Docusate

Generic Name: Docusate

Brand Names: Citranatal Harmony, Colace, Docusol, Docusol Plus, Dok, Dulcolax, Enemeez, Enemeez Plus, Ferralet 90, Laxacin, Pedia-lax Liquid, Peri-colace Reformulated Feb 2008, Phillips Stool Softener, Promolaxin, Senexon S, Senokot-S

Drug Type: Small Molecule

Chemical Formula: C_₂₀H_₃₈O_₇S

CAS Number: 10041-19-7

Unique Ingredient Identifier: M7P27195AG

Overview

Docusate, or dioctyl sulfosuccinate, is a stool softener indicated for the treatment of constipation. Docusate acts by increasing the amount of water the stool absorbs in the gut, making the stool softer and easier to pass . Docusate can be orally or rectally administered. Docusate is on the World Health Organization's List of Essential Medicines. However the effectiveness of docusate in treating constipation remains unclear, as several studies report docusate to be no more effective than placebo for increasing the frequency of stool or stool softening . Recently there has been pressure to stop prescribing docusate as it has been identified as an ineffective medicine. Additionally, it does not appear to lessen symptoms associated with constipation such as abdominal cramps. Still docusate is available in over-the-counter products as a common laxative.

Background

Indication

Indicated for the treatment of constipation associated with dry, hard stools or opioid induced constipation. Though recently, pressure has been building to end the use of docusate over concerns of efficacy.

Associated Conditions

Constipation
Occasional Constipation

Research Report

Published: May 13, 2025

Docusate

Name (English): Docusate
DrugBank ID: DB11089
Type: Small Molecule
CAS Number: 10041-19-7
Description: Docusate, also known as dioctyl sulfosuccinate, is a stool softener used to treat constipation. It increases water absorption in the gut, softening the stool for easier passage. It can be administered orally or rectally.
Mechanism of Action: Docusate is a surfactant laxative that reduces the surface tension of the oil-water interface of stool. This enhances the incorporation of water and fat into the stool, resulting in a softer fecal mass. Its effects are primarily local in the jejunum.
Pharmacokinetics:
- Onset of Action: 6-72 hours orally, 2-15 minutes rectally.
- Absorption: Significant amounts can be excreted in bile, indicating some absorption.
- Excretion: Primarily in feces.
Indications: Treatment of occasional constipation. Often used when straining during bowel movements should be avoided.
Contraindications: Hypersensitivity to docusate, intestinal obstruction, symptoms of appendicitis or acute abdominal pain, fecal impaction, concomitant use of mineral oil, nausea or vomiting.
Warnings/Precautions: Electrolyte imbalance with excessive use, dependence with excessive use, rectal use only for enemas (lubricate, discontinue if irritation or resistance occurs), consult healthcare professional for stomach pain, nausea, vomiting, or persistent changes in bowel habits. Discontinue and consult if bleeding occurs or if no bowel movement after use or need for continued use beyond 7 days.
Adverse Effects: Abdominal cramping, diarrhea, excessive bowel activity, intestinal obstruction, throat irritation (with liquid/syrup forms).
Drug Interactions: May interact with various medications, potentially decreasing the efficacy of some (e.g., some anticholinergics, opioids, calcium channel blockers) or increasing the risk of adverse effects with others (e.g., calciu