Excessive use of stimulant laxatives can cause diarrhoea and related effects such as hypokalaemia; risk of electrolyte imbalance with prolonged use (in children).
Bisacodyl
- Gastro-resistant tablets 5mg (£3.74 = 60 tabs)
- Suppositories 10mg (£2.99 = 12 suppositories)
- Suppositories 5mg (paediatric) (£1.11 = 5 suppositories)
Indications and dose
Notes
- Time to effect: 10-12 hours orally, 20-60 minutes rectally
- The tablets are licensed for use in children aged 4 years and older.
- The usual maintenance dose is half the disimpaction dose.
Senna
(Sennoside)
- Tablets 7.5mg (£1.16 = 60 tabs)
- Oral solution sugar free 7.5mg/5ml (£10.09 = 500ml)
Indications and dose
Notes
- Do not prescribe the 15mg OTC tablets due to higher acquisition cost
- Time to effect: 8-12 hours
- Licensed only for short term use.
- Efficacy is decreased with continued use
- Syrup not licensed for use in children under 2 years and tablets not licensed for use in children under 6 years.
- The usual maintenance dose is half the disimpaction dose.
Docusate sodium
- Capsules 100mg (£2.14 = 30 caps)
- Paediatric oral solution sugar free 12.5mg/5ml (£26.89 = 300ml)
Indications and dose
Notes
- Time to effect: 1-2 days
- Adjust dose according to response
- Has a relatively weak stimulant effect, but also stool-softening properties.
- Only the liquid formulation is licensed for use in children younger than 12 years of age.
Glycerol
- Suppositories 4g (£2.03 = 12 suppositories)
Indications and dose
Notes
- Time to effect: 15-30 minutes
- Lubricating and weak stimulant. Can be used for hard or soft stools.
- Licensed for occasional use only
Lecicarbon
- Lecicarbon A Suppositories (£8.20 = 10 suppositories) – For use in adults
- Lecicarbon C Suppositories (£8.20 = 10 suppositories) – For use in children
Indication and dose
Notes
- Lecicarbon suppositories contain soya lecithin and are contraindicated in patients who have peanut or soya allergies.
- The routine commissioning of Lecicarbon A suppositories is accepted in Devon for the management of chronic constipation. (see Commissioning Policy for more details).
Co-danthramer
(Dantron with poloxamer 188)
- Oral suspension sugar free 25mg/200mg/5ml (£245.29 = 300ml)
- Strong oral suspension sugar free 5mg/1000mg/5ml (£503.98 = 300ml)
Indications and dose
Notes
- For use in palliative care only
- Time to effect: 6-12 hours
- Patients should be warned that it discolours the urine.
- Prolonged contact with the skin (eg. faecal or urinary incontinence) can cause a dantron burn
Co-danthrusate
(Dantron with docusate sodium)
- Oral suspension sugar free 50mg/60mg/5ml
Indications and dose
Notes
- For use in palliative care only
- Time to effect: 6-12 hours
- Patients should be warned that it discolours the urine.
- Prolonged contact with the skin (e.g. faecal or urinary incontinence) can cause a dantron burn