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Laxatives  (Oral)

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Brand Names

Some commonly used brand names are:

In the U.S.—

  • Agoral 37
  • Alophen26
  • Alphamul31
  • Alramucil Orange6
  • Alramucil Regular6
  • Bisac-Evac26
  • Black-Draught27
  • Black-Draught Lax-Senna34
  • Carter's Little Pills26
  • Cholac13
  • Citroma14
  • Citrucel Orange Flavor3
  • Citrucel Sugar-Free Orange Flavor3
  • Colace43
  • Constilac13
  • Constulose13
  • Correctol26
  • Correctol Caplets26
  • Correctol Herbal Tea34
  • Correctol Stool Softener Soft Gels43
  • DC Softgels43
  • Diocto43
  • Diocto-C37
  • Dioeze43
  • Diosuccin43
  • Docu-K Plus37
  • DOK43
  • DOK Softgels43
  • D.O.S. Softgels43
  • Dr. Caldwell Senna Laxative34
  • D-S-S43
  • D-S-S plus37
  • Dulcolax26
  • Emulsoil31
  • Enulose13
  • Epsom salts17
  • Equalactin4
  • Evac-U-Gen35
  • Ex-Lax35
  • Ex-Lax Chocolate35
  • FemiLax26
  • Fiberall6
  • Fibercon Caplets4
  • Fiber-Lax4
  • FiberNorm4
  • Fleet Laxative26
  • Fleet Mineral Oil22
  • Fleet Phospho-Soda18
  • Fleet Soflax Gelcaps43
  • Fleet Soflax Overnight Gelcaps37
  • Fletcher's Castoria34
  • Genasoft Plus Softgels37
  • Gentle Laxative26
  • Haley's M-O19
  • Herbal Laxative35
  • Hydrocil Instant6
  • Kondremul Plain22
  • Konsyl5
  • Konsyl-D6
  • Konsyl Easy Mix6
  • Konsyl-Orange6
  • Konsyl-Orange Sugar Free6
  • Laxinate 10043
  • Liqui-Doss22
  • Mag-Ox 40016
  • Maltsupex1
  • Metamucil6
  • Metamucil Apple Crisp Fiber Wafers6
  • Metamucil Cinnamon Spice Fiber Wafers6
  • Metamucil Orange Flavor6
  • Metamucil Smooth, Citrus Flavor6
  • Metamucil Smooth, Orange Flavor6
  • Metamucil Smooth Sugar-Free, Citrus Flavor6
  • Metamucil Smooth Sugar-Free, Orange Flavor6
  • Metamucil Smooth Sugar-Free, Regular Flavor6
  • Metamucil Sugar-Free, Lemon-Lime Flavor6
  • Metamucil Orange Flavor6
  • Metamucil Sugar-Free, Orange Flavor6
  • MiraLax46
  • Modane26
  • Modane Bulk6
  • Mylanta Natural Fiber Supplement6
  • Mylanta Sugar Free Natural Fiber Supplement6
  • Nature's Remedy35
  • Neoloid31
  • Perdiem8
  • Perdiem Fiber5
  • Peri-Colace37
  • Peri-Dos Softgels37
  • Phillips' Chewable15
  • Phillips' Concentrated15
  • Phillips' Stool Softner Laxative Softgels43
  • Phillips' Milk of Magnesia15
  • Prompt10
  • Purge31
  • Reguloid Natural6
  • Reguloid Natural Sugar Free6
  • Reguloid Orange6
  • Reguloid Orange Sugar Free6
  • Senexon34
  • Senna-Gen34
  • Senokot35
  • Senokot Children's Syrup35
  • Senokot-S42
  • SenokotXTRA35
  • Senolax34
  • Serutan6
  • Serutan Toasted Granules7
  • Silace43
  • Silace-C37
  • Sulfolax43
  • Surfak43
  • Syllact5
  • Veracolate26
  • V-Lax6
  • X-Prep Liquid34

