Docusate sodium

Stool Softener·Gastrointestinal - Laxatives

Prevention and treatment of hard, dry stools

SOFTENERColoxyl, Coloxyl with Senna (combo)50 mg tabletUNSCHEDULEDTGA

Max Dose

480 mg/day

Onset

1-3 Days

Stimulation

NONE

Efficacy

LOW

Rapid Summary

Overview

Anionic surfactant (detergent). Lowers the surface tension of stool, allowing water and fats to mix in, softening the fecal mass. 'Mush without the push'.

Maximum Dose

Max 480 mg/day.

Clinical Focus

Completely useless as monotherapy for opioid-induced constipation. Must be paired with a stimulant (Senna).

Bottom Line

Docusate sodium is a gentle stool softener for patients where straining is contraindicated, but has weak evidence for efficacy and is often insufficient as monotherapy.

Formulation & Access

Brand Names

Coloxyl, Coloxyl with Senna (combo)

Oral Routes

Tablets (50 mg, 120 mg). Drops for pediatrics.

Prescribing & PBS

OTC; docusate 50 mg tablets are also listed on the RPBS/PBS item record.

Indications & Use

Primary

TGA

Prevention and treatment of hard, dry stools.

Clinical Place

Used when straining is contraindicated (e.g., post-MI, post-hernia repair, hemorrhoids).

Quick reference

Class & Role

Stool Softener — Anionic surfactant (detergent).

Route / Formulation

Tablets (50 mg, 120 mg). Drops for pediatrics. (Coloxyl, Coloxyl with Senna (combo))

Usual Dose & Max

PO 120 mg once or twice daily; max 480 mg/day in divided doses. Combination docusate/senna is commonly used for opioid/palliative constipation.

Key Indication Doses

Constipation: PO 100-200 mg BD. Max 500 mg/day. Elderly / Frail: Often given as 120 mg BD.

Best Uses

Docusate sodium is a gentle stool softener for patients where straining is contraindicated, but has weak evidence for efficacy and is often insufficient as monotherapy.

Avoid / Cautions

Intestinal obstruction. Pregnancy Category A. Widely used post-partum.

Key Risks

Gastrointestinal: Mild abdominal cramping, bitter taste (if liquid is used). Systemic: Extremely benign safety profile. Very safe in the elderly.

Key Interactions

Liquid paraffin (mineral oil laxatives). Docusate increases the systemic absorption of mineral oil, leading to lipoid pneumonia and hepatic granulomas. Never combine them.

Monitoring

Monitor bowel chart. Efficacy is often poor in severe constipation without a stimulant.

Clinical Pearl

Opioids paralyze the gut. Giving Docusate alone to a patient on Oxycodone just creates soft stool sitting in a paralyzed bowel. You MUST add Senna (the push).

Access

Coloxyl, Coloxyl with Senna (combo)50 mg tablet

Brand: Coloxyl, Coloxyl with Senna (combo)
Formulation: Tablets (50 mg, 120 mg)

Docusate sodium

Stool Softener·Gastrointestinal - Laxatives

Prevention and treatment of hard, dry stools

SOFTENERColoxyl, Coloxyl with Senna (combo)50 mg tabletUNSCHEDULEDTGA

Max Dose

480 mg/day

Onset

1-3 Days

Stimulation

NONE

Efficacy

LOW

Rapid Summary

Overview

Anionic surfactant (detergent). Lowers the surface tension of stool, allowing water and fats to mix in, softening the fecal mass. 'Mush without the push'.

Maximum Dose

Max 480 mg/day.

Clinical Focus

Completely useless as monotherapy for opioid-induced constipation. Must be paired with a stimulant (Senna).

Bottom Line

Docusate sodium is a gentle stool softener for patients where straining is contraindicated, but has weak evidence for efficacy and is often insufficient as monotherapy.

Formulation & Access

Brand Names

Coloxyl, Coloxyl with Senna (combo)

Oral Routes

Tablets (50 mg, 120 mg). Drops for pediatrics.

Prescribing & PBS

OTC; docusate 50 mg tablets are also listed on the RPBS/PBS item record.

Indications & Use

Primary

TGA

Prevention and treatment of hard, dry stools.

Clinical Place

Used when straining is contraindicated (e.g., post-MI, post-hernia repair, hemorrhoids).

Quick reference

Class & Role

Stool Softener — Anionic surfactant (detergent).

Route / Formulation

Tablets (50 mg, 120 mg). Drops for pediatrics. (Coloxyl, Coloxyl with Senna (combo))

Usual Dose & Max

PO 120 mg once or twice daily; max 480 mg/day in divided doses. Combination docusate/senna is commonly used for opioid/palliative constipation.

Key Indication Doses

Constipation: PO 100-200 mg BD. Max 500 mg/day. Elderly / Frail: Often given as 120 mg BD.

Best Uses

Docusate sodium is a gentle stool softener for patients where straining is contraindicated, but has weak evidence for efficacy and is often insufficient as monotherapy.

Avoid / Cautions

Intestinal obstruction. Pregnancy Category A. Widely used post-partum.

Key Risks

Gastrointestinal: Mild abdominal cramping, bitter taste (if liquid is used). Systemic: Extremely benign safety profile. Very safe in the elderly.

Key Interactions

Liquid paraffin (mineral oil laxatives). Docusate increases the systemic absorption of mineral oil, leading to lipoid pneumonia and hepatic granulomas. Never combine them.

Monitoring

Monitor bowel chart. Efficacy is often poor in severe constipation without a stimulant.

Clinical Pearl

Opioids paralyze the gut. Giving Docusate alone to a patient on Oxycodone just creates soft stool sitting in a paralyzed bowel. You MUST add Senna (the push).

Access

Coloxyl, Coloxyl with Senna (combo)50 mg tablet

Brand: Coloxyl, Coloxyl with Senna (combo)
Formulation: Tablets (50 mg, 120 mg)