Class Name: laxative (Oral route)
Commonly used brand name(s):
In the U.S.
Available Dosage Forms:
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:
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:
Laxatives are available both over-the-counter (OTC) and with your doctor's prescription.
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 these uses are not included in product labeling, psyllium hydrophilic mucilloid is used in certain patients with the following medical conditions:
For patients taking psyllium hydrophilic mucilloid for high cholesterol:
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.
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.
Tell your doctor if you have ever had any unusual or allergic reaction to medicines in this group or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.
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.
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.
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:
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.
Using medicines in this class with any of the following medicines is not recommended. Your doctor may decide not to treat you with a medication in this class or change some of the other medicines you take.
Using medicines in this class with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using medicines in this class with any of the following is not recommended. Your doctor may decide not to treat you with a medication in this class, change some of the other medicines you take, or give you special instructions about the use of food, alcohol, or tobacco.
The presence of other medical problems may affect the use of medicines in this class. Make sure you tell your doctor if you have any other medical problems, especially:
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:
The dose medicines in this class will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of these medicines. If your dose is different, do not change it unless your doctor tells you to do so.
The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.
Keep out of the reach of children.
Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.
Do not keep outdated medicine or medicine no longer needed.
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:
Large doses of mineral oil may cause some leakage from the rectum. The use of absorbent pads or a decrease in dose may be necessary to prevent the soiling of clothing.
Do not take mineral oil within 2 hours of a stool softener (emollient laxative). The stool softener may increase the amount of mineral oil absorbed.
For patients taking laxatives containing a stimulant ingredient:
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:For bulk-forming-containing
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:For hyperosmotic-containing
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
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