D.O.S.
D.O.S. Uses, Dosage, Side Effects, Food Interaction and all others data.
D.O.S. acts primarily by increasing the penetration of fluid into the faeces. It may also have effects on intestinal fluid secretion, and probably act both as stimulant and faecal softening agent. It also softens ear wax through penetration into the dry matrix of the ceruminous mass, reducing it into semi-solid debris.
D.O.S. sodium is a laxative and an anionic detergent that supposedly promotes incorporation of water and fats into stool through a reduction in surface tension, resulting in softer fecal mass . D.O.S.'s onset of action is 6-72 hours orally and 2-15 minutes rectally . The effects of docusate are thought to be exerted locally in the jejunum.
| Trade Name | D.O.S. |
| Availability | Rx and/or OTC |
| Generic | Docusate |
| Docusate Other Names | Dioctyl sulfosuccinate, Docusate hydrogen |
| Related Drugs | MiraLAX, Colace, Linzess, bisacodyl, senna, magnesium oxide |
| Type | |
| Formula | C20H38O7S |
| Weight | Average: 422.577 Monoisotopic: 422.23382426 |
| Groups | Approved |
| Therapeutic Class | Stool softener |
| Manufacturer | |
| Available Country | USA |
| Last Updated: | September 19, 2023 at 7:00 am |
Uses
D.O.S. is used for Constipation, Bowel evacuation, Softening of ear wax, Constipation
D.O.S. is also used to associated treatment for these conditions: Constipation, Occasional Constipation, Bowel preparation therapy
How D.O.S. works
Recent studies suggest that docusate's mechanism of action is due largely to it's surfactant effect in the intestines, which allow fat and water into the feces to soften the stool.
D.O.S.’s mechanism of action was investigated in 1985 on healthy patients. D.O.S. was added directly to the jejunum based on calculated concentrations of docusate in the jejunum. At this concentration, there was an increase in secretion of water, sodium, chloride, and potassium as well as a decrease in absorption of glucose and bicarbonate. Based on in vitro data, the authors suggested this effect was due to an increase in intracellular cyclic AMP either directly through docusate or E series prostaglandins.
Dosage
D.O.S. dosage
Constipation:
- Adult: 50-300 mg daily in divided doses. Max: 500 mg daily.
- Child: ≥12 yr Same as adult dose.
Bowel evacuation:
- Adult: As adjunct to abdominal radiological procedures: 400 mg given with barium meal.
- Child: ≥12 yr Same as adult dose.
Side Effects
Anorectal pain or bleeding (rectal). Rarely, diarrhoea, abdominal cramps, nausea, skin rash.
Toxicity
D.O.S. is not known to be carcinogenic or cause reproductive toxicity. It was not mutagenic in the Ames assay . Acute oral LD50 in rat is 1900 mg/kg .
Precaution
Rectal admin in patient with haemorrhoids or anal fissures. Children. Pregnancy and lactation.
Interaction
May enhance GI uptake of other drugs (e.g. liquid paraffin). May increase effects of anthraquinone laxatives. Increased incidence of adverse effects in GI mucosa with aspirin.
Food Interaction
No interactions found