Constipation can impact routines and affect social, professional responsibilities. Various options for treatment of constipation include the use stool softeners and laxatives. Depending on the type of constipation, medications are recommended and used by patients. Docusate Sodium, belonging to the class of stool softeners, is one among the popular forms of medication, which increases absorption of water by the stool in the guts, which in turn makes it easy to perform ablutions without constipation. Like all medications, there are possible undesirable side effects that may be experienced with the stool softener. Let’s take a detailed look at docusate sodium side effects to be better equipped to deal with the problem.
Overview and docusate sodium side effects
Before we look at docusate sodium side effects it is necessary to learn a little more about the medication and its mechanism of action. The primary action is the increase intake or absorption of water from the guts by the stool, which softens and makes it easier to pass. Improved motility and softer stools greatly alleviate the problem of constipation, helping individuals get back to near normal or normal routines. The medication can be administered either rectally or as oral formulations. Available as over the counter formulation, one of the associated issues with the medication is its inability to relieve abdominal cramps in some cases.
Mechanism of action and docusate sodium side effects
Before we look at the docusate sodium side effects, here is a closer look at the mechanism of action of the medication. The mechanism of action of docusate sodium is the increased incorporation of water and fat. As an anionic detergent, it significantly softens the stool, reducing friction and surface tension. The action of the medication commences anywhere between 6 hours to 72 hours from the time it is administered orally, and in the case of rectally administered forms, the onset of action is anywhere between two minutes to fifteen minutes. The surfactant effect is regarded as the primary effect of the medication.
Studies revealed that increased secretion of water, potassium, sodium and chloride were recorded when the medication was administered. This also worked with a simultaneous decrease in bicarbonate and glucose absorption. This has been attributed to the increase in intracellular cyclic AMP.
Ideal dosage to prevent docusate sodium side effects
In many instances, the actual docusate sodium side effects have been attributed to incorrect dosage or the wrong manner of taking the medication. Here are recommended dosages based on various requirements. It is important to remember that the recommended dosages are only the ideal average dosages. The actual dosages required may differ from person to person and could depend on various factors. The available dosages are 50 mg, 100 mg and 250 mg. The tablets are typically available in dosages of 100 mg. Oral liquid formulations are available as 10 mg/mL or 50 mg/mL quantities. The syrup is available as 60 mg/15 mL, and when it is recommended as enema and administered rectally, the available dosages are 283 mg for adults and 100 mg for pediatric uses.
The ideal prescribed doses/quantities are as explained herein to avoid docusate sodium side effects. Adults administered the medication orally are prescribed anywhere between 50 mg to 300 mg per day, which could be taken either once a day or divided into a few doses. When given as an enema for adults, the maximum dose is 283 mg for every instance, with the procedure being performed either once a day or three times per day. Children between the age of 2 to 12 years are recommended a dose anywhere between 50 mg to 150 mg per day, with the oral formulations being given either once or divided into different doses. In the case of children above the age of 12 years, the recommended dosage is between 50 mg to 300 mg per day, taken either once or divided into multiple doses. The medication is not considered as safe enough to be given to children below the age of 2 years.
When administered rectally for children the prescribed doses to avoid docusate sodium side effects are as explained. Children above the age of 12 years are prescribed a dose of 283 mg for each enema, that could be performed either once a day or thrice a day. In the case of children below the age of 12 years and above 2 years, the prescribed dose is 100 mg for each enema. For children of this category, the enema is to be performed once a day, and if performed on alternative days, the dose can be increased to that of 283 mg. The medication is not considered as safe for rectal administration for children below the age of two years.
Commonly reported docusate sodium side effects
Some of the commonly reported docusate sodium side effects include the outbreak of rashes on the body, that is not attributed to any other reason. There is the possibility of developing dependence on the medication for the purpose of performing ablutions. Individuals may also end up with low levels of electrolyte in the body when it is used heavily. There is a possibility of it being used always and this could result in reducing electrolyte levels. Patients have reported abdominal cramps as a result of the medication, and as mentioned above, the formulation sometimes does not offer relief from cramps that may have been experienced as part of symptoms. Similarly, stomach pain is also likely to be experienced by patients, which may not be attributed to any other reason.
