1. About docusate
Docusate is a type of medicine called a laxative. It helps to soften your poo and makes your bowel movements easier if you have problems pooing (constipation).
It is helpful when you have difficulty going to the toilet because of dry poos or piles (haemorrhoids) or if you have a tear in the lining of your intestine near your anus (anal fissure).
You may also be given docusate if you're going to have an x-ray of your stomach. It can help you empty your bowels beforehand.
Docusate comes as capsules and as a liquid that you swallow. It also comes as an enema. This is a tube of liquid medicine which you squeeze into your anus (bottom).
Docusate is available on prescription or to buy from pharmacies. There is one brand called DulcoEase that you can buy in pharmacies and shops.
2. Key facts
- Docusate capsules and liquid take 1 or 2 days to work.
- The enema usually works within 20 minutes, so it's best to stay close to a toilet.
- Only give docusate to a child under 12 years old if their doctor prescribes it.
- Do not take it for more than a week without talking with your doctor.
- Common side effects include feeling sick (nausea).
3. Who can and cannot take docusate
Most adults and children aged 12 years and over can safely take docusate.
Important
Never give docusate to a child under 12 years old unless their doctor prescribes it.
Docusate is not suitable for some people. To make sure it is safe for you, tell your doctor or pharmacist if you have:
- ever had an allergic reaction to docusate or any other medicines
- a blockage in your gut (intestine)
- stomach pains
- been feeling sick or have vomited in the last 24 hours
Do not use an enema containing docusate if you have:
- piles (haemorrhoids) or bleeding from your bottom
- a sore around your anus (anal fissure)
- ulcerative colitis or Crohn's disease, or other inflammatory bowel condition
- parlytic ileus (when the muscles in your bowel are not able to move food and liquid along)
4. How and when to take or use docusate
Docusate comes as capsules, liquid and an enema.
How to take or use it
Capsules – swallow the capsule whole with plenty of water.
Liquid – this comes with a plastic cup or spoon to measure the dose. Do not use a kitchen spoon as it will not give the right amount. If you do not have a cup or spoon, ask your pharmacist for one. When you've swallowed it, drink plenty of water or have another drink, such as milk or orange juice.
Enema – squeeze the tube of liquid gently into your anus. The information leaflet which comes with your docusate will explain how to do this.
Docusate does not usually upset your stomach. You can take the capsules or liquid with or without food. Try to take your medicine at regular intervals throughout the day. Mealtimes (breakfast, lunch and dinner) are useful reminders.
There is no specific time of day to use an enema but it works quickly (usually between 5 and 20 minutes), so use it when you know you'll be near a toilet.
Dosage
Capsules – the normal dose is 1 capsule, taken 3 times a day. Do not take more than 5 capsules in a day.
Liquid – the normal dose is two or three 5ml spoonfuls. Take this dose 3 times a day.
Enema – normally 1 tube of liquid is all you need. If you need a second dose, you can use it later in the day or the next day.
You will usually feel more comfortable within 1 or 2 days of treatment. Reduce the dose as your condition gets better.
Drink plenty of fluids (6 to 8 glasses a day) while you are taking docusate or your constipation may get worse.
What if I forget to take it?
If you forget a dose of docusate, do not worry. Just take the next dose as normal.
Never take 2 doses at the same time. Never take an extra dose to make up for a forgotten one.
What if I take too much?
Taking an extra dose of docusate as a one-off is unlikely to harm you, but it is a good idea to drink lots of water. You may get diarrhoea and stomach pain, but this will usually get better within 1 or 2 days.
If you're worried, talk to your doctor or a pharmacist for advice.
5. Side effects
Like all medicines, docusate may cause side effects in some people but most people have no side effects or only minor ones.
Common side effects
If you get any of these side effects, talk to your doctor or pharmacist:
- feeling sick (nausea)
- diarrhoea
- stomach cramps
These side effects are mild and usually go away after a couple of days.
When using a docusate enema you may get a burning feeling or pain around your bottom (anus). Occasionally the wall of the anus may bleed. This is a reaction to the enema and it usually clears up quickly. If the pain or bleeding does not go away or you are worried, talk to your doctor or pharmacist.
Serious side effects
In rare cases, it's possible to have a serious allergic reaction (anaphylaxis) to docusate.
Immediate action required: Call 999 now if:
- your lips, mouth, throat or tongue suddenly become swollen
- you're breathing very fast or struggling to breathe (you may become very wheezy or feel like you're choking or gasping for air)
- your throat feels tight or you're struggling to swallow
- your skin, tongue or lips turn blue, grey or pale (if you have black or brown skin, this may be easier to see on the palms of your hands or soles of your feet)
- you suddenly become very confused, drowsy or dizzy
- someone faints and cannot be woken up
- a child is limp, floppy or not responding like they normally do (their head may fall to the side, backwards or forwards, or they may find it difficult to lift their head or focus on your face)
You or the person who's unwell may also have a rash that's swollen, raised, itchy, blistered or peeling.
These can be signs of a serious allergic reaction and may need immediate treatment in hospital.
These are not all the side effects of docusate. For a full list see the leaflet inside your medicines packet.
You can report any suspected side effect using the Yellow Card safety scheme.
6. How to cope with side effects of docusate
What to do about:
- feeling sick – try taking docusate with a meal or snack. You could also try mixing your dose with some water or fruit juice.
