Docusate
Clinical data | |
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Trade names | Colace, Ex-Lax Stool Softener, others |
Other names | Dioctyl sulfosuccinate |
AHFS/Drugs.com | Monograph |
MedlinePlus | a601113 |
License data | |
Pregnancy category |
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Stool softener | |
ATC code | |
Legal status | |
Legal status |
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Pharmacokinetic data | |
Onset of action | 12 hrs to 5 days[1] |
Duration of action | 3 days[1] |
Identifiers | |
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JSmol) |
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Density | 1.1 g/cm3 |
Melting point | 153 to 157 °C (307 to 315 °F) 173-179 °C |
Solubility in water | 1 in 70 parts mg/mL (20 °C) |
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Docusate is the common chemical and pharmaceutical name of the
It is on the World Health Organization's List of Essential Medicines.[11] In 2021, it was the 133rd most commonly prescribed medication in the United States, with more than 4 million prescriptions.[12][13] In 2021, the combination with senna was the 275th most commonly prescribed medication in the United States, with more than 800,000 prescriptions.[12][14]
History
Sodium docusate was patented in 1937 by Coleman R. Caryl and Alphons O. Jaeger for American Cyanamid,[3] which commercialized it for many years as a detergent under the brand name Aerosol OT.
Its use for the treatment of constipation was first proposed in 1955 by James L. Wilson and David G. Dickinson,[4] and quickly popularized under the name Doxinate.[15]
Medical use
Constipation
The main medical use of docusate sodium is to treat
When administered by mouth, a bowel movement often occurs in 1 to 3 days,[1] while rectal use may be effective within 20 minutes.[16]
Sodium docusate is recommended as a stool softener for children.[1]
However, its effectiveness for constipation is poorly supported by evidence.[5][6] Multiple studies have found docusate to be no more effective than a placebo for improving constipation.[5][6][7][8] Others have found it to be less useful for the treatment of chronic constipation than psyllium.[8][17][18]
The medication may be given to people who are receiving opioid medication, although prolonged use may cause irritation of the gastrointestinal tract.[8][18]
Other medical uses
Docusate sodium, when used with ear syringing, may help with
Sodium docusate is also used as a
Precautions and contraindications
Docusate sodium is approved and recommended as safe during pregnancy and breastfeeding.[21][22]
Docusate is not recommended in people with appendicitis, acute abdomen, or ileus.[18]
When taken by mouth it should be ingested with plenty of water.
Side effects
Side effects are uncommon and typically mild,
Serious allergic reactions may occur with the drug. The most severe side effect of docusate, although very rare, is rectal bleeding.[23]
Interactions
Docusate might increase resorption of other drugs, for example, dantron (1,8-dihydroxyanthraquinone).[18]
Mechanism of action
Docusate is an
It does not stay in the gastrointestinal tract, but is absorbed into the bloodstream and excreted via the gallbladder[18] after undergoing extensive metabolism.
The effect of docusate may not necessarily be all due to its surfactant properties. Perfusion studies suggest that docusate inhibits fluid absorption or stimulates secretion in the portion of the small intestine known as the jejunum.[medical citation needed]
Pharmaceutical brand names
In the U.S., docusate sodium for pharmaceutical use is available under multiple brand names: Aqualax, Calube, Colace, Colace Micro-Enema, Correctol Softgel Extra Gentle, DC-240, Dialose, Diocto, Dioctocal, Dioctosoftez, Dioctyn, Dionex, Doc-Q-Lace, Docu Soft, Docucal, Doculax, Docusoft S, DOK, DOS, Doss-Relief, DSS, Dulcolax - Stool Softener (not to be confused with another drug marketed under the Dulcolax brand, bisacodyl, which is a stimulant laxative), Ex-Lax Stool Softener, Fleet Sof-Lax, Genasoft, Kasof, Laxa-basic, Modane Soft, Octycine-100, Pedia-Lax, Preferred Plus Pharmacy Stool Softener, Regulax SS, Sulfalax Calcium, Sur-Q-Lax, Surfak Stool Softener, and Therevac-SB. Generic preparations are also available.
In the UK, dioctyl sodium sulfosuccinate is sold under the brand name Docusol (Typharm Ltd) and DulcoEase (Boehringer Ingelheim).
In Australia, dioctyl sodium sulfosuccinate is sold as Coloxyl and Coloxyl with senna.
In India, preparations include Laxatin by Alembic, Doslax by Raptakos Laboratories, Cellubril by AstraZeneca, and Laxicon by Stadmed.
