Stimulant Lax Plus 8.6-50mg Tabs
It is used to treat constipation.
Drug Class
Laxative, Stool Softener and Stimulant
Pharmacologic Class
Docusate: Anionic Surfactant; Senna: Anthraquinone Derivative
Pregnancy Category
Category C
FDA Approved
Jan 1970
DEA Schedule
Not Controlled
Overview
What is this medicine?
This medication is a combination of two types of laxatives. Docusate is a stool softener that helps water and fats get into your stool, making it softer and easier to pass. Senna is a stimulant laxative that makes your bowel muscles contract, helping to move stool through your intestines. Together, they help relieve occasional constipation.
How to Use This Medicine
Taking Your Medication Correctly
To get the most benefit from your medication, follow your doctor's instructions carefully. Read all the information provided with your prescription and follow the instructions closely. If you take this medication once a day, it's best to take it at bedtime. Always take it with a full glass of water. Additionally, avoid taking other medications within 2 hours of taking this drug.
Storing and Disposing of Your Medication
To keep your medication effective and safe, store it at room temperature in a dry place, away from the bathroom. Keep all medications in a secure location, out of the reach of children and pets. When you no longer need this medication or it has expired, dispose of it properly. Do not flush it down the toilet or pour it down the drain unless instructed to do so by your pharmacist. If you're unsure about the best way to dispose of your medication, consult your pharmacist. You may also want to check if there are any drug take-back programs in your area.
What to Do If You Miss a Dose
If you take this medication regularly and miss a dose, take it as soon as you remember. However, if it's close to the time for your next dose, skip the missed dose and resume your regular schedule. Do not take two doses at the same time or take extra doses. If you take this medication as needed, do not take it more frequently than directed by your doctor.
To get the most benefit from your medication, follow your doctor's instructions carefully. Read all the information provided with your prescription and follow the instructions closely. If you take this medication once a day, it's best to take it at bedtime. Always take it with a full glass of water. Additionally, avoid taking other medications within 2 hours of taking this drug.
Storing and Disposing of Your Medication
To keep your medication effective and safe, store it at room temperature in a dry place, away from the bathroom. Keep all medications in a secure location, out of the reach of children and pets. When you no longer need this medication or it has expired, dispose of it properly. Do not flush it down the toilet or pour it down the drain unless instructed to do so by your pharmacist. If you're unsure about the best way to dispose of your medication, consult your pharmacist. You may also want to check if there are any drug take-back programs in your area.
What to Do If You Miss a Dose
If you take this medication regularly and miss a dose, take it as soon as you remember. However, if it's close to the time for your next dose, skip the missed dose and resume your regular schedule. Do not take two doses at the same time or take extra doses. If you take this medication as needed, do not take it more frequently than directed by your doctor.
Lifestyle & Tips
- Drink plenty of fluids (6-8 glasses of water daily) to help the medication work and prevent dehydration.
- Increase dietary fiber intake (fruits, vegetables, whole grains) to help prevent future constipation.
- Engage in regular physical activity to promote bowel regularity.
- Do not use for more than 7 days unless directed by a doctor.
- Take at bedtime for a bowel movement the next morning.
Available Forms & Alternatives
Available Strengths:
Dosing & Administration
Adult Dosing
Standard Dose:
1-2 tablets orally at bedtime
Dose Range:
1 - 2 mg
Condition-Specific Dosing:
constipation:
For occasional constipation relief. Do not use for more than 7 days unless directed by a doctor.
Pediatric Dosing
Neonatal:
Not established
Infant:
Not established
Child:
Consult a physician for dosing in children under 12 years. Typically 1/2 to 1 tablet at bedtime for children 6-12 years, but specific product instructions should be followed.
Adolescent:
1-2 tablets orally at bedtime for adolescents 12 years and older.
Dose Adjustments
Renal Impairment:
Mild:
No specific adjustment recommended, use with caution.
Moderate:
Use with caution, monitor for electrolyte imbalance and dehydration.