The possibility of diarrhea also cannot be ruled out as one of the docusate sodium side effects. As a consequence of the increased intake of water and fats, it is highly likely that the patient may experience an increase in bowel activity and this could also upend routines. In certain instances, patients have reported irritation in the throat, while others have complained of experiencing obstruction in the intestines.
Possible drug interactions that trigger docusate sodium side effects
In addition to the above docusate sodium side effects, there is also the possibility of the medication interacting with other drugs. The most commonly reported interaction of the medication is with other mineral oil. This is mainly as a result of the mechanism of action of the formulation, and the mechanism of action of mineral oil. While there are no known or reported interactions with other drug it is possible that some patients may experience some kind of adverse results when on other medication. It is necessary to intimate or list out the use of other medications to the treating specialist at the time of prescription of the medication in any form. There is the possibility of existing allergies to the active ingredients in the medication. It is therefore necessary to avoid the medication if there is any previous history of allergy to docusate or other ingredients.
Precautions that need to be followed
Certain precautions are necessary to avoid possible docusate sodium side effects. For instance, individuals using the medication for more than a week are likely to end up being dependent, which could cause electrolyte imbalance. Whenever the formulation is administered rectally as enema, it is necessary to follow the right kind of lubrication procedures. In the event of any discomfort or irritation, it is important to discontinue use, this will prevent the possibility of injuries to the rectum. While the medication is easily available as over the counter formulation, it is advisable to seek medical advice prior to its use. This is especially important if there are other symptoms alongside constipation, such as nausea or pain in the stomach or an urge to vomit. Patients who experience bleeding in the rectum are advised to immediately discontinue use of the medication and seek medical attention.
Precautions in the case of pregnant women and lactating mothers
To avoid possible docusate sodium side effects in pregnant women and lactating mothers, the following recommendations need to be followed. As adequate studies have not been conducted to verify the safety of the medication in pregnant women and lactating mothers, it is necessary to use the formulation only if there is a pressing need. The best option is to use it with professional advice, to ensure that the effects are controlled or mitigated.
Individuals with pre-existing conditions
Individuals with certain pre-existing conditions need to intimate the same to the treating specialist to avoid docusate sodium side effects. Individuals with inflammatory bowel disease need to inform the same to the treating specialist to ensure that no adverse effects are experienced. Patients with issues in the stomach or intestines are also expected to seek professional advice prior to taking the medication. Any abnormal bowel movements that precede the treatment regimen also require to be intimated to the specialist, as this could also have an impact on the medication’s outcomes. Patients with a history of allergy to the active ingredients in the medication are to avoid it altogether. For instance, allergy to docusate, dyes, or artificial preservatives, or senna are all strong reasons for avoiding the medication. Patients with blockage in the bowel or experiencing vomiting sensations are also advised to seek professional advice before taking any OTC stool softener, either as oral medication or enema.
The need to be aware of suitable medications for constipation
While the above sections dealt with docusate sodium side effects it is equally important to know the difference between laxatives and stool softeners. This will help identify the most suitable formulation for specific uses. This will greatly reduce the possibility of side effects, especially when there is an urge to take OTC medications without professional advice. Laxatives typically cause bowel movements, while stool softeners are a type of laxative that absorb water and reduce surface tension in stool motility. The commonly available laxatives include osmotic laxatives, fiber based laxatives, saline laxatives, lubricant laxatives, stimulant laxatives and guanylate cyclase-C agonist laxatives. Each type of laxative is prescribed depending on the condition. For instance, individuals who suffer from dehydration are not to take osmotic laxatives, while patients with chronic constipation may be prescribed fiber based laxatives. Patients on medication to lower sodium levels are advised to stay off saline laxatives, while individuals with long term constipation are advised to avoid lubricant laxatives. Individuals who suffer from painful bouts of constipation will find stimulant laxatives more suitable as a remedy.
Education: Master’s in Nursing (MSN) from Johns Hopkins University. Experience: 7 years writing for online health portals and nursing journals, specializing in patient education and chronic illness management.
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