Over The Counter Drugs For Constipation
The common OTC medications for constipation have been grouped as follows: 1–4
Bulk-forming agents
Lubricating agents
Stool softeners
Osmotic laxatives
Stimulants
Bulkforming Agents
Bulk-forming agents absorb water and help in the formation of soft, bulky stool, which prompt normal contraction of the muscles of the intestine leading to defecation. Some of these agents along with their trade names are as follows:
- Methylcellulose (Citrucel)
Indications
- Constipation
- Long term preventive treatment
Dosage: Oral dose of 15–60 g/day along with at least 8 glasses of water in a day.
Contraindications
- Obstruction in the intestine
Interactions: These agents prevent absorption of medications that are taken within 30 min of the bulk forming agent
Lubricating Agents
These agents tend to lubricate intestine by decreasing the absorption of water from intestine thereby facilitating easy passage of stool.
Some of the drugs under this group are:
- Glycerin (as a suppository)
Indications: Short term constipation
Dosage: Oral dose of 15–45 mL (mineral oil)
Contraindications: Allergy to the drug.
Interactions: These agents prevent absorption of certain medications such as warfarin, oral contraceptives, and fat-soluble vitamins.
Stool Softeners
The stool softeners also known as emollient laxatives cause addition of water and fat to stool which softens it and allows strain-free movement.
The common drugs are:
- Docusate calcium (Surfak)
Indications
- For individuals with anal fissures or hemorrhoids
Dosage: Oral dose of 50–360 mg/day.
Contraindications
- Short and severe pain in the abdomen
Interactions: Prevents absorption of certain medications such as warfarin.
Osmotic Laxatives
These agents cause secretion of water into the intestine by osmosis and thereby soften the stool to ensure its easy passage.
The commonly used drugs and their dosages are as follows:
- Magnesium citrate:0.5–1 bottle (296 mL)/day
- Magnesium hydroxide (Milk of Magnesia): 30–60 mL once-daily
- Polyethylene glycol 3350 (Miralax): Once-daily
- Sodium biphosphate (Phospho-Soda): 20–45 mL daily
- Sorbitol: 30–150 mL daily
Indications: Long-term constipated individuals who do not respond to dietary fibre supplementation.
Contraindications
- Decreased or absent urine formation (Sorbitol is contraindicated)
- Colitis, bowel perforation, gastric retention or bowel obstruction (Miralax)
The osmotic agents should be used carefully in individuals with congestive heart failure and long-term kidney disorders.
Interactions: Prevents absorption of certain medications, which are taken orally.
Stimulants
These agents initiate rhythmic contractions of the muscles of the intestine muscles to eliminate stool.
The common drugs and their dosages are:
- Bisacodyl (Dulcolax): 5–15 mg daily
- Cascara sagrada: 5 mL/L tablet once-daily
- Castor oil: 15–60 mL once-daily
- Senna (Senokot): 2 or 4 tablets once/twice-daily
Indications: Short-term constipation.
Contraindications
- Vomiting or vomiting sensation
- Bleeding from the gastrointestinal tract
Interactions: Prevents absorption ofcertain medications, which are taken orally.
Written by: Healthplus24 team
Date last updated: March 21, 2012