Usual Adult Dose for Constipation - Acute

Oral:
Heavy liquid: 30 to 60 mL orally once a day at bedtime

Non-emulsified liquid: 30 to 45 mL orally

Suspension/microemulsion: 30 to 90 mL orally once a day (or as directed)

• Maximum dose: 90 mL/day

Rectal: 118 mL rectally once a day

Comments:

• Non-emulsified liquid formulations should be taken at least 2 hours prior to/after other oral drugs.
• Suspension/microemulsion formulations may be taken as a single dose or given in up to 3 equally divided doses.

Uses:

• Relief of fecal impaction
• Relief of occasional constipation
• Removal of residue after barium administration

Usual Adult Dose for Constipation

Oral:
Heavy liquid: 30 to 60 mL orally once a day at bedtime

Non-emulsified liquid: 30 to 45 mL orally

Suspension/microemulsion: 30 to 90 mL orally once a day (or as directed)

• Maximum dose: 90 mL/day

Rectal: 118 mL rectally once a day

Comments:

• Non-emulsified liquid formulations should be taken at least 2 hours prior to/after other oral drugs.
• Suspension/microemulsion formulations may be taken as a single dose or given in up to 3 equally divided doses.

Uses:

• Relief of fecal impaction
• Relief of occasional constipation
• Removal of residue after barium administration

Usual Adult Dose for Fecal Impaction

Oral:
Heavy liquid: 30 to 60 mL orally once a day at bedtime

Non-emulsified liquid: 30 to 45 mL orally

Suspension/microemulsion: 30 to 90 mL orally once a day (or as directed)

• Maximum dose: 90 mL/day

Rectal: 118 mL rectally once a day

Comments:

• Non-emulsified liquid formulations should be taken at least 2 hours prior to/after other oral drugs.
• Suspension/microemulsion formulations may be taken as a single dose or given in up to 3 equally divided doses.

Uses:

• Relief of fecal impaction
• Relief of occasional constipation
• Removal of residue after barium administration

Usual Pediatric Dose for Constipation - Acute

Rectal:

• Children 2 to 12 years: 59 mL rectally once a day
• Children 12 years and older: 118 mL rectally once a day

Oral:
Heavy liquid:
Children 6 to 12 years: 5 to 15 mL orally once a day (at bedtime)
Children 12 years and older: 15 to 30 mL orally once a day (at bedtime)

Non-emulsified liquid:
Children 6 to 12 years: 5 to 15 mL orally once a day (at bedtime)

• Maximum dose: 15 mL/24 hours

Children 12 years and older: 15 to 45 mL orally once a day (or as directed)

• Maximum dose: 45 mg/24 hours

Suspension/microemulsion:
Children 6 to 12 years: 10 to 30 mL orally once a day (or as directed)
Children 12 years and older: 30 to 90 mL orally once a day (or as directed)

• Maximum dose: 90 mL/day

Comments:

• Non-emulsified liquid formulations should be taken at least 2 hours prior to/after other oral drugs.
• Suspension/microemulsion formulations may be taken as a single dose or given in up to 3 equally divided doses.

Uses:

• Relief of fecal impaction
• Relief of occasional constipation
• Removal of residue after barium administration

Usual Pediatric Dose for Constipation

Rectal:

• Children 2 to 12 years: 59 mL rectally once a day
• Children 12 years and older: 118 mL rectally once a day

Oral:
Heavy liquid:
Children 6 to 12 years: 5 to 15 mL orally once a day (at bedtime)
Children 12 years and older: 15 to 30 mL orally once a day (at bedtime)

Non-emulsified liquid:
Children 6 to 12 years: 5 to 15 mL orally once a day (at bedtime)

• Maximum dose: 15 mL/24 hours

Children 12 years and older: 15 to 45 mL orally once a day (or as directed)

• Maximum dose: 45 mg/24 hours

Suspension/microemulsion:
Children 6 to 12 years: 10 to 30 mL orally once a day (or as directed)
Children 12 years and older: 30 to 90 mL orally once a day (or as directed)

• Maximum dose: 90 mL/day

Comments:

• Non-emulsified liquid formulations should be taken at least 2 hours prior to/after other oral drugs.
• Suspension/microemulsion formulations may be taken as a single dose or given in up to 3 equally divided doses.

Uses:

• Relief of fecal impaction
• Relief of occasional constipation
• Removal of residue after barium administration

Usual Pediatric Dose for Fecal Impaction

Rectal:

• Children 2 to 12 years: 59 mL rectally once a day
• Children 12 years and older: 118 mL rectally once a day

Oral:
Heavy liquid:
Children 6 to 12 years: 5 to 15 mL orally once a day (at bedtime)
Children 12 years and older: 15 to 30 mL orally once a day (at bedtime)

Non-emulsified liquid:
Children 6 to 12 years: 5 to 15 mL orally once a day (at bedtime)

• Maximum dose: 15 mL/24 hours

Children 12 years and older: 15 to 45 mL orally once a day (or as directed)

• Maximum dose: 45 mg/24 hours

Suspension/microemulsion:
Children 6 to 12 years: 10 to 30 mL orally once a day (or as directed)
Children 12 years and older: 30 to 90 mL orally once a day (or as directed)

• Maximum dose: 90 mL/day

Comments:

• Non-emulsified liquid formulations should be taken at least 2 hours prior to/after other oral drugs.
• Suspension/microemulsion formulations may be taken as a single dose or given in up to 3 equally divided doses.

Uses:

• Relief of fecal impaction
• Relief of occasional constipation
• Removal of residue after barium administration

Renal Dose Adjustments

Rectal: Data not available

Oral:
Heavy liquid:

• Renal dysfunction: Data not available
• Renal failure: Contraindicated

Non-emulsified liquid, suspension/microemulsion: Data not available

Liver Dose Adjustments

Data not available

Precautions

CONTRAINDICATIONS:
Rectal:

• Patients with abdominal pain, nausea, or vomiting (unless otherwise directed)

Oral:
Heavy liquid:

• Infants or young children (unless otherwise directed)
• Older patients (unless otherwise directed)
• Patients who are bedridden (unless otherwise directed)
• Patients with abdominal pain, bowel habit changes lasting longer than 2 weeks, nausea, vomiting, rectal bleeding, and/or renal failure
• Use for longer than 1 week

Non-emulsified liquid:

• Children under 6 years of age
• Older patients
• Patients who are bedridden
• Patients with difficulty swallowing
• Pregnant patients
• Use for longer than 1 week

Suspension/microemulsion:

• Children under 6 years of age
• Patients who are bedridden
• Patients with difficulty swallowing
• Pregnant patients

Safety and efficacy of rectal formulations have not been established in patients younger than 2 years; this drug is not recommended for use in these patients.

Safety and efficacy of some oral formulations have not been established in patients younger than 6 years; this drug is not recommended for use in these patients.

Consult WARNINGS section for additional precautions.

Dialysis

Data not available

Other Comments

Administration advice:

• This drug should not be taken with meals.
• Oral liquid formulations should be mixed/shaken well prior to administration.
• Some experts recommend avoiding administration of oral formulations less than 2 hours before lying down.

Storage requirements:

• Oral: Protect from light; keep bottle tightly closed when not in use.

Monitoring:

• GASTROINTESTINAL: Sudden, persistent bowel function changes over 2 weeks; rectal bleeding or continued constipation during treatment

Patient advice:

• Advise patients to speak to their healthcare provider if they become pregnant, intend to become pregnant, or are breastfeeding.
• Patients should be instructed to stop treatment and seek further advice if rectal bleeding occurs and/or they fail to have a bowel movement.