesium oxide/nicotinamide/pyridoxine/riboflavin/sodium docusate/thiamine/zinc oxide
• alpha tocopheryl acetate/ascorbate/biotin/carbonyl iron/cobalamin/folic acid/sodium docusate
• alpha tocopheryl acetate/ascorbate/biotin/carbonyl iron/cobalamin/copper sulfate/folic acid/sodium docusate
• alpha tocopherol/ascorbate/cholecalciferol/docosahexaenoate/ferrous fumarate/folic acid/pyridoxine/sodium docusate
• alpha tocopherol/ascorbate/calcium phosphate/cholecalciferol/docosahexaenoate/ferrous fumarate/folic acid/pyridoxine/sodium docusate
• alpha tocopherol/ascorbate/calcium citrate/carbonyl iron/cholecalciferol/folic acid/nicotinamide/potassium iodide/pyridoxine/riboflavin/sodium docusate/thiamine/zinc oxide
• alpha tocopherol/ascorbate/calcium citrate/carbonyl iron/cholecalciferol/docosahexaenoate/folic acid/nicotinamide/potassium iodide/pyridoxine/riboflavin/sodium docusate/thiamine/zinc oxide
• alpha tocopherol/ascorbate/calcium carbonate/carbonyl iron/cholecalciferol/cobalamin/cupric oxide/folic acid/magnesium oxide/nicotinamide/pyridoxine/riboflavin/sodium docusate/thiamine/zinc oxide
• alpha tocopherol/ascorbate/beta carotene/calcium carbonate/cholecalciferol/cobalamin/ferrous fumarate/folic acid/nicotinamide/pantothenate/pyridoxine/riboflavin/sodium docusate/thiamine/zinc oxide
• ascorbate/cobalamin/folic acid/iron carbonyl/sodium docusate
• senna/sodium docusate; sennosides-docusate sodium; senokot-S, senna-S
• ascorbate/cobalamin/folic acid/sodium docusate
• casanthranol/docusate (Peri-Colace)

Database

• PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=11338