Posts Tagged ‘docusate’

Is It a Stool Softener or a Laxative?

Q: What’s the difference between a stool softener and a laxative?

A laxative encourages movement of the stool and assists you in eliminating feces. The word laxative means “to loosen” and is related to the word “lax” which means loose or relaxed. A laxative works to “loosen” your bowels and relieve constipation. Stool softeners are actually considered a type of laxative called emollient laxatives.

When you become constipated, it’s often because the muscles of your intestines are not moving as well as they should, slowing down the removal of your feces. The longer it takes your feces to move from your small intestine to your rectum the more water gets pulled out of it along the way, making your stool smaller, harder and more painful to eliminate. An emollient is a substance that works by softening or increasing moisture. Two types of stool softeners that work as emollient laxatives are docusate and mineral oil.

Docusate is a surfactant that acts just like a detergent or soap. Like detergents, docusate decreases the surface tension of water and helps it move water into your stool. Although docusate doesn’t directly stimulate the muscles of your intestines or the movement of stool, it can help avoid and relieve constipation by counteracting how much water your stool loses as it moves through your intestine. Docusate is usually easy to tolerate but may occasionally cause diarrhea or stomach cramps. Unlike mineral oil, it doesn’t interfere with absorption of nutrients or any vitamins.

You’ll find docusate more effective as a preventative than as a laxative because it works more slowly. You should allow 12 to 72 hours for it to work. Most of the time it will give you results within 2 days but can take up to five days for full effect. It’s often combined with a stimulating laxative for a faster effect.

The other emollient laxative is mineral oil. Mineral oil is a liquid that helps to soften the stool but doesn’t change the amount of water in it like docusate does. Mineral oil is not as safe to use as docusate because if you aspirate or inhale it by accident it can cause life-threatening irritation to your lungs called aspiration pneumonitis. Mineral oil interferes with absorption of fat-soluble vitamins like vitamin A, D, E and K, and can cause oily leakage out of the rectum. Avoid taking docusate along with mineral oil as a laxative. Docusate will help mineral oil get absorbed into your body instead of staying in your intestines, where it needs to be to work.

5 Tips for Using Docusate Successfully as a Stool Softener:

  1. Increase your water and fluid intake when taking docusate; this will increase its effectiveness. Because docusate works by helping move water into your stool, drinking more fluids help it do its job better.
  2. If you are on a sodium-restricted diet, look for the calcium form of docusate instead of the more common sodium formulation. Docusate calcium comes as a 240mg capsule instead of 250mg, like docusate. It’s sometimes hard to find; if you don’t see the calcium form of docusate on the shelf, ask your pharmacist.
  3. Docusate sodium comes as liquid-filled capsules in two sizes: a 100 mg size and a much bigger 250 mg size. If you have any trouble swallowing capsules, you should select the 100 mg capsules, but because the 100 mg and the 250 mg are usually about the same price, the 250mg capsules are a better value.
  4. Although I have seen root beer flavored mineral oil, most mineral oil is bland tasting. Docusate is not bland. It tastes just like soap! Avoid biting or cutting docusate capsules unless you like the taste of your mother washing your mouth out with soap. The syrup is nearly as bad; it ranks consistently at the bottom of our liquid taste tests and the soapy taste can linger for hours.
  5. If you need a faster result, combine docusate with a more stimulating laxative like senna or bisacodyl. Senakot-S® and Peri-Colace® are examples of combination products.

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Can You EAR Me Now?

June 1st, 2015. Filed Under: consumer information, medicines.
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One week before my daughter Maureen’s 3rd birthday she started tugging at her left ear. When I tried to see into her ear, she wouldn’t let me, so the following week I asked our pediatrician to take a look. He looked into each ear with the otoscope, and then told me, “she has external otitis – an irritation of her ear canal. It needs to be cleaned out.”

As they flushed out her ear canal I was AMAZED at what came floating out: 3 balls of fuzz the exact color of our living room carpet, 2 rolled up wads of white paper, another 2 balls of carpet colored fuzz and a small white button! Her ear itched and she kept trying to relieve the itching by sticking things into it.

The medical name for earwax is cerumen, based on the Latin word cera, which means wax. But cerumen isn’t really wax, it’s a sticky liquid secreted by the cells in the skin lining your ear canal designed to protect your eardrum by trapping dirt and dust before they can irritate or damage it.

For some people, earwax just flakes away and never causes them any trouble. Then there are the REST of us. Problems with earwax are one of the most common reasons people make appointments to see their doctor. Cerumen can build up against the eardrum, causing hearing loss, ear pain and interfering with hearing aids. Trying to remove it by sticking cotton-tipped swabs or bobby pins up your ear canal only forces it further inside your ear canal, leading to pressure, pain and impaction.

If swabs can’t do it, how do you remove earwax? By softening it first. Making cerumen more pliable makes it easier to dislodge when flushing it out. Unfortunately there isn’t any consensus of what type of eardrops are most effective. A systematic review of studies done on earwax removal using several different types of eardrops showed no difference between them.

The leading product purchased in the United States for earwax is Debrox®, a 6.5% solution of carbamide peroxide. According to a 2013 OTC survey funded by US News and World Report and Pharmacy Times, 86% of American pharmacists surveyed recommend Debrox® drops to their customers.

