What is Colace

Colace is an emollient laxative medicine that is used to treat constipation (difficulty pooing). Colace contains the active ingredient Docusate. Colace (Docusate) helps to soften your poo (stool softener) and makes your bowel movements easier to pass.

Colace (Docusate) is used to treat or prevent constipation, and to reduce pain or rectal damage caused by hard stools or by straining during bowel movements. Colace (Docusate) may also be used for purposes not listed in this medication guide.

Colace (Docusate) is helpful when you have difficulty going to the toilet because of dry poos or piles (hemorrhoids) or if you have a tear in the lining of your back passage (an anal fissure). Colace (Docusate) makes your bowel movements softer and easier to pass.

You may also be given Colace (Docusate) if you’re going to have an x-ray of your stomach. It can help you empty your bowels beforehand.

Colace (Docusate) comes as capsules and as a liquid that you swallow. Colace (Docusate) also comes as an enema – a tube of liquid medicine which you squeeze into your back passage.

Colace (Docusate) is available on prescription. You can also buy it from pharmacies.

Key facts

• Colace (Docusate) capsules and liquid take 1 or 2 days to work.
• The Colace (Docusate) enema usually works within 20 minutes – so it’s best to stay close to a toilet.
• Do not give Colace (Docusate) to a child under 12 years old unless their doctor prescribes it.
• Do not take Colace (Docusate) for more than a week without talking with your doctor.
• Docusate is also known by the brand names Surfak, Dulcoease, Dioctyl,Diocto, Dioeze, Doc-Q-Lace, Docu, Docu Soft, Doculase, Docuprene, Docusil, Docusoft S, DocuSol, DOK, DSS, Dulcolax Stool Softener, Enemeez Mini, Kao-Tin, Octycine-250, Pedia-Lax Stool Softener, Phillips Stool Softener, Promolaxin, Silace, Surfak Stool Softener, Sur-Q-Lax, Vacuant. The enema is known by the brand name Norgalax.

Colace mechanism of action

Colace (Docusate) stool softener (emollient laxative) encourages bowel movements by helping water and fats to get into the stool and prevent dry, hard stool masses. This type of laxative has been said to allow patient to have a bowel movement without straining.

Colace (Docusate) is not a stimulant laxative.

How long does it take for Colace to work?

Colace (Docusate) capsules and liquid normally take 1 or 2 days to work. The enema usually works within 20 minutes, so it’s best to stay close to a toilet.

Talk to your doctor or pharmacist if you are still constipated after a week.

How long should I take Colace for?

Take Colace (Docusate) for up to 1 week. If you take Colace (Docusate) for longer, your bowel can start to rely on it, rather than working on its own.

If you are still constipated after taking Colace (Docusate) for a week, talk to your doctor.

If your constipation is caused by an illness or a medicine you’re taking, your doctor will advise you about when it’s best to stop taking Colace (Docusate).

Is it safe to take Colace for a long time?

Ideally, you should only use Colace (Docusate) occasionally and for a few days at a time.

Using laxatives like Colace (Docusate) for longer can lead to long term diarrhea. They can also cause an electrolyte imbalance. This means that levels of substances like sodium, potassium and magnesium in your body get too high or too low. A severe electrolyte imbalance can cause serious health problems such as muscle spasm and twitching, and even fits (convulsions).

Using Colace (Docusate) for many weeks, even months, could also stop your bowel working properly on its own.

Can I take different laxatives together?

For most people, 1 laxative will be enough to relieve constipation.

Occasionally, you may need to take 2 different types of laxatives at the same time to get your bowels moving again.

Only take 2 laxatives together on the advice of your doctor or pharmacist as there is an increased risk of side effects.

Are other laxatives any better?

There are other types of laxative. They work in a different way to Colace (Docusate) but are equally good at treating constipation.