Severe:
Avoid use or use with extreme caution, monitor closely for electrolyte imbalance and dehydration.
Dialysis:
Avoid use or use with extreme caution, monitor closely for electrolyte imbalance and dehydration. Consult nephrologist.
Hepatic Impairment:
Mild:
No specific adjustment recommended, use with caution.
Moderate:
Use with caution, monitor for adverse effects.
Severe:
Use with caution, monitor for adverse effects.
Pharmacology
Mechanism of Action
Docusate sodium acts as an anionic surfactant, lowering the surface tension of the stool, allowing water and fats to penetrate and soften the fecal mass. Senna glycosides (sennosides) are prodrugs that are metabolized by colonic bacteria into active anthrones. These active metabolites stimulate colonic motility (peristalsis) and increase water and electrolyte secretion into the bowel lumen, leading to a laxative effect.
Pharmacokinetics
Absorption:
Bioavailability:
Docusate: Minimal systemic absorption; Senna: Poorly absorbed as parent compound, active metabolites absorbed from colon.
Tmax:
Not applicable for docusate (local action); Senna: Active metabolites reach systemic circulation within 6-12 hours.
FoodEffect:
Food does not significantly alter efficacy, but taking at bedtime is common for morning effect.
Distribution:
Vd:
Not available
ProteinBinding:
Not available
CnssPenetration:
No
Elimination:
HalfLife:
Not available (for combination); Senna active metabolites: Approximately 1.5-2 hours.
Clearance:
Not available
ExcretionRoute:
Docusate: Bile; Senna: Renal (active metabolites), Fecal (unabsorbed/unmetabolized).
Unchanged:
Not available
Pharmacodynamics
OnsetOfAction:
6-12 hours (due to Senna component)
PeakEffect:
Not well-defined, typically within 8-12 hours.
DurationOfAction:
Single dose effect typically resolves within 24 hours.
Safety & Warnings
Side Effects
Urgent Side Effects: Seek Medical Help Right Away
If you experience any of the following symptoms, call your doctor immediately or seek emergency medical attention. Although rare, some people may have severe and potentially life-threatening side effects when taking this medication. Be aware of the following signs and symptoms that may indicate a serious reaction:
- Allergic reaction symptoms, such as rash, hives, itching, red, swollen, blistered, or peeling skin (with or without fever), wheezing, tightness in the chest or throat, difficulty breathing, swallowing, or talking, unusual hoarseness, or swelling of the mouth, face, lips, tongue, or throat.
Other Possible Side Effects
It's essential to remember that all medications can cause side effects, but many people either do not experience any or have only mild side effects. If you have side effects that bother you or do not go away, contact your doctor for advice. Not all possible side effects are listed here. If you have questions or concerns about side effects, discuss them with your doctor.
Reporting Side Effects
For medical advice about side effects, contact your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
If you experience any of the following symptoms, call your doctor immediately or seek emergency medical attention. Although rare, some people may have severe and potentially life-threatening side effects when taking this medication. Be aware of the following signs and symptoms that may indicate a serious reaction:
- Allergic reaction symptoms, such as rash, hives, itching, red, swollen, blistered, or peeling skin (with or without fever), wheezing, tightness in the chest or throat, difficulty breathing, swallowing, or talking, unusual hoarseness, or swelling of the mouth, face, lips, tongue, or throat.
Other Possible Side Effects
It's essential to remember that all medications can cause side effects, but many people either do not experience any or have only mild side effects. If you have side effects that bother you or do not go away, contact your doctor for advice. Not all possible side effects are listed here. If you have questions or concerns about side effects, discuss them with your doctor.
Reporting Side Effects
For medical advice about side effects, contact your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
Seek Immediate Medical Attention If You Experience:
- Severe abdominal pain, cramping, or nausea/vomiting (stop use and consult doctor).
- Rectal bleeding or failure to have a bowel movement after using the laxative (stop use and consult doctor).
- Signs of dehydration (e.g., excessive thirst, dry mouth, dizziness, decreased urination).
