Drug Product Table: Constipation

Available
Dosage Forms:

Class:

Available Agents:

Bulk-forming

Methylcellulose
(Citrucel)
Calcium polycarbophil
(FiberCon, FiberLax)
Psyllium (Metamucil)

Hyperosmotic
agents

Polyethylene glycol
(MiraLax,
GlycoLax)
Glycerin

Emollient
agent

Docusate (Colace,
Stool Softener,
Dulcolax Stool
Softener)

Capsule
Oral Syrup

Lubricant
agent

Mineral oil (Fleet Oil)

Oral liquid/emulsion
Rectal liquid enema

Saline
laxative
agents

Magnesium citrate
(Citroma)
Magnesium hydroxide
(Milk of Magnesia)
Magnesium sulfate
(Epsom Salt)
Mono/di-basic sodium
(Fleet Enema)

Oral liquid, rental

liquid, chewable
tablet, solid

Stimulant
agents

Senna (Ex-Lax,
Senokot)
Bisacodyl (Dulcolax,
Bisacodyl Laxative)
Castor oil

Tablet, chocolate
pieces, rectal
suppository, liquid

Docusate + senna
(Senokot-S)

Tablet

Combination

Caplet/Capsule
Powder

Powder
Rectal suppository

Onset of
Action:
12 to 24 hours
(Up to 72
hours)

Indicated for:
Most patients
presenting with acute
constipation

Avoid Use In:

Patients with difficulty
swallowing
Patients requiring fluid restriction
Patients who are immobile

Powder:
12 to 72 hours
Up to 96 hours
Suppository:
15 to 30
minutes

Most patients
presenting with acute
constipation

Patients with intestinal

obstruction

12 to 72 hours

Opioid-users (in
combination with
stimulant)
Patients who need to
avoid straining after
surgery/heart attack

Patients using mineral oil

No one

Patients using docusate

Most patients

Oral: 6 to 8
hours
Rectal: 5 to 15
minutes
Mag Citrate:
30 min to 3
hours
Mono-/dibasic
sodium phos:
2 to 15
minutes
Mag
hydroxide: 30
min to 6 hours
Senna/bisacod
yl PO: 6 to 10
hours, Rectal:
15 to 60
minutes
6 to 10 hours

Patients seeking quick

relief

Opioid users (in

combination with stool
softener)
Opioid users

Patients at risk for electrolyte

imbalances
Patients requiring a sodiumrestricted diet
Magnesium sulfate (Epsom salts)
NOT RECOMMENDED FOR
ANYONE

Castor oildo not use in

pregnancy

Drug Product Table: Diarrhea

Medication:

Dosage Form

Directions

Loperamide

Caplet
Liquid

4 mg (2 tabs) po
initially, then 2 mg
(1 tab) after each
subsequent loose
stool

Bismuth
Subsalicylate

Tablets
Caplets
Liquid

Powder
Rectal suppository

Chewable tablets,
caplets, liquid

Follow package
directions

Digestive
Enzymes

Max Dose

Length of
Treatment

8 mg/day

48 hours

4,200 mg per
day (8 doses)

48 hours

With each dairy meal

Avoid Use In:

Febrile patients
Patients < 6 years old
Patients with bloody stool
Patients meeting exclusions for
self care
Patients < 12 years old
Hypersensitivity, mild tinnitus, or
signs of neurotoxicity with
previous salicylate use