• Bulk-forming laxatives, for example Fybogel and methylcellulose. These increase the ‘bulk’ or weight of poo which in turn stimulates bowel movement. They take 2 or 3 days to work.
• Osmotic laxatives, for example lactulose. These draw water from the rest of the body into your bowel to soften your poo and make it easier to pass. They take at least 2 days to work.
• Stimulant laxatives, for example senna. These stimulate the muscles that line your gut, helping them to move poo along your gut to your back passage. Senna takes about 8 hours to work.

Is there any food and drink I need to avoid?

You can eat and drink normally while taking Colace (Docusate).

It might be a good idea to stop eating pastries, puddings, sweets, cheese and cake for a while as these foods can make constipation worse.

Can I drink alcohol with Colace?

Yes, you can drink alcohol with Colace (Docusate).

Can I use Colace after surgery?

It’s quite common to have constipation after surgery. Using a laxative may help relieve the discomfort.

If you have constipation after an operation, it’s better to use lactulose because it is gentler than Colace (Docusate). You can get it from pharmacies.

Can lifestyle changes help constipation?

It’s often possible to improve constipation without having to use laxatives. Before trying Colace (Docusate) – or to stop constipation coming back – it may help to:

• eat more fiber – aim for about 30-35 g of fiber a day. High-fiber foods include fruit, vegetables and cereals. If you’re not used to a high-fiber diet, increase the amount of fiber you eat gradually.
• add bulking agents, such as wheat bran, to your diet. These will help make your poo softer and easier to pass (although bran and fiber can sometimes make bloating worse).
• drink plenty of water – to keep poo soft
• exercise regularly – keeping your body active will help to keep your gut moving

Who can and can’t take Colace

Most adults can safely take Colace (Docusate), but do not give it to a child under 12 years old unless their doctor prescribes it.

• Never give Colace (Docusate) to a child under 12 years old unless their doctor prescribes it.

Colace (Docusate) isn’t suitable for some people. To make sure it is safe for you, tell your doctor or pharmacist if you have:

• ever had an allergic reaction to Colace (Docusate) or any other medicines in the past
• ever had an allergic reaction to fructose or sorbitol (types of sugar)
• a blockage in your gut (intestine)
• chronic stomach pain that has not been checked by a doctor
• nausea, vomiting, or severe stomach pain
• stomach pains
• been feeling sick in the last 24 hours or have been sick
• been taking a mineral oil laxative such as liquid paraffin

Ask a doctor or pharmacist if it is safe for you to take Colace (Docusate):

• if you are on a low-salt diet; or
• if you have recently had a sudden change in your bowel habits lasting for longer than 2 weeks.

Do not use an enema containing Colace (Docusate) if you have:

• piles (hemorrhoids) or bleeding from your back passage
• sores around your back passage called anal fissures
• illnesses where your bowel or back passage become inflamed such as ulcerative colitis or Crohn’s disease
• ileus – when the muscles in your bowel aren’t able to move food and liquid along

Pregnancy and breastfeeding

Tell your pharmacist or doctor if you’re trying to get pregnant, are already pregnant or if you’re breastfeeding.

FDA pregnancy category C: Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.

It is not known whether Colace (Docusate) will harm an unborn baby. Do not use this medicine without a doctor’s advice if you are pregnant.

Colace (Docusate) may not be suitable if you’re pregnant or breastfeeding because small amounts might be absorbed by your gut.

If you’re pregnant or breastfeeding, it’s always better to try to treat constipation without taking a medicine. Your doctor or midwife will first advise you to eat more fiber and drink plenty of fluids. It may also help to do gentle exercise.

If diet and lifestyle changes don’t work, your doctor or midwife may recommend a laxative, such as lactulose or Fybogel. These are safer laxatives to take during pregnancy and while breastfeeding.

I just found out I am pregnant. Should I stop taking Colace?

You should always talk with your health care provider before making any changes in your medication. It is important to consider the benefits of treating constipation symptoms during pregnancy. Your health care provider may also want to confirm diagnosis of constipation and see how dietary and other lifestyle therapies may help.

Can use of Colace during pregnancy cause birth defects?

