Docusate Sodium in Pregnancy and Breastfeeding

Risk Factor: C
Class: Gastrointestinal agents / Laxatives/purgatives

Contents of this page:
Fetal Risk Summary
Breast Feeding Summary
References
Questions and Answers

Fetal Risk Summary

No reports linking the use of docusate sodium (DSS) with congenital defects have been located. DSS is a common ingredient in many laxative preparations available to the public. In a large prospective study, 116 patients were exposed to this drug during pregnancy (1). No evidence for an association with malformations was found. Similarly, no evidence of fetal toxicity was noted in 35 women treated with a combination of docusate sodium and dihydroxyanthraquinone (2).

In a surveillance study of Michigan Medicaid recipients involving 229,101 completed pregnancies conducted between 1985 and 1992, 232 newborns had been exposed to a docusate salt during the 1st trimester (F. Rosa, personal communication, FDA, 1993). Nine (3.9%) major birth defects were observed (nine expected), including one cardiovascular defect (two expected) and one polydactyly (one expected). No anomalies were observed in four other categories of defects (oral clefts, spina bifida, limb reduction defects, and hypospadias) for which specific data were available. These data do not support an association between the drug and congenital defects.

Chronic use of 150250 mg/day or more of docusate sodium throughout pregnancy was suspected of causing hypomagnesemia in a mother and her newborn (3). At 12 hours of age, the neonate exhibited jitteriness, which resolved spontaneously. Neonatal serum magnesium levels ranged from 0.91.1 mg/dL between 2248 hours of age with a maternal level of 1.2 mg/dL on the 3rd postpartum day. All other laboratory parameters were normal.

Breast Feeding Summary

A combination of docusate sodium and dihydroxyanthraquinone (Normax) was given to 35 postpartum women in a 1973 study (2). One infant developed diarrhea, but the relationship between the symptom and the laxative is unknown.

References

  1. Heinonen OP, Slone D, Shapiro S. Birth Defects and Drugs in Pregnancy. Littleton, MA:Publishing Sciences Group, 1977:442.
  2. Greenhalf JO, Leonard HSD. Laxatives in the treatment of constipation in pregnant and breast-feeding mothers. Practitioner 1973;210:25963.
  3. Schindler AM. Isolated neonatal hypomagnesaemia associated with maternal overuse of stool softener. Lancet 1984;2:822.

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Questions and Answers

can taking Docusate Sodium in stool softeners elevate your blood pressure?, If someone is taking 2 mg of Hytrin and also Azor 40mg, and take stool softener with 100 mg of docusate sodium every night, could that be raising the blood pressure? If so, why?

Docusate should have no effect on the BP.

Which is better to relieve hard stools... docusate sodium or docusate calcium?? And what is the difference?, Which is better for stool softening... docusate sodium or docusate calcium?? and why?? and what is the difference between the two of them besides the fact that docusate calcium is 240 mg and can only be taken once a day, and docusate sodium is 100mg and can be taken twice. Which is a better choice? And which will work better and/or faster??

Or neither?? ... one of the best things on the market, and now available without an Rx, is Miralax. (And no, I'm not getting paid to say that, though I sound like a commercial.) It really works, and doctors use it in the hospital ALL the time. It's odorless, tasteless, and non-gritty. You put it in a beverage and drink it down. Works like a charm.

What about Senna and Docusate Sodium?, My gastroentologist told me to try taking this stool softener/laxative for my constant constipation. I have heard though that it's bad to keep taking laxatives. So I need to know the effect that taking this daily until I get regular. Please help!

Normally the first route would be a fibre/bulking agent like psyllium or methylcellulose (e.g. Metamucil, Citrucel, Benefiber) plus plenty of water, and other lifestyle changes (such as more exercise if possible, examining medications that could worsen the problem etc). But I assume that your GE doctor has gone through that already?

Senna is a stimulant and Docusate is an surfactant that basically softens things up by allowing fats and water to enter the stool... so it's a fairly good combination to use - speed up the gut contractions and soften things along the way.

The general advice has been to avoid using stimulant laxatives constantly because the long term use is believed to make the gut dependent upon them to work, but this is now under doubt by some medical professionals (first link is to a paper that suggests that).

In your case, you're being given them under the advice of a doctor and chronic use is regarded as using the product at least 3 times a week for a year or longer - so for even weeks or a few months of use while you get your gut back into a normal routine, then you should be OK (second paper).

At the end of the day, this is still a fairly gentle type of laxative product to use - something like Bisacodyl, Fleet, and so on are much harsher on your gut. But hopefully you can use this product to get things into a good routine and can then stop and move onto dietary answers etc.

Constipation is horrible - is there a specific cause for yours?

Edit: You may want to check some of the support sites for IBS sufferers then, and ask for things that they've found helpful (e.g. diet and lifestyle etc) but hopefully this won't be a long term medication for you. I suffer horribly at the hands of prescription painkillers and so you have my sympathy!

Can you consume alcohol while taking a stool softener(docusate sodium)?,

drinking a lot of alcohol already softens your stool, so unless you're just having ONE drink... you may have problems. If the label says no alcohol, just stop taking it when you intend to drink.

is docusate sodium safe during pregnancy? it seems to be in all the prescription prenatal vitamins. Anyone?, It doesn't seem like something you should take for your entire pregnancy yet it is in almost all of the prescription prenatal vitamins. Any info would be helpful.

if it's an ingredient in prenatal prescriptions, obviously it's safe, they wouldn't prescribe something if they knew it would harm your baby, don't be paranoid!

How often can you safely take Docusate Sodium?? (is that the right name?) to help soften stool?,

http://www.rxlist.com/laxatives_for_cons...

how docusate sodium acts inside the human body? how it prevents constipation?, how central nervous system works

Docusate sodium acts as a surfectant or lubricant which softens the stools. It does not get absorbed so it passes through your gut as it dissolves and binds your waste in a detergent like matter making it easier to pass.

what are the side effects of docusate sodium 100mg.............stool softener?,

The biggest one is diarrhea if you use too much or use it for too long. If you do have extreme diarrhea, some of your electrolytes (potassium, sodium, chloride) can be out of balance and you can get dehydrated. This can land you in the hospital.

You can also get abdominal cramps and/or abdominal pain.

Lastly, please inform your doctor you are taking it. Although it is over-the-counter, that does not mean it can't be harmful.

Stool softener (docusate soduim), Dependency?, I have struggled with IBS-Constipation for about 4-5 years now. After taking prescription after prescription, I finally made my own little regimen. I just need to know if docusate sodium causes dependency? Some articles say yes and some no. If anyone knows of any sites that say it DOES NOT cause dependency, can you please let me know. Thanks :)

I don't know about the dependency but I have taken one to two pills every day for the last 3 years,It has helped eliminate my constipation.My doctor says that I can take as many a day as I need with out any problem as long as it does not have the laxative in it.