1. About docusate
Docusate is a laxative that is used to treat constipation (difficulty pooing). It helps to soften your poo and makes your bowel movements easier.
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 back passage (an 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 - a tube of liquid medicine which you squeeze into your back passage.
Docusate is available on prescription. You can also buy it from pharmacies.
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.
- Do not give docusate to a child under 12 years old unless their doctor prescribes it.
- Do not take it for more than a week without talking with your doctor.
- Docusate is also known by the brand names Dulcoease or Dioctyl. The enema is known by the brand name Norgalax.
3. Who can and can't take docusate
Most adults can safely take docusate, but do not give it to a child under 12 years old unless their doctor prescribes it.
Never give docusate to a child under 12 years old unless their doctor prescribes it.
Docusate isn't 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 in the past
- ever had an allergic reaction to fructose or sorbitol (types of sugar)
- a blockage in your gut (intestine)
- stomach pains
- been feeling sick in the last 24 hours or have been sick
- been taking a mineral oil laxative such as liquid paraffin
Do not use an enema containing docusate if you have:
4. How and when to take it
Docusate comes as capsules, liquid and an enema.
How to take 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 don't have a cup or spoon, ask your pharmacist for one. When you've swallowed it, drink plenty of water or another drink, such as milk or orange juice.
- Enema - squeeze the tube of liquid gently into your back passage. The information leaflet which comes with your docusate will explain how to do this.
Docusate doesn't usually upset your tummy. You can take the capsules or liquid with or without food. Try to take them 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.
How much to take
- Capsules - the normal dose is 1 capsule 3 times a day. Do not take more than 5 capsules in a day.
- Liquid - the normal dose is 2 or 3 x 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 should 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, don't 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 by accident is unlikely to harm you but you should drink lots of water. You may get diarrhoea and stomach pain but this should ease off within a day or two.
If you're worried, talk to your doctor or 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. If you get any of these side effects, talk to your doctor or pharmacist:
- feeling sick (nausea)
- stomach cramps
These side effects are mild and usually go away after a couple of days.
With the docusate enema sometimes people get a burning or pain around their back passage. Occasionally the wall of the anus may bleed. This is a reaction to the enema and it should clear up quickly. If the pain or bleeding doesn't go away or you are worried about them, talk to your doctor or pharmacist.
Serious allergic reaction
In rare cases, it's possible to have a serious allergic reaction (anaphylaxis) to docusate.
Urgent advice: Contact a doctor straight away if:
- you get a skin rash that may include itchy, red, swollen, blistered or peeling skin
- you're wheezing
- you get tightness in the chest or throat
- you have trouble breathing or talking
- your mouth, face, lips, tongue or throat start swelling
These are warning signs of a serious allergic reaction. A serious allergic reaction is an emergency.
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 to the UK safety scheme.
6. How to cope with side effects
What to do about:
- feeling sick (nausea) - try taking docusate with meals or mixing your dose with some water or fruit juice.
- diarrhoea - drink plenty of water or other fluids. It may also help to take an oral rehydration drink to prevent dehydration. You can buy sachets of powder from a pharmacy which you mix with water. Reducing the dose of docusate may also help diarrhoea. Don't 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 it goes away.
7. Pregnancy and breastfeeding
Docusate may not be suitable if you're pregnant or breastfeeding because small amounts might be absorbed by your gut.
If you're pregnant or breastfeeding, it's always better to try to treat constipation without taking a medicine. Your doctor or midwife will first advise you to eat more fibre and drink plenty of fluids. It may also help to do gentle exercise.
Non-urgent advice: Tell your doctor if you're:
- trying to get pregnant
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.
For safety, tell your doctor or pharmacist if you're taking any other medicines, including herbal remedies, vitamins or supplements.
9. Common questions
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 them to move poo along your bowel to your back passage.
When will I feel better?
Docusate capsules and liquid normally take 1 or 2 days to work. The enema usually works within 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 should I 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?
Ideally, you should only 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 substances 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 (convulsions).
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 other laxatives any better?
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 and methylcellulose. 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 pass. They take at least 2 days to work.
- Stimulant laxatives, for example senna. These stimulate the muscles that line your gut, helping them to move poo along your gut to your back passage. 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 it 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