Few studies have been done to look at the possible risks of Colace (Docusate) during pregnancy. However, the available studies show that when used in recommended doses Colace (Docusate) is not expected to increase the chance of birth defects.

In every pregnancy, a woman starts out with a 3-5% chance of having a baby with a birth defect. This is called her background risk.

What if the father of the baby takes Colace?

There are no studies looking at possible problems with conceiving or risks to a pregnancy when the father takes Colace (Docusate). In general, exposures that fathers have are unlikely to increase risks to a pregnancy.

What are the dangers of taking too much Colace sodium?

When used in recommended doses, Colace (Docusate) is unlikely to cause problems during pregnancy. However, when more than the recommended amount of this product is used, it can lower the levels of magnesium in a person’s blood. There is one reported case of low magnesium levels in a newborn that was linked to the mother overusing Colace (Docusate). The baby’s main symptom was jitteriness, which went away by the second day of life. There have been no reported problems linked to the use of recommended levels of Colace (Docusate) in pregnancy.

Colace and breastfeeding

It is not known whether Colace (Docusate) passes into breast milk or if it could harm a nursing baby. Do not use this medicine without a doctor’s advice if you are breast-feeding a baby.

While some of the Colace (Docusate) is absorbed by the mother, the amount that passes into milk is likely low ¹. There have been no reports of problems in babies that are breastfeeding while the mother is taking Colace (Docusate). Be sure to talk to your health care provider about all your choices for breastfeeding.

In a randomized, blinded trial, 35 postpartum breastfeeding patients received a laxative containing docusate in a dose of 120 mg daily in addition to danthron 100 mg daily. One patient stated that diarrhea occurred in her breastfed infant ². The diarrhea was most likely caused by the danthron. Danthron is a reddish, synthetic anthraquinone derivative ³. Danthron has been widely used as a laxative, but is no longer used to treat constipation and is currently used as an antioxidant in synthetic lubricants, in the synthesis of experimental antitumor agents, as a fungicide and as an intermediate for making dyes.

If diet and lifestyle changes don’t work, your doctor or midwife may recommend a laxative, such as lactulose or Fybogel. These are safer laxatives to take during pregnancy and while breastfeeding.

Cautions with other medicines

Do not take docusate with a mineral oil laxative such as liquid paraffin.

What is Colace used for

Colace (Docusate) is used to treat or prevent constipation, and to reduce pain or rectal damage caused by hard stools or by straining during bowel movements. Colace (Docusate) may also be used for purposes not listed in this medication guide.

Colace (Docusate) is helpful when you have difficulty going to the toilet because of dry poos or piles (hemorrhoids) or if you have a tear in the lining of your back passage (an anal fissure). Colace (Docusate) makes your bowel movements softer and easier to pass.

You may also be given Colace (Docusate) if you’re going to have an x-ray of your stomach. It can help you empty your bowels beforehand.

• Ask a doctor before use if you notice a sudden change in bowel habits that persists over a period of 2 weeks.
• Stop use and ask a doctor if you have rectal bleeding or you fail to have a bowel movement after use.
• If pregnant or breast-feeding, ask a health professional before use.
• Keep out of reach of children. In case of overdose, get medical help or contact a Poison Control Center right away.

Colace vs Dulcolax

Dulcolax contains the active ingredient Bisacodyl, is a laxative that stimulates bowel movements. Bisacodyl acts by directly stimulating the nerve endings in the mucosa of the colon, increasing the movement of the intestines.

Dulcolax (Bisacodyl) is used to treat constipation or to empty the bowels before surgery, colonoscopy, x-rays, or other intestinal medical procedure. Dulcolax (Bisacodyl) tablets generally produce a bowel movement in 6 to 12 hours.

Dulcolax (Bisacodyl) is used in hospitals to help you empty your bowels before surgery or some examinations or treatments. Your hospital will explain how to use it.

Dulcolax (Bisacodyl) comes as a tablet and a suppository (a medicine that you push gently into your back passage).