- Muscle weakness or cramps (may indicate electrolyte imbalance).
Before Using This Medicine
Before Taking This Medication: Important Information to Share with Your Doctor
It is essential to inform your doctor about the following:
Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the allergic reaction and its symptoms.
Certain health conditions, including:
+ Bowel blockage
+ Abdominal pain
+ Upset stomach
+ Rectal bleeding
+ Vomiting
+ Changes in bowel habits that last longer than 2 weeks
* If you are currently taking mineral oil
This list is not exhaustive, and it is crucial to discuss all your medications (prescription, over-the-counter, natural products, and vitamins) and health problems with your doctor and pharmacist. They will help determine if it is safe to take this medication with your other medications and health conditions. Never start, stop, or adjust the dose of any medication without first consulting your doctor.
It is essential to inform your doctor about the following:
Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the allergic reaction and its symptoms.
Certain health conditions, including:
+ Bowel blockage
+ Abdominal pain
+ Upset stomach
+ Rectal bleeding
+ Vomiting
+ Changes in bowel habits that last longer than 2 weeks
* If you are currently taking mineral oil
This list is not exhaustive, and it is crucial to discuss all your medications (prescription, over-the-counter, natural products, and vitamins) and health problems with your doctor and pharmacist. They will help determine if it is safe to take this medication with your other medications and health conditions. Never start, stop, or adjust the dose of any medication without first consulting your doctor.
Precautions & Cautions
It is essential to inform all of your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication.
Do not use this medication for a period exceeding 1 week unless specifically instructed to do so by your doctor.
Additionally, refrain from using other laxatives or stool softeners concurrently with this medication unless your doctor advises you to do so.
If you experience rectal bleeding or fail to have a bowel movement after using this drug, it is crucial that you consult with your doctor.
If you are pregnant, planning to become pregnant, or are currently breast-feeding, notify your doctor. You and your doctor will need to discuss the potential benefits and risks of using this medication to ensure the best outcome for both you and your baby.
Do not use this medication for a period exceeding 1 week unless specifically instructed to do so by your doctor.
Additionally, refrain from using other laxatives or stool softeners concurrently with this medication unless your doctor advises you to do so.
If you experience rectal bleeding or fail to have a bowel movement after using this drug, it is crucial that you consult with your doctor.
If you are pregnant, planning to become pregnant, or are currently breast-feeding, notify your doctor. You and your doctor will need to discuss the potential benefits and risks of using this medication to ensure the best outcome for both you and your baby.
Overdose Information
Overdose Symptoms:
- Severe diarrhea
- Abdominal cramping
- Dehydration
- Electrolyte imbalance (especially hypokalemia)
- Nausea
- Vomiting
What to Do:
Discontinue use immediately. Seek medical attention. Treatment is supportive, focusing on fluid and electrolyte replacement. Call 1-800-222-1222 (Poison Control Center) for advice.
Drug Interactions
Contraindicated Interactions
- Patients with acute abdominal pain, nausea, vomiting, or other symptoms of appendicitis or undiagnosed abdominal pain.
- Patients with intestinal obstruction or fecal impaction.
Major Interactions
- Not typically associated with major drug-drug interactions when used as directed. Prolonged or excessive use can lead to electrolyte imbalances, which can potentiate effects of certain drugs.
Moderate Interactions
- Diuretics (thiazide, loop): Increased risk of hypokalemia with prolonged use.
- Corticosteroids: Increased risk of hypokalemia with prolonged use.
- Cardiac Glycosides (e.g., Digoxin): Hypokalemia induced by laxative abuse can potentiate digoxin toxicity.
- Warfarin: Senna may theoretically increase the risk of bleeding due to effects on gut flora, though clinically significant interactions are rare with short-term use.
Minor Interactions
- Not typically associated with minor interactions beyond potential for mild gastrointestinal upset with other GI agents.
Monitoring
Baseline Monitoring
Bowel history (frequency, consistency)
Rationale: To assess baseline constipation severity and guide treatment.