In Canada—

  • Acilac13
  • Apo-Bisacodyl26
  • Bicholate Lilas30
  • Bisacolax26
  • Carter's Little Pills26
  • Citro-Mag14
  • Colace43
  • Correctol26
  • Correctol Stool Softener Soft Gels43
  • Dulcolax26
  • Ex-Lax35
  • Ex-Lax Chocolate35
  • Ex-Lax Extra Strength35
  • Ex-Lax Gentle Strength42
  • Feen-a-Mint 26
  • Fletcher's Castoria35
  • Glysennid35
  • Herbal Laxative34
  • Kondremul22
  • Lansoÿl22
  • Lansoÿl Sugar Free22
  • Magnolax19
  • Metamucil6
  • Metamucil Orange Flavor6
  • Metamucil Sugar Free6
  • Metamucil Sugar-Free, Orange Flavor6
  • Natural Source Fibre Laxative6
  • Nature's Remedy35
  • Nujol22
  • Peri-Colace37
  • Phillips' Magnesia Tablets15
  • Phillips' Milk of Magnesia15
  • PMS-Bisacodyl26
  • PMS-Docusate Calcium43
  • PMS-Docusate Sodium43
  • PMS-Lactulose13
  • PMS-Sennosides35
  • Prodiem Plain6
  • Prodiem Plus9
  • Pro-Lax46
  • Senokot35
  • Senokot-S42
  • SenoKot XTRA35
  • Silace43
  • Soflax43
  • Surfak43
  • Vitalax Super Smooth Sugar Free Orange Flavor6
  • Vitalax Unflavored6

Note:

