Docusate
From Pharmacopedia
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Docusate (sodium or calcium)
Colace (sodium), Surfak (calcium); many generics OTC
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Summary
Classes
Common uses
Constipation prevention (especially with opioids or in postoperative settings)0, Cerumen impaction (liquid otic, marginal evidence)0
Pharmacy
Starting dose
100-200 mg PO once or twice daily; pediatric weight-based
Preparations
50, 100, 250 mg capsules; 50 mg/5 mL syrup; OTC
US FDA Max
~500 mg/d typical
Pharmacology
Routes
Oral, rectal
Onset
1-3 days
Duration
Hours
Half-life
Not meaningfully described
Bioavailability
Local action; minimal systemic effect
Pregnancy
Generally considered safe.[citation needed]
Legal status
OTC in US
Purported mechanism
Docusate is an anionic surfactant that lowers the surface tension at the oil-water interface in the gut, allowing water and fats to penetrate stool and producing softer consistency without stimulating motility.0 Evidence for clinical benefit in routine constipation is surprisingly weak; multiple RCTs in hospitalized patients show no advantage over placebo. Continues to be widely used in practice (especially as adjunct to opioid-induced constipation regimens) despite the modest evidence base.