Stool Softener Medications Commonly Used

The Most Common Stool Softener

Brand Names: Colace
Therapeutic Category: Stool Softener
Dosage Forms: Oral Capsule/ Liquid /Tablet, Rectal Enemal
Use: Labeled Indications: Stool softener
Off Label Indication: Ceruminolytic
Dosing : Adult: Oral: Docusate calcium: 240 mg once daily
Docusate sodium: 50 to 360 mg once daily or in divided doses
Rectal: 283 mg per 5 mL: 283 mg
Pediatric: Children 2 years to <12 years: 50 to 150 mg/day in single or divided doses
Children ≥12 years and Adolescents: 50 to 360 mg/day in single or divided doses
Dose Adjustments

Renal Impairment:. No dosage adjustment.
Hepatic Impairment: No dosage adjustment.
Adverse Drug Interaction:
Throat irritation
Pharmacodynamics/Kinetics:
Onset of action: Oral: 12 to 72 hours
Rectal: 2 to 15 minutes
Important Notes:
When used for self-medication (OTC), patients should be instructed to contact healthcare provider prior to use if nausea, stomach pain, or vomiting are present
Some dosage forms may contain propylene glycol; in neonates large amounts of propylene glycol delivered orally have been associated with potentially fatal toxicities
Pregnancy & Lactation: Agents other than docusate are preferred for initial treatment / not known if present in breast milk
Hypomagnesemia was reported in a newborn following chronic maternal overuse of docusate sodium throughout pregnancy
Drug safety issue:

Colace may be confused with Calan, Cozaar

Brand Names: MiraLax
Therapeutic Category: Laxative, Osmotic Stool Softener
Dosage Forms: Oral Packet
Use: Labeled Indications: Constipation, occasional: Treatment of occasional constipation
Off Label Indication: Bowel preparation before colonoscopy
Dosing : Adult Bowel preparation before colonoscopy (off-label use): Oral: 17 g in 240 mL of clear liquid every 10 minutes until 2,000 mL of volume are consumed (start within 6 hours after administering bisacodyl delayed-release tablets or magnesium citrate)
Constipation, occasional: Oral: 17 g dissolved in 120 to 240 mL of beverage, once daily; do not use for >1 to 2 weeks
Pediatric: Constipation: Oral: 0.2 to 0.8 g/kg/day (maximum daily dose: 17 g/day)
Dose Adjustments

Renal Impairment:. no dosage adjustments
Hepatic Impairment: No dosage adjustment.
Adverse Drug Interaction:
Diarrhea, Flatulence, nausea, abdominal pain, loose stools
Pharmacodynamics/Kinetics:
Onset of action: Oral: 24 to 96 hours
Excretion: Feces (93%)
Important Notes:
Electrolyte imbalance: Prolonged, frequent, or excessive use may lead to electrolyte imbalance.
Pregnancy & Lactation: has minimal systemic absorption and would be unlikely to cause fetal malformations
Drug safety issue:
MiraLax may confused with Mirapex
Polyethylene glycol 3350 may confused with polyethylene glycol electrolyte solution, propylene glycol