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docusate (DOC u sate)
casanthranol (cas ANTH ran al)
What is docusate/casanthranol?
Docusate is basically a detergent that is not absorbed by the body. It encourages the mixture of water and dietary fat within the stool, making the stool softer. It does not hold water like some bulking agents nor does it stimulate the bowel like true laxatives.
Casanthranol is a stimulant type of laxative. The drug irritates the lining of the bowel to secrete fluid and so produce softer or more liquid bowel movements.
What is it used for?
This medication should be used only for the short-term correction of simple constipation. It is generally not recommended for long-term use, diverticulosis or irritable bowel syndrome.
How do I take it?
Follow your physician’s instructions carefully. Take this medication with a full glass of water at least 1 hour before or after any other medicine. It may be given in milk, fruit juice or infant formula to mask the taste. Store it in a tightly sealed container at room temperature. Keep all medications away from children. Never share your medications with anyone else.
What do I do for a missed dose?
If you miss a dose of this medicine, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and return to your regular schedule. Do not double up on this medication.
Are there interactions with food or beverages?
There are no known interactions with food or beverages. An increase in fluid intake, a diet rich in fiber or bran and regular exercise can improve bowel regularity.
Are there interactions with other drugs?
An interaction generally means that one drug may increase or decrease the effect of another drug. Also, the more medications a person takes, the more likely there will be a drug interaction. There are no known drug interactions with this preparation. However, it should not be taken within 1 hour before or after any other medications because it may interfere with their absorption.
Is there a problem if I have another disorder or disease?
At times, a drug may have a different or enhanced effect when other diseases are present. At other times, the drug may worsen or effect another disease. Since this preparation also contains other sugars such as lactose and galactose, patients with diabetes should consult their physician.
What about allergies?
People who have known allergies or asthma may be at an increased risk for a reaction from any new medication. The physician should always know a patient’s allergy history. Signs of an allergic reaction are skin rash, hives and itching. Of course, a person should not take docusate/casanthranol if there has been a previous reaction to any stool softeners, bulking agents or laxatives.
What if I’m pregnant, considering pregnancy or breast-feeding?
Constipation is a common problem during pregnancy. It is always best to prevent this by eating a healthy diet containing lots of fiber. See High Fiber Diet below. Most females now know that, if possible, no drug, including alcohol, should be taken during pregnancy or lactation. The potential danger, of course, is an injury to the baby. However, some drugs are much safer than others in this regard. So, the FDA has a grading system for each drug which reflects what is known medically. It ranks drugs from A, where medical studies show no evidence for danger to the fetus or mother, to B, C, D and X, where the medical evidence indicates that the risk to the fetus outweighs any benefit to the mother. Docusate/casanthranol is ranked C. Always consult your physician before taking this or any drug during or when planning pregnancy.
What are the effects on sexual function?
There are no known adverse effects of this drug on sexual function.
Are there other precautions?
Laxatives should only be used occasionally. Frequent or prolonged use of any laxative may result in bowel dependence. To prevent hard stools, it may be sufficient to use a stool softener instead of this laxative combination.
How long is it safe to take docusate/casanthranol?
With this laxative, bowel movements are usually induced overnight or in 8 to 12 hours. This medicine can be used to manage chronic or temporary constipation but prolonged use may result in laxative dependence and is not recommended.
How about side effects?
Adverse reactions can occur with any drug, even over-the-counter medications. Some of these are mild such as a stomach upset, which may be avoided by taking the medication with food. Minor reactions may go away on their own but if they persist, contact the physician. For major reactions, the patient should contact the physician immediately.
For docusate/casanthranol, the following are the observed side effects:
- mild abdominal cramps
- rumbling sounds
- severe abdominal pain
A physician’s comment…
Irritant stimulant types of laxatives like casanthranol, senna, cascara or phenolphthalein should not be used more than occasionally. A chronically irritated bowel can actually end up being weaker than before so that the constipation problem actually becomes worse. The physician, especially a gastroenterologist, can often develop a satisfactory bowel program for most patients.