- diarrhoea – if you’re using docusate for mild constipation and get diarrhoea, stop taking docusate. Your bowels will usually return to normal in a few days. Drink plenty of water or other fluids to prevent dehydration and stop the constipation returning. If your doctor has prescribed docusate for severe or long-term constipation and you get diarrhoea, ask them for advice about what to do. Do not take any other medicines to treat diarrhoea without speaking to a pharmacist or doctor.
- stomach cramps – if you get stomach cramps, reduce your dose of docusate until this goes away.
7. Pregnancy and breastfeeding
If you're pregnant or breastfeeding, you can try to treat constipation without taking a medicine. This involves eating more fibre and drinking plenty of fluids. It may also help to do gentle exercise.
If diet and lifestyle changes do not work, your doctor or midwife may recommend a laxative, such as lactulose or Fybogel. These laxatives are quite often used during pregnancy and while breastfeeding.
Docusate in pregnancy
Docusate is occasionally used in pregnancy and there is no evidence to suggest it will harm your baby. However, other types of laxative are usually tried first, because there is more information to say that they are safe.
Docusate and breastfeeding
If your doctor or midwife recommends docusate, instead of lactulose or Fybogel, it’s usually ok to use this medicine while breastfeeding. The amounts of docusate found in breast milk are probably very small and are unlikely to affect your baby.
If you notice that your baby is not feeding as well as usual, or if you have any other concerns about your baby, talk to your health visitor, midwife or doctor as soon as possible.
Non-urgent advice: Tell your doctor if you're:
- trying to get pregnant
- pregnant
- breastfeeding
For more information about how laxatives can affect you and your baby, read this leaflet about treating constipation on the Best Use of Medicines in Pregnancy (BUMPs) website.
8. Cautions with other medicines
Do not take docusate with a mineral oil laxative such as liquid paraffin.
Mixing docusate with herbal remedies and supplements
There's very little information about taking herbal remedies and supplements with docusate.
Important: Medicine safety
Tell your doctor or pharmacist if you're taking any other medicines, including herbal medicines, vitamins or supplements.
9. Common questions about docusate
How does docusate work?
Docusate helps to soften your poo by increasing the amount of water in it. This makes it easier for you to go to the toilet.
Docusate also stimulates the muscles that line your gut, helping poo to move poo along your bowel to your anus.
When will I feel better?
Docusate capsules and liquid normally take 1 or 2 days to work. The enema usually works after 5 to 20 minutes, so it's best to stay close to a toilet.
Talk to your doctor or pharmacist if you are still constipated after a week.
How long willI take docusate for?
Take docusate for up to 1 week. If you take docusate for longer, your bowel can start to rely on it, rather than working on its own.
If you are still constipated after taking docusate for a week, talk to your doctor.
If your constipation is caused by an illness or a medicine you're taking, your doctor will advise you about when it's best to stop taking docusate.
Is it safe to take docusate for a long time?
It's best to use docusate occasionally and for a few days at a time.
Using laxatives like docusate for longer can lead to long term diarrhoea.
They can also cause an electrolyte imbalance. This means that levels of salts and minerals like sodium, potassium and magnesium in your body get too high or too low. A severe electrolyte imbalance can cause serious health problems such as muscle spasm and twitching, and even fits or seizures.
Using docusate for many weeks, even months, could also stop your bowel working properly on its own.
Can I take different laxatives together?
For most people, 1 laxative will be enough to relieve constipation.
Occasionally, you may need to take 2 different types of laxatives at the same time to get your bowels moving again.
Only take 2 laxatives together on the advice of your doctor or pharmacist as there is an increased risk of side effects.
Are there other laxatives I can try?
There are other types of laxative. They work in a different way to docusate but are equally good at treating constipation.
Bulk-forming laxatives, for example Fybogel. These increase the bulk or weight of poo which in turn stimulates bowel movement. They take 2 or 3 days to work.
Osmotic laxatives, for example lactulose. These draw water from the rest of the body into your bowel to soften your poo and make it easier to go to the toilet. They take at least 2 days to work.
Stimulant laxatives, for example senna and bisacodyl. These stimulate the muscles that line your gut, helping them to move poo along your gut. Senna takes about 8 hours to work.
Is there any food or drink I need to avoid?
You can eat and drink normally while taking docusate.
It might be a good idea to stop eating pastries, puddings, sweets, cheese and cake for a while as these foods can make constipation worse.
Can I drink alcohol with it?
Yes, you can drink alcohol with docusate.
Can I use docusate after surgery?
It's quite common to have constipation after surgery. Using a laxative may help relieve the discomfort.
If you have constipation after an operation, it's better to use lactulose because it is gentler than docusate. You can get lactulose from pharmacies.
Can lifestyle changes help constipation?
It's often possible to improve constipation without having to use laxatives. Before trying docusate – or to stop constipation coming back – it may help to:
- eat more fibre – aim for about 30g of fibre a day. High-fibre foods include fruit, vegetables and cereals. If you're not used to a high-fibre diet, increase the amount of fibre you eat gradually.
- add bulking agents, such as wheat bran, to your diet. These will help make your poo softer and easier to pass (although bran and fibre can sometimes make bloating worse).
- drink plenty of water – to keep poo soft
- exercise regularly – keeping your body active will help to keep your gut moving