The tablets and suppositories are available on prescription and to buy from pharmacies.

Dulcolax (Bisacodyl) may be given as follows:

• Usual Adult Dose for Constipation
  • 5 to 15 mg (1 to 3 tablets) orally once a day as needed or
  • 10 mg (1 suppository) rectally once a day as needed or
  • 10 mg rectal liquid once a day as needed.
• Usual Adult Dose for Bowel Preparation
  • 5 to 15 mg (1 to 3 tablets) orally once a day as needed or
  • 10 mg (1 suppository) rectally once a day as needed or
  • 10 mg rectal liquid once a day as needed.

Elderly patients taking Dulcolax (Bisacodyl) have an increased risk of fecal incontinence.

Dulcolax (Bisacodyl) can be used during lactation however, it should only be used occasionally during pregnancy

The onset of action of Dulcolax (Bisacodyl) is as follows:

• Oral: 6-12 hours
• Suppository: 15-60 minutes
• Enema: 5-15 minutes

How and when to take Colace

Colace (Docusate) comes as capsules, liquid and an enema.

Use exactly as directed on the label, or as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended.

• Do not crush, chew, break, or open a Colace (Docusate) capsule or tablet. Swallow it whole.
• Colace (Docusate) should generally be used for a period of less than 1 week. For longer than one week see your doctor for advice.
  

Take this medicine with a full glass of water. Drink plenty of liquids while you are taking Colace (Docusate).

Measure liquid medicine with the dosing syringe provided, or with a special dose-measuring spoon or medicine cup. If you do not have a dose-measuring device, ask your pharmacist for one. Mix the liquid with 6 to 8 ounces of milk, fruit juice, or infant formula and drink the mixture right away.

After taking Colace (Docusate) by mouth (tablets, capsules, liquid), you should have a bowel movement within 12 to 72 hours.

• Do not take Colace (Docusate) Rectal Enema by mouth. It is for use only in your rectum.

Wash your hands before and after using Colace (Docusate) enema.

Try to empty your bowel and bladder just before using the enema. Remove the cap from the enema applicator tip. Lie down on your left side with your knees bent, and gently insert the tip of the enema applicator into the rectum. Squeeze the tube to empty the entire contents into the rectum. Throw away the tube, even if there is still some medicine left in it. For best results, hold in the enema for as long as possible, or until you have a bowel movement.

The rectal enema should produce a bowel movement within 2 to 15 minutes.

Do not use Colace (Docusate) for longer than 7 days unless your doctor has told you to. Call your doctor if your symptoms do not improve, or if you have not had a bowel movement within 1 to 3 days. Overuse of a stool softener can lead to serious medical problems.

Store at room temperature away from moisture and heat.

How to take Colace

• Capsules – swallow the capsule whole with plenty of water.
• Liquid – this comes with a plastic cup or spoon to measure the dose. Do not use a kitchen spoon as it will not give the right amount. If you don’t have a cup or spoon, ask your pharmacist for one. When you’ve swallowed it, drink plenty of water or another drink, such as milk or orange juice.
• Enema – squeeze the tube of liquid gently into your back passage. The information leaflet which comes with your Colace (Docusate) will explain how to do this.

Colace (Docusate) doesn’t usually upset your tummy. You can take the capsules or liquid with or without food. Try to take them at regular intervals throughout the day. Mealtimes (breakfast, lunch and dinner) are useful reminders.

There is no specific time of day to use an enema but it works quickly (usually between 5 and 20 minutes), so use it when you know you’ll be near a toilet.

How much to take

• Capsules – the normal dose is 1 capsule 3 times a day. Do not take more than 5 capsules in a day.
• Liquid – the normal dose is 2 or 3 x 5ml spoonfuls. Take this dose 3 times a day.
• Enema – normally 1 tube of liquid is all you need. If you need a second dose, you can use it later in the day or the next day.

You should feel more comfortable within 1 or 2 days of treatment. Reduce the dose as your condition gets better.