For quick reference the following laxatives are numbered to match the corresponding brand names.
Bulk-forming laxatives—
1.  Malt Soup Extract (malt soup EX-tract)
2.  Malt Soup Extract and Psyllium (malt soup EX-tract and SILL-i-yum)
3.  Methylcellulose (meth-ill-SELL-yoo-lose)
4.  Polycarbophil (pol-i-KAR-boe-fil)
5.  Psyllium (SILL-i-yum)
6.  Psyllium Hydrophilic Mucilloid (SILL-i-yum hye-droe-FILL-ik MYOO-sill-oid)
7.  Psyllium Hydrophilic Mucilloid and Carboxymethylcellulose (SILL-i-yum hye-droe-FILL-ik MYOO-sill-oid and kar-box-ee-meth-ill-SELL-yoo-lose)
45.  Polycarbophil and Psyllium (pol-i-KAR-boe-fil and SILL-i-yum)
‡  Generic name product may be available in the U.S.
§  Generic name product may be available in Canada
*  Not commercially available in the U.S.
†  Not commercially available in CanadaBulk-forming and stimulant combinations—
8.  Psyllium and Senna (SILL-i-yum and SEN-na)
9.  Psyllium Hydrophilic Mucilloid and Senna (SILL-i-yum hye-droe-FILL-ik MYOO-sill-oid and SEN-na)*
10.  Psyllium Hydrophilic Mucilloid and Sennosides (SILL-i-yum hye-droe-FILL-ik MYOO-sill-oid and SEN-no-sydes)
‡  Generic name product may be available in the U.S.
§  Generic name product may be available in Canada
*  Not commercially available in the U.S.
†  Not commercially available in CanadaBulk-forming, stimulant, and stool softener (emollient) combinations—
11.  Product not available
‡  Generic name product may be available in the U.S.
§  Generic name product may be available in Canada
*  Not commercially available in the U.S.
†  Not commercially available in CanadaBulk-forming and stool softener (emollient) combinations—
12.  Product not available
‡  Generic name product may be available in the U.S.
§  Generic name product may be available in Canada
*  Not commercially available in the U.S.
†  Not commercially available in CanadaHyperosmotic laxatives—Lactulose:
13.  Lactulose (LAC-tu-los)
‡  Generic name product may be available in the U.S.
§  Generic name product may be available in Canada
*  Not commercially available in the U.S.
†  Not commercially available in CanadaHyperosmotic laxatives—Polymer:
46.  Polyethylene glycol 3350 (pol-ee-ETH-ill-een GLYE-cal)
‡  Generic name product may be available in the U.S.
§  Generic name product may be available in Canada
*  Not commercially available in the U.S.
†  Not commercially available in CanadaHyperosmotic laxatives—Saline:
14.  Magnesium Citrate (mag-NEE-zhum SI-trate)
15.  Magnesium Hydroxide (mag-NEE-zhum hye-DROX-ide)
16.  Magnesium Oxide (mag-NEE-zhum OX-ide)
17.  Magnesium Sulfate (mag-NEE-zhum SUL-fate)
18.  Sodium Phosphate (SOE-dee-um FOS-fate)
‡  Generic name product may be available in the U.S.
§  Generic name product may be available in Canada
*  Not commercially available in the U.S.
†  Not commercially available in CanadaHyperosmotic and lubricant combinations—
19.  Milk of Magnesia and Mineral Oil (milk of mag-NEE-zha and MIN-er-al oil)
20.  Mineral Oil and Glycerin (MIN-er-al oil and GLIH-ser-in)*
‡  Generic name product may be available in the U.S.
§  Generic name product may be available in Canada
*  Not commercially available in the U.S.
†  Not commercially available in CanadaHyperosmotic and stimulant combinations—
21.  Milk of Magnesia and Cascara Sagrada (milk of mag-NEE-zha and kas-KAR-a sa-GRA-da)
‡  Generic name product may be available in the U.S.
§  Generic name product may be available in Canada
*  Not commercially available in the U.S.
†  Not commercially available in CanadaLubricant laxatives—
22.  Mineral Oil (MIN-er-al oil)
‡  Generic name product may be available in the U.S.
§  Generic name product may be available in Canada
*  Not commercially available in the U.S.
†  Not commercially available in CanadaStimulant laxatives—
26.  Bisacodyl (bis-a-KOE-dill)
27.  Casanthranol (cas-SAN-thrah-nole)
28.  Cascara Sagrada (kas-KAR-a sa-GRA-da)
29.  Cascara Sagrada and Aloe (kas-KAR-a sa-GRA-da and AL-owe)
30.  Cascara Sagrada and Bisacodyl (kas-KAR-a sa-GRA-da and bis-a-KOE-dill)
31.  Castor Oil (KAS-tor)
32.  Dehydrocholic Acid (dee-hye-droe-KOE-lik acid)
34.  Senna (SEN-na)
35.  Sennosides (SEN-no-sides)§
‡  Generic name product may be available in the U.S.
§  Generic name product may be available in Canada
*  Not commercially available in the U.S.
†  Not commercially available in CanadaStimulant and stool softener (emollient) combinations—
36.  Bisacodyl and Docusate (bis-a-KOE-dill and doc-CUE-sayt)*
37.  Casanthranol and Docusate (cas-SAN-thrah-nole and doc-CUE-sayt)
38.  Danthron and Docusate (DAN-thron and doc-CUE-sayt)*
39.  Dehydrocholic Acid and Docusate (dee-hye-droe-KOE-lik acid and doc-CUE-sayt)
42.  Sennosides and Docusate (SEN-no-sides and doc-CUE-sayt)
‡  Generic name product may be available in the U.S.
§  Generic name product may be available in Canada
*  Not commercially available in the U.S.
†  Not commercially available in CanadaStool softener (emollient) laxatives—
43.  Docusate (doc-CUE-sayt)
44.  Poloxamer 188 (pol-OX-a-mer 188)
‡  Generic name product may be available in the U.S.
§  Generic name product may be available in Canada
*  Not commercially available in the U.S.
†  Not commercially available in Canada

Category


Description

Oral laxatives are medicines taken by mouth to encourage bowel movements to relieve constipation.