Other uses
Dioctyl sodium sulfosuccinate is used as a
Food additive
Dioctyl sodium sulfosuccinate has been approved by the
Microencapsulation
Sodium docusate is the most widely used surfactant in reverse micelle encapsulation studies.[30]
Non-medical brand names
As a surfactant, docusate sodium is or has been commercialized under many brand names, including DSSj Aerosol OT, Alphasol OT, Colace, Complemix, Coprol, Dioctylal, Dioctyl-Medo Forte, Diotilan, Diovac, Disonate, Doxinate, Doxol, Dulsivac, Molatoc, Molofac, Nevax, Norval, Regutol, Softili, Solusol, Sulfimel DOS, Vatsol OT, Velmol, and Waxsol[31]
Chemistry
Structure and properties
The
The compound is a white, wax-like, plastic solid, with an odor suggestive of
Solubility of dioctyl sodium sulfosuccinate in water is 14 g/L at 25 °C, increasing to 55 g/L at 70 °C.
The ester groups are easily cleaved under basic conditions, but are stable against acids.[18]
Synthesis
Sodium dioctyl sulfosuccinate can be obtained by treating dioctyl maleate with sodium bisulfite. The bisulfite anion adds to the double bond:
- −CH=CH− + HSO−3 → −CH(−SO−3)−CH2−
Toxicity
Ingestion may cause the side effects described above, such as diarrhea, intestinal bloating, and occasionally cramping pains. Dioctyl sodium sulfosuccinate is not known to be
Marine species
Dioctyl sodium sulfosuccinate is of low toxicity for
In a 2010 study, dioctyl sodium sulfosuccinate exhibited higher toxicity against bacteria (
Freshwater species
The substance is highly toxic for rainbow trout with a median lethal concentration (LC50) of 0.56 mg/L after 48 hours for the pure substance. It is only slightly to moderately toxic for rainbow trout fingerlings, and slightly toxic for harlequin rasboras (LC50 27 mg/L of a 60% formulation after 48 hours).
References
- ^ a b c d e f g h "Docusate Salts". The American Society of Health-System Pharmacists. Archived from the original on 23 September 2015. Retrieved 11 August 2015.
- ^ a b American Society of Health-System Pharmacists (15 August 2011). "Stool Softeners". Archived from the original on 5 September 2015.
- ^ a b US 2181087, Caryl CR, Jaeger AO, "Detergent composition", issued 21 November 1939, assigned to American Cyanamid
- ^ PMID 14367076.
- ^ PMID 30785419.
- ^ PMID 25520993.
- ^ PMID 25967924.
- ^ S2CID 13869933.
- ^ ISBN 9781449642846.
- ISBN 9781890595661.
- hdl:10665/345533. WHO/MHP/HPS/EML/2021.02.
- ^ a b "The Top 300 of 2021". ClinCalc. Archived from the original on 15 January 2024. Retrieved 14 January 2024.
- ^ "Docusate - Drug Usage Statistics". ClinCalc. Archived from the original on 20 January 2024. Retrieved 14 January 2024.
- ^ "Senna; Docusate - Drug Usage Statistics". ClinCalc. Archived from the original on 18 January 2024. Retrieved 14 January 2024.
- PMID 13362832.
- ^ "Docusate sodium". 18 December 2004. Archived from the original on 21 July 2011. Retrieved 6 March 2019.
- PMID 23449608.
- ^ ISBN 978-3-7741-9846-3.
- ^ "How effective is docusate as a cerumenolytic agent?". GlobalRPH.com. Archived from the original on 23 November 2010.
- ISBN 978-3-85200-190-6.
- ISBN 9781608317080.
- PMID 16831610.
- ^ drugs.com: Docusate Archived 16 July 2010 at the Wayback Machine
- ^ ISBN 9780323393072– via Elsevier Science Direct.
- ISBN 9781449665869.
- PMID 20983186.
- .
- ^ a b "GRAS Notice Inventory Agency Response Letter GRAS Notice No. GRN 000006". Center for Food Safety and Applied Nutrition. 20 July 1998. Archived from the original on 31 October 2017. Retrieved 24 January 2020.
- ^ "CFR - Code of Federal Regulations Title 21". www.accessdata.fda.gov. Retrieved 29 January 2020.
- .
- ^ ISBN 9780122608025.
- ^ ScienceLab.com: Docusate sodium Material Safety Data Sheet Archived 17 October 2006 at the Wayback Machine
- PMID 20579683.
External links
- Stool Softeners at the N.I.H. PubMed Health resource.