Drink plenty of fluids (6 to 8 glasses a day) while you are taking Colace (Docusate) or your constipation may get worse.

Usual Adult Dose for Constipation

• Oral: 50 to 400 mg (using any of the salt forms) orally administered in 1 to 4 equally divided doses each day.
• Rectal: 200 to 283 mg rectally administered as an enema once or twice.
• Alternative: 50 to 100 mg (docusate sodium liquid) added to a retention or flushing enema once a day.

Usual Pediatric Dose for Constipation

• Oral:
  • less than 3 years: 10 to 40 mg (docusate sodium) orally divided in 1 to 4 doses.
  • 3 to 6 years: 20 to 60 mg (docusate sodium) orally divided in 1 to 4 doses.
  • 6 to 12 years: 40 to 150 mg (docusate sodium) orally divided in 1 to 4 doses.
  • older than 12 years: 50 to 400 mg (using any of the salt forms) orally administered in 1 to 4 equally divided doses each day.
• Rectal:
  • 3 to 18 years: 50 to 100 mg (docusate sodium liquid) added to a retention or flushing enema once a day.
  • Alternative: 200 to 283 mg rectally administered as an enema once daily as needed for constipation.

Renal Dose Adjustments

• Data not available

Liver Dose Adjustments

• Data not available

Kidney Dialysis

• Data not available

What if I forget to take it?

If you forget a dose of Colace (Docusate), don’t worry, just take the next dose as normal.

Never take 2 doses at the same time. Never take an extra dose to make up for a forgotten one.

What if I take too much?

Taking an extra dose of Colace (Docusate) by accident is unlikely to harm you but you should drink lots of water. You may get diarrhoea and stomach pain but this should ease off within a day or two.

If you’re worried, talk to your doctor or pharmacist for advice.

Colace dosage

Colace Regular Strength

Colace Regular Strength Warnings

• Do not use laxative products for longer than 1 week unless told to do so by a doctor.
• Do not use if you are presently taking mineral oil unless told to do so by a doctor.
• Ask a doctor before use if you have:
  • Stomach pain
  • Nausea
  • Vomiting
  • Noticed a sudden change in bowel habits that lasts over two weeks
• Stop use and ask a doctor if you have rectal bleeding or fail to have a bowel movement after use of a laxative. These could be signs of a serious condition.
• If pregnant or breastfeeding, ask a health professional before use.
• Keep out of reach of children. In case of overdose, get medical help or contact a Poison Control Center right away.

Colace Regular Strength Uses

• Treat occasional constipation – including constipation associated with certain medical conditions – safely, gently, and effectively with Colace Capsules.
• For gentle, reliable relief from occasional constipation (irregularity)
• Stimulant-free for comfortable relief
• Generally produces bowel movement in 12 to 72 hours

Colace Regular Strength Directions of Use

• Take only by mouth. May be taken as a single daily dose or in divided doses.
• Adults and children 12 years of age and over: 1 to 3 capsules daily
• Children 2 to under 12 years of age: 1 capsule daily
• Children under 2 years: Ask a doctor

Colace Clear

Colace Clear is a stool softener available in a clear formulation that is dye-free and a lower strength. Use Colace Clear to treat occasional constipation, including constipation associated with certain medical conditions.

• For gentle, reliable relief from occasional constipation (irregularity)
• Stimulant-free for those who have conditions where they should avoid straining
• Dye-free
• Generally produces bowel movement in 12 to 72 hours

Colace Clear Warnings

• Do not use laxative products for longer than 1 week unless told to do so by a doctor.
• Do not use if you are presently taking mineral oil unless told to do so by a doctor.
• Ask a doctor before use if you have:
  • Stomach pain
  • Nausea
  • Vomiting
  • Noticed a sudden change in bowel habits that lasts over two weeks
• Stop use and ask a doctor if you have rectal bleeding or fail to have a bowel movement after use of a laxative. These could be signs of a serious condition.
• If pregnant or breastfeeding, ask a health professional before use.
• Keep out of reach of children. In case of overdose, get medical help or contact a Poison Control Center right away.