There are several different types of oral laxatives and they work in different ways. Since directions for use are different for each type, it is important to know which one you are taking. The different types of oral laxatives include:

Bulk-formers

Bulk-forming laxatives are not digested but absorb liquid in the intestines and swell to form a soft, bulky stool. The bowel is then stimulated normally by the presence of the bulky mass. Some bulk-forming laxatives, like psyllium and polycarbophil, may be prescribed by your doctor to treat diarrhea.

Hyperosmotics

Hyperosmotic laxatives encourage bowel movements by drawing water into the bowel from surrounding body tissues. This provides a soft stool mass and increased bowel action.

There are three types of hyperosmotic laxatives taken by mouth—the saline, the lactulose , and the polymer types. The saline type is often called ''salts.'' They are used for rapid emptying of the lower intestine and bowel. They are not used for long-term or repeated correction of constipation. With smaller doses than those used for the laxative effect, some saline laxatives are used as antacids. The information that follows applies only to their use as laxatives. Sodium phosphate may also be prescribed for other conditions as determined by your doctor.

The lactulose type is a special sugar-like laxative that works the same way as the saline type. However, it produces results much more slowly and is often used for long-term treatment of chronic constipation. Lactulose may sometimes be used in the treatment of certain medical conditions to reduce the amount of ammonia in the blood. It is available only with your doctor's prescription.

The polymer typeis a polyglycol (polyethylene glycol), a large molecule that causes water to be retained in the stool; this will soften the stool and increase the number of bowel movements. It is used for short periods of time to treat constipation.

Lubricants

Lubricant laxatives, such as mineral oil, taken by mouth encourage bowel movements by coating the bowel and the stool mass with a waterproof film. This keeps moisture in the stool. The stool remains soft and its passage is made easier.

Stimulants

Stimulant laxatives, also known as contact laxatives, encourage bowel movements by acting on the intestinal wall. They increase the muscle contractions that move along the stool mass. Stimulant laxatives are a popular type of laxative for self-treatment. However, they also are more likely to cause side effects. One of the stimulant laxatives, dehydrocholic acid, may also be used for treating certain conditions of the biliary tract.

Stool softeners (emollients)

Stool softeners encourage bowel movements by helping liquids mix into the stool and prevent dry, hard stool masses. This type of laxative has been said not to cause a bowel movement but instead allows the patient to have a bowel movement without straining.

Combinations

There are many products that you can buy for constipation that contain more than one type of laxative. For example, a product may contain both a stool softener and a stimulant laxative. In general, combination products may be more likely to cause side effects because of the multiple ingredients. In addition, they may not offer any advantage over products containing only one type of laxative. If you are taking a combination laxative, make certain you know the proper use and precautions for each of the different ingredients.

Most laxatives (except saline laxatives) may be used to provide relief:

Saline laxatives have more limited uses and may be used to provide rapid results:

Most laxatives are available without a prescription; however, your doctor may have special instructions for the proper use and dose for your medical condition. They are available in the following dosage forms:



Before Using This Medicine

Importance of diet, fluids, and exercise to prevent constipation

Laxatives are to be used to provide short-term relief only, unless otherwise directed by a doctor. A proper diet containing roughage (whole grain breads and cereals, bran, fruit, and green, leafy vegetables), with 6 to 8 full glasses (8 ounces each) of liquids each day, and daily exercise are most important in maintaining healthy bowel function. Also, for individuals who have problems with constipation, foods such as pastries, puddings, sugar, candy, cake, and cheese may make the constipation worse.

If you are taking this medicine without a prescription, carefully read and follow any precautions on the label. For oral laxatives, the following should be considered:

Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to laxatives. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Diet—Make certain your health care professional knows if you are on any special diet, such as a low-sodium or low-sugar diet. Some laxatives have large amounts of sodium or sugars in them.