Carbamide peroxide reacts with earwax to release oxygen, creating foam that liquefies the cerumen and helps it to be rinsed away. Like many people, when I use Debrox® I can hear crackling and popping sounds and can feel a distinct tickling sensation in my ear.

Another eardrop product that we used to recommend for earwax was Cerumenex®, which contained triethanolamine to emulsify cerumen. Introduced in 1958, it was withdrawn in 2008 due to reports of permanent hearing loss or irritation after only one application. When further investigation proved the risk was real Cerumenex® was discontinued.
Docusate sodium (Waxsol®) drops are used to soften earwax in the UK. Docusate sodium, also known as Colace® is a stool softener that pulls liquid into hard stool to make it softer, and does the same thing to impacted cerumen. Most surfactants work just like liquid detergent. If you ever taste docusate, either as a liquid or syrup, it’s like washing your mouth out with liquid dish soap. Yuk!!

In our clinic we use a two-step process: first, docusate liquid in the ear for 1-3 days, then flush with warm water. One way you can try docusate at home is to poke a hole in the end of a capsule and squeeze out its contents into your ear canal, repeating up to three times a day for one or two days. Remove your now-softened earwax by flushing GENTLY with warm water in a bulb syringe or by tipping your head up during a warm shower. Dry afterward with a hair dryer on a low setting.

If, like me, you suffer from excess cerumen, here are some DONT’s:
DON’T clean earwax from your ear canal with a cotton-tipped swab, bobby pin or rolled napkin.
DON’T use eardrops if you have ear pain, bleeding or any discharge from your ear; instead, contact your doctor.
DON’T use a Water Pik® or similar apparatus to flush out your ears.
Don’t use cold water to flush out your ears. It can cause problems with your balance.

More information is on earwax and ear care is available at

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My Favorite Remedies

If you were stranded on a desert island, which remedies would you be sure to take? I’ve been thinking about my own “must haves” for that. Here are some of my favorites:

1.  Meclizine 25mg tablets.

Indispensable in controlling my motion sickness when riding in cars, planes or ships, meclizine is such a travel essential that I NEVER leave home without it. Sure, I do fine if I’m the driver, but if I’m a passenger I’ll get a headache, nausea or worse. One dose of 25mg meclizine lasts 24 hours, allowing me to travel comfortably, even in the back seat. I can even read a book or surf the Internet on my phone. Sure, I probably wouldn’t need it while ON the desert island, but what about the trip going TO and FROM it?

2. New Skin® liquid.

This stuff is absolutely wonderful to prevent ingrown toenails. Since I’ve been using it painful or ingrown toenails have not bothered me. I apply just a little bit just under the nail and to the skin immediately around the sides of my nail and it toughens the skin and helps keep my toenails from curling under and cutting into the tender skin underneath. It also protects small cuts from dirt, a nice bonus on a desert island. New Skin® now comes in a handy 15 ml bottle which takes up less space compared to its original 30 ml size bottle.

3. Docusate 250mg capsules.

I struggle with earwax buildup and often end up in my doctor’s office getting my ears flushed out. I used to use Debrox® liquid made my ears go “snap, crackle and pop” caused an unbearable tickling sensation. This year I decided to try docusate, because docusate liquid is what most doctor’s offices use to soften impacted earwax before flushing it out. However, it’s not sold as earwax remover in the United States.

Last month my left ear became completely blocked with earwax, to the point I couldn’t hear at all. I cut off the end of a 250mg docusate capsule with kitchen scissors and squeezed the contents into my left ear. The capsule had just the perfect amount of liquid for my ear canal and unlike Debrox® it didn’t crackle or tickle. I followed that up with another capsule 12 hours later and waited another couple of hours then used my little blue bulb syringe to gently flush it out. I could hear again! The bulb syringe even helped me draw out the leftover water out of my ear.

I prefer the convenience of the capsules (buy 250mg instead of 100mg capsules), but you can also buy an empty dropper bottle and fill it with docusate liquid (not the syrup), both available from your pharmacist.

4.  Butterfly bandages.

These would be very useful on a desert island. Ever since my training as an Emergency Medical Technician, I keep both large and small butterfly bandages in my medicine cabinet and in my car. They work really well to match up the edges of medium to large cuts and help avoid getting stitches. Sometimes I cut the big ones in half lengthwise and use them extra close together to help seal up the edges.

Last week I dropped a full jar of molasses onto my husband’s empty deep green glass coffee mug. CRASH! As I reached over to carefully pick up the green shards, my thumb brushed up against the newly razor-sharp edge of a clear 4-cup glass Pyrex pitcher also broken in the crash. Thank goodness for those butterfly bandages! HOWEVER, if you can see bone or have any trouble moving your fingers get medical attention immediately, as you may have nicked a tendon which can cause permanent disability if not treated.

5. Calendula cream.

For dry or irritated skin, I’ll be sure to pack my favorite Arbordoun’s Abundantly Herbal Calendula Cream® that contains calendula and lavender in an olive oil base. Although it’s a little greasy when I first put it on, it soaks in completely in just a couple of minutes.

6. My pillbox.

Since I’ve been using a pillbox I’m SO much more consistent in taking my medicine. It’s the number one strategy I recommend to everyone for taking your medicine safely.

What are some of YOUR favorite remedies?

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