Don’t use stool softeners alone to prevent opioid induced constipation.

Docusate is a widely used stool softener. A review of the evidence found that docusate is no more effective than placebo in the prevention or management of constipation and suggests that the drug has very little utility when given alone for opioid-induced constipation. Compared with placebo, docusate did not increase stool frequency or soften the stool. Docusate also failed to alleviate the common symptoms of opioid-induced constipation such as difficulty passing stools, hard stools, abdominal cramping, and incomplete stool passage.

 

Sources:

Ahmedzai SH, et al. Constipation in people prescribed opioids [Internet]. Clin Evid. 2010 [cited 2014 Jun 2].

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Hawley PH, et al. A comparison of sennosides-based bowel protocols with and without docusate in hospitalized patients with cancer. J Palliat Med. 2008 May;11(4):575-81. PMID: 18454610.

Ruston T, et al. Efficacy and side-effect profiles of lactulose, docusate sodium, and sennosides compared to PEG in opioid-induced constipation: a systematic review. Can Oncol Nurs J. 2013 Autumn;23(4):236-46. PMID: 24428006.

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