Colace Clear Uses

• Treat occasional constipation – including constipation associated with certain medical conditions – safely, gently, and effectively with Colace Capsules.
• For gentle, reliable relief from occasional constipation (irregularity)
• Stimulant-free for comfortable relief
• Generally produces bowel movement in 12 to 72 hours

Colace Regular Strength Directions of Use

• Take only by mouth. May be taken as a single daily dose or in divided doses.
• Adults and children 12 years of age and over: 1 to 6 capsules daily
• Children 2 to under 12 years of age: 1 to 3 capsules daily
• Children under 2 years: Ask a doctor

Colace side effects

Like all medicines, Colace (Docusate) may cause side effects in some people but most people have no side effects or only minor ones.

If you get any of these side effects, talk to your doctor or pharmacist:

• feeling sick
• diarrhea
• stomach cramps
• dizziness, weakness
• gas, bloating, mild diarrhea
• rectal irritation
• sweating

These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.

These side effects are mild and usually go away after a couple of days.

With the Colace (Docusate) enema sometimes people get a burning or pain around their back passage. Occasionally the wall of the back passage may bleed. This is a reaction to the enema and it should clear up quickly. If the pain or bleeding don’t go away or you are worried about them, talk to your doctor or pharmacist.

Stop using Colace (Docusate) and call your doctor at once if you have:

• pounding heartbeats or fluttering in your chest;
• a light-headed feeling, like you might pass out;
• rectal bleeding or irritation;
• numbness or a rash around your rectum;
• vomiting, severe diarrhea or stomach cramps; or
• continued constipation, or no bowel movement.

Gastrointestinal

Gastrointestinal side effects have included gastrointestinal cramping. Reports of bitter taste and throat irritation have been reported with administration of primarily the syrup and liquid formulations.

Dermatologic

Dermatologic side effects have included rash.

Metabolic

Metabolic side effects have included at least one case report of hypomagnesemia.

Metabolic abnormalities reported include hypomagnesemia in one woman who took docusate chronically throughout her pregnancy. Magnesium levels returned to normal following discontinuation of Colace (Docusate).

Serious side effects

Serious allergic reaction

In rare cases, it’s possible to have a serious allergic reaction to Colace (Docusate).

• A serious allergic reaction is an emergency. Contact a doctor straight away if you think you or someone around you is having a serious allergic reaction.

The warning signs of a serious allergic reaction are:

• getting a skin rash that may include itchy, red, swollen, blistered or peeling skin
• wheezing
• tightness in the chest or throat
• having trouble breathing or talking
• swelling of the mouth, face, lips, tongue or throat

These are not all the side effects of Colace (Docusate). For a full list see the leaflet inside your medicines packet.

How to cope with side effects

What to do about:

• feeling sick – try taking Colace (Docusate) with meals or mixing your dose with some water or fruit juice.
• diarrhea – drink plenty of water or other fluids. It may also help to take an oral rehydration drink to prevent dehydration. You can buy sachets of powder from a pharmacy which you mix with water. Reducing the dose of Colace (Docusate) may also help diarrhea. Don’t take any other medicines to treat diarrhea without speaking to a pharmacist or doctor.
• stomach cramps – if you get stomach cramps, reduce your dose of Colace (Docusate) until it goes away.

1. Lewis JH, Weingold AB and the Committee of FDA-Related Matters, American College of Gastroenterology. The use of gastrointestinal drugs during pregnancy and lactation. Am J Gastroenterol. 1985;80:912-23 https://www.ncbi.nlm.nih.gov/pubmed/2864852[↩]
2. Greenhalf JO, Leonard HS. Laxatives in the treatment of constipation in pregnant and breast-feeding mothers. Practitioner. 1973;210:259-63 https://www.ncbi.nlm.nih.gov/pubmed/4570522[↩]
3. Danthron. https://pubchem.ncbi.nlm.nih.gov/compound/danthron[↩]