Stool softener (anionic surfactant) Pregnancy: Inadequate evidence of safety in human pregnancy; in wide use for many years without apparent ill consequence. Use in pregnancy only if benefits outweigh potential risks. Excreted in breast milk - use with caution in lactating mothers.

Docusate sodium

Brand names: Dioctyl, Docusol, Docusate (Norgalax mini-enema), Docusate-Senna (Manevac alternative)

Docusate sodium is a stool softener with weak stimulant laxative activity, used to treat constipation and, given rectally, as part of bowel preparation or to relieve impaction.

Auto-extracted from the source labelling — not yet independently clinician-verified. These values were distilled from the UK SPC (or the US label where noted) but have not had a clinician sign-off. Confirm against the current SmPC before prescribing.

Adult dose

Dose: 100 mg (10 ml) to 150 mg (15 ml) three times a day (50 mg/5 ml oral solution)

Route: Oral (take as a single dose followed by plenty of water or a flavoured drink e.g. milk or orange juice)

Frequency: Three times a day

Max: Maximum daily dose 500 mg (50 ml)

Commence with large doses, decreasing as the patient's condition improves. For barium meals: 400 mg (40 ml) taken with the meal. Elderly: no dosage adjustment necessary. Paediatric: this 50 mg/5 ml strength is not recommended for children aged 12 years and under; for children and infants over 6 months a different strength (docusate sodium 12.5 mg/5 ml) is directed - verify against a children's formulary. Exclude organic disorders before giving any laxative; prolonged use can precipitate an atonic non-functioning colon and hypokalaemia.

Dose auto-extracted from UK Summary of Product Characteristics (SPC) via the eMC; US FDA prescribing information (openFDA / DailyMed) — cross-check; US labelling may differ from UK — not yet clinician-verified. Always confirm against the product SmPC and your local formulary before prescribing.

Contraindications

Known hypersensitivity to docusate sodium or any excipient
Presence of abdominal pain, intestinal obstruction, nausea, or if vomiting occurs

Side effects

Diarrhoea (rare)
Nausea (rare)
Abdominal cramps (rare)
Skin rash and pruritus (frequency not known)
Burning sensation in mouth and throat (spontaneous reports)

Interactions

Mineral oil - should not be taken concurrently
Anthraquinone derivatives - take in reduced doses if co-administered (their absorption is increased)

Clinical monograph

How it works

As a surface-active (wetting) agent it reduces surface tension and allows water and fats to penetrate and soften the stool, and it has a mild stimulant action on the bowel.

Prescribing in practice

Avoid in intestinal obstruction and do not give concurrently with liquid paraffin, as docusate may enhance its absorption.
Onset of the oral preparation may take a day or two, so it is not suitable when rapid evacuation is needed.
It is available in oral and rectal forms; the rectal route acts more quickly.

Monitoring

Monitor bowel frequency and stool consistency; routine laboratory monitoring is not required.

Counselling the patient

The oral form may take a day or two to work.
Drink plenty of fluids while taking it.
Do not take it at the same time as liquid paraffin.

Evidence & guidelines

Its faecal-softening action is well established through long clinical use and described in current prescribing references and the SPC.

Reference: SmPC Docusol / Norgalax; NICE CKS Constipation; Cochrane Review on stool softeners; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. The structured dose values shown have been reviewed by a clinician. Monograph status: clinician-reviewed (2026-07-04).

Curated clinical cross-links plus same-class fallbacks.

Calculators

Pathways