1.6.2 Stimulant laxatives

Many of these products are cheap to buy and are readily available, along with advice, from pharmacies. Some self-care medicines are available in shops and supermarkets. Please click here for further information and a patient leaflet

Bisacodyl

  • Tablets 5mg (£4.79 = 10mg daily)
  • Suppositories 5mg (paed) (£5.82 = 5mg daily)
  • Suppositories 10mg (£8.24 = 10mg daily)

Indications

Dose

  • Adult oral: 5–10mg at night, increased if necessary to maximum 20mg at night
  • Child oral: 4–18 years 5–20mg once daily, adjusted according to response
  • Adult rectally: 10mg in the morning
  • Child rectally: 5–10mg once daily, adjusted according to response

Notes

  1. Time to effect: 6-12 hours

Senna

  • Tablets 7.5mg sennosides (£1.50 = 15mg daily)
  • Syrup 7.5mg sennosides in 5ml (£5.33 = 15mg daily)

Indications

Dose

  • 2–4 tablets or 10-20ml, usually at night; initial dose should be low then gradually increased

Notes

  1. Time to effect: 8-12 hours
  2. Licensed only for short term use. Efficacy is decreased with continued use

Docusate sodium

  • Capsules 100mg (£7.80 = 200mg twice daily)
  • Paediatric oral solution 12.5mg/5ml (£10.91 = 12.5mg three times daily)
  • Oral solution 50mg/5ml (£29.90 = 200mg twice daily)
  • Enema 120mg in 10g (£4.67 each)

Indications

Dose

  • Chronic constipation (adult), up to 500mg daily in divided doses;
  • Child 6 months–2 years 12.5mg 3 times daily
  • Child 2–12 years 12.5–25mg 3 times daily.
  • Dose adjusted according to response (use paediatric oral solution)

Notes

  1. Time to effect: 1-2 days

Glycerol

  • Suppositories 1g, 2g, 4g (£1.16 = 4g x 12 pack)

Indications

Dose

  • 1 suppository when required

Notes

  1. Time to effect: 15-30 minutes
  2. Lubricating and weak stimulant. Can be used for hard or soft stools.
  3. Licensed for occasional use only

Co-danthramer (Dantron with poloxamer 188)

  • Suspension 25mg/200mg in 5ml (£168.93 = 300ml)
  • Strong suspension 75mg/1000mg in 5ml (£337.05 = 300ml)

Indications

Dose

  • 5–10ml at night 25mg/200mg; or 5ml at night 75mg/1000mg

Notes

  1. For use in palliative care only
  2. Time to effect: 6-12 hours
  3. Patients should be warned that it discolours the urine. Prolonged contact with the skin (eg. faecal or urinary incontinence) can cause a dantron burn

Co-danthrusate (Dantron with docusate sodium)

  • Suspension 50mg/60mg in 5ml (£154.40 = 200ml)

Indications

Dose

  • Adult (and children aged 12 year and over): 5–15ml at night
  • Child 6–11 years: 5ml at night

Notes

  1. For use in palliative care only
  2. Time to effect: 6-12 hours
  3. Patients should be warned that it discolours the urine. Prolonged contact with the skin (e.g. faecal or urinary incontinence) can cause a dantron burn

Lecicarbon A

  • Suppositories (£8.20 = 10 suppositories)

Indication

Dose

  • Insert one suppository when required. If necessary, this can be repeated after 30-60 minutes

Notes

  1. Lecicarbon A suppositories contain soya lecithin and are contraindicated in patients who have peanut or soya allergies
  2. The routine commissioning of lecicarbon A suppositories for the management of chronic constipation has been accepted in Devon (see Commissioning Policy for more details).

Sodium Picosulfate

  • Elixir 5mg/5ml (£6.63 = 10mg daily)

Indications

Dose

  • Adult: 5–10mg at night
  • Child 1 month–4 years: 2.5–10mg once daily, adjusted according to response
  • Child 4–18 years: 2.5–20 mg once daily, adjusted according to response

Notes

  1. Time to effect: 6-12 hours

 

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