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Dioctyl
c
(UCB Pharma)
Capsules
,
yellow/white,
docusate sodium 100 mg,
net price 30-cap pack = £1.92,
100-cap pack = £6.40
Docusol
c
(Typharm)
Adult oral solution
,
sugar-free,
docusate sodium
50 mg/5 mL,
net price 300 mL = £5.49
Paediatric oral solution
, sugar-free, docusate sodium
12.5 mg/5 mL,
net price 300 mL = £5.29
Rectal preparations
Norgalax Micro-enema
c
(Norgine)
Enema
,
docusate sodium 120 mg in 10-g single-dose
disposable packs.
Net price 10-g unit = 57p
Dose
ADULT and CHILD (but see section 1.6) over 12 years, 10-g
unit
GLYCEROL
(Glycerin)
Indications
constipation
Dose
. See below
Glycerol Suppositories, BP
(Glycerin Suppositories)
Suppositories
,
gelatin 140 mg,
glycerol 700 mg,
pur-
ified water to 1 g, net price 12 = £1.27 (1 g), £1.29 (2 g),
£1.48 (4 g)
Dose
1 suppository moistened with water before use, when
required.
The usual
sizes are for
INFANT under 1 year,
small (1-g
mould),
CHILD 1–12 years medium (2-g mould), ADULT and CHILD
over 12 years,
large (4-g mould)
SENNA
Indications
constipation
Cautions
see notes above
Contra-indications
see notes above
Pregnancy
see Pregnancy,
p.
67
Breast-feeding
not known to be harmful
Side-effects
see notes above
Dose
. See under preparations
Note
Acts in 8–12 hours
Senna
(Non-proprietary)
Tablets
,
total sennosides (calculated as sennoside B)
7.5 mg.
Net price 60 = £1.47
Dose
2–4 tablets, usually at night; initial dose should be low then
gradually increased;
CHILD (but see section 1.6) 2–6 years see
BNF for Children
;
6–18 years 1–4 tablets once daily,
adjusted
according to response
Note
Lower dose on packs on sale to the public
Brands include
Senokot
c
D
Manevac
c
(HFA Healthcare)
Granules
, coated, senna fruit 12.4%, ispaghula 54.2%,
net price 400 g = £7.45.
Label:
25,
counselling,
administration
Excipients
include sucrose 800 mg per level 5-mL spoonful of granules
Dose
ADULT and CHILD over 12 years,
1–2 level 5-mL spoonfuls
at night with at least 150 mL water, fruit juice, milk or warm drink
Counselling
Preparations that swell in contact with liquid should
always be carefully swallowed with water or appropriate fluid and
should not be taken immediately before going to bed
Senokot
c
(Reckitt Benckiser)
Tablets
D,
see above
Syrup
, sugar-free, brown, total sennosides (calculated
as sennoside B) 7.5 mg/5 mL,
net price 500 mL =
£2.69
Dose
10–20 mL,
usually at bedtime;
CHILD (but see section 1.6)
1 month–2 years see
BNF for Children
, 2–4 years 2.5–10 mL once
daily, adjusted according to response; 4–18 years 2.5–20 mL once
daily,
adjusted according to response
Note
Lower dose on packs on sale to the public
SODIUM PICOSULFATE
(Sodium picosulphate)
Indications
constipation;
bowel evacuation before
abdominal radiological and endoscopic procedures
on the colon,
and surgery (section 1.6.5);
acts within
6–12 hours
Cautions
see notes above; active inflammatory bowel
disease (avoid if fulminant)
Contra-indications
see notes above;
severe dehydra-
tion
Pregnancy
see Pregnancy,
p.
67
Breast-feeding
not known to be present in milk but
manufacturer advises avoid unless potential benefit
outweighs risk
Side-effects
see notes above
Dose
. 5–10 mg at night;
CHILD
(but see section 1.6) 1 month–
4 years 2.5–10 mg once daily,
adjusted according to
response;
4–18 years 2.5–20 mg once daily,
adjusted
according to response
Note
Sodium picosulfate doses in BNF may differ from those
in product literature
Sodium Picosulfate
(Non-proprietary)
Elixir
,
sodium picosulfate 5 mg/5 mL,
net price
100 mL = £1.85
Note
The
brand
name
Dulcolax
c
Pico Liquid
(Boehringer
Ingelheim) is used for sodium picosulfate elixir 5 mg/5 mL
Dulcolax
c
Pico
(Boehringer Ingelheim)
Perles
c
(= capsules),
sodium picosulfate 2.5 mg,
net
price 20-cap pack = £1.93,
50-cap pack = £2.73
Note
The brand name
Dulcolax
c
is also used for bisacodyl tablets
and suppositories
Bowel cleansing preparations
Section 1.6.5
Other stimulant laxatives
Unstandardised preparations of
cascara,
frangula,
rhu-
barb,
and senna should be avoided as their
laxative
action is
unpredictable.
Aloes,
colocynth,
and jalap
should be avoided as they have a drastic purgative
action.
1.6.3
Faecal softeners
Liquid paraffin,
the traditional
lubricant,
has disadvan-
tages (see below). Bulk laxatives (section 1.6.1) and non-
ionic surfactant
‘wetting’
agents e.g.
docusate sodium
(section 1.6.2)
also have softening properties.
Such
drugs are useful for oral
administration in the manage-
ment of haemorrhoids and anal fissure; glycerol (section
1.6.2) is useful for rectal use.
Enemas containing arachis oil (ground-nut oil,
peanut
oil) lubricate and soften impacted faeces and promote a
bowel movement.
ARACHIS OIL
Indications
see notes above
Dose
. See below
70
1.6.3 Faecal softeners
BNF 61
1
Gastro-intestinal system