Timing: Prior to initiation of therapy.
Hydration status
Rationale: To ensure adequate fluid intake and prevent dehydration.
Timing: Prior to initiation of therapy.
Routine Monitoring
Bowel movements (frequency, consistency)
Frequency: Daily during use
Target: Regular, soft, formed stools
Action Threshold: No bowel movement after 12-24 hours, or persistent diarrhea/abdominal pain.
Hydration status
Frequency: Daily during use
Target: Adequate fluid intake, no signs of dehydration
Action Threshold: Signs of dehydration (e.g., dry mouth, decreased urination, dizziness).
Electrolytes (especially potassium)
Frequency: Only if prolonged use (>7 days) or in patients at risk for electrolyte imbalance (e.g., on diuretics)
Target: Within normal limits
Action Threshold: Abnormal electrolyte levels, especially hypokalemia.
Symptom Monitoring
- Abdominal pain or cramping
- Nausea or vomiting
- Rectal bleeding
- Signs of dehydration (e.g., thirst, dry mouth, decreased urination, dizziness)
- Weakness or muscle cramps (suggestive of electrolyte imbalance)
Special Patient Groups
Pregnancy
Generally considered safe for short-term use during pregnancy for occasional constipation, but always consult a healthcare provider. Docusate is often preferred as a first-line agent. Senna is also commonly used, but prolonged use should be avoided.
Trimester-Specific Risks:
First Trimester:
Low risk with short-term use. Consult physician.
Second Trimester:
Low risk with short-term use. Consult physician.
Third Trimester:
Low risk with short-term use. Consult physician.
Lactation
Both docusate and senna are generally considered compatible with breastfeeding for short-term use. Small amounts of senna metabolites may pass into breast milk, but are not typically harmful to the infant. Monitor infant for diarrhea.
Infant Risk:
Low risk. Monitor for loose stools or diarrhea in the infant.
Pediatric Use
Use with caution and only under medical supervision for children under 12 years. Dosing must be carefully adjusted by age and weight. Prolonged use can lead to laxative dependence and electrolyte imbalances.
Geriatric Use
Use with caution. Elderly patients may be more susceptible to dehydration and electrolyte imbalances (especially hypokalemia) with laxative use. Start with the lowest effective dose and monitor hydration and electrolyte status closely. Avoid prolonged use.
Clinical Information
Clinical Pearls
- This combination is effective for occasional constipation, especially when stool softening and stimulant action are both needed.
- Not intended for long-term use; chronic constipation should be evaluated by a healthcare professional.
- Encourage adequate fluid intake and dietary fiber to maximize effectiveness and prevent recurrence.
- Advise patients that a bowel movement typically occurs 6-12 hours after taking the medication, so bedtime dosing is common.
- Warn against overuse, which can lead to laxative dependence, electrolyte disturbances, and damage to the colon.
Alternative Therapies
- Bulk-forming laxatives (e.g., psyllium, methylcellulose)
- Osmotic laxatives (e.g., polyethylene glycol, magnesium hydroxide, lactulose)
- Other stimulant laxatives (e.g., bisacodyl)
- Other stool softeners (e.g., docusate sodium monotherapy)
- Dietary and lifestyle modifications (increased fiber, fluids, exercise)
Cost & Coverage
Average Cost:
$5 - $20 per 30 tablets
Generic Available:
Yes
Insurance Coverage:
OTC (Over-The-Counter) - generally not covered by prescription insurance, but may be covered by FSA/HSA.
General Drug Facts
If your symptoms or health issues persist or worsen, it's essential to contact your doctor for further guidance. To ensure your safety, never share your medication with others or take someone else's medication. Some medications may come with an additional patient information leaflet, so be sure to check with your pharmacist for more information. If you have any questions or concerns about this medication, don't hesitate to reach out to your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately call your local poison control center or seek emergency medical attention. When seeking help, be prepared to provide details about the medication, including the amount taken and the time it happened, to help healthcare professionals provide the best possible care.