Pregnancy—Although laxatives are often used during pregnancy, some types are better than others. Stool softeners (emollient) laxatives and bulk-forming laxatives are probably used most often. If you are using a laxative during pregnancy, remember that:

Breast-feeding—Laxatives containing cascara and danthron may pass into the breast milk. Although the amount of laxative in the milk is generally thought to be too small to cause problems in the baby, your doctor should be told if you plan to use such laxatives. Some reports claim that diarrhea has been caused in the infant.

Children—Laxatives should not be given to young children (up to 6 years of age) unless prescribed by their doctor . Since children usually cannot describe their symptoms very well, they should be checked by a doctor before being given a laxative. The child may have a condition that needs other treatment. If so, laxatives will not help, and may even cause unwanted effects or make the condition worse.

Mineral oil should not be given to young children (up to 6 years of age) because a form of pneumonia may be caused by the inhalation of oil droplets into the lungs.

Also, bisacodyl tablets should not be given to children up to 6 years of age because if chewed they may cause stomach irritation.

Older adults—Mineral oil should not be taken by bedridden elderly persons because a form of pneumonia may be caused by the inhalation of oil droplets into the lungs. Also, stimulant laxatives (e.g., bisacodyl or casanthranol), if taken too often, may worsen weakness, lack of coordination, or dizziness and light-headedness.

Polyethylene glycol 3350 should be discontinued if diarrhea occurs, especially in elderly persons in nursing homes.

Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking oral laxatives, it is especially important that your health care professional know if you are taking any of the following:

Other medical problems—The presence of other medical problems may affect the use of oral laxatives. Make sure you tell your doctor if you have any other medical problems, especially:


Proper Use of This Medicine

For safe and effective use of your laxative:

With all kinds of laxatives, at least 6 to 8 glasses (8 ounces each) of liquids should be taken each day. This will help make the stool softer.

For patients taking laxatives containing a bulk-forming ingredient:

For patients taking laxatives containing a stool softener (emollient):

For patients taking laxatives containing a hyperosmotic ingredient:

For patients taking laxatives containing mineral oil :

For patients taking laxatives containing a stimulant ingredient:

Dosing—

There are a large number of laxative products on the market. The dose of laxatives will be different for different products. The number of capsules or tablets or teaspoonfuls of crystals, gel, granules, liquid, or powder that you use; the number of caramels or wafers that you eat; or the number of pieces of gum that you chew depends on the strength of the medicine. Follow your doctor's orders if this medicine was prescribed, or follow the directions on the box if you are buying this medicine without a prescription.

Storage—

To store this medicine:


Precautions While Using This Medicine

Do not take any type of laxative:

If you notice a sudden change in bowel habits or function that lasts longer than 2 weeks, or that keeps returning off and on, check with your doctor before using a laxative. This will allow the cause of your problem to be determined before it may become more serious.

The ''laxative habit''—Laxative products are overused by many people. Such a practice often leads to dependence on the laxative action to produce a bowel movement. In severe cases, overuse of some laxatives has caused damage to the nerves, muscles, and tissues of the intestines and bowel. If you have any questions about the use of laxatives, check with your health care professional.

Many laxatives often contain large amounts of sugars, carbohydrates, and sodium. If you are on a low-sugar, low-caloric, or low-sodium diet, check with your health care professional before using a laxative.

For patients taking laxatives containing mineral oil :

For patients taking laxatives containing a stimulant ingredient:


Side Effects of This Medicine

Side Effects of This Medicine

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

Other side effects may occur that usually do not need medical attention. These side effects are less common and may go away during treatment as your body adjusts to the medicine. However, check with your doctor if any of the following side effects continue or are bothersome:

Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.


Additional Information

Once a medicine has been approved for marketing for a certain use, experience may show that it is also useful for other medical problems. Although this use is not included in product labeling, psyllium hydrophilic mucilloid is used in certain patients with high cholesterol (hypercholesterolemia).

For patients taking psyllium hydrophilic mucilloid for high cholesterol:

Other than the above information, there is no additional information relating to proper use, precautions, or side effects for this use.

Revised: 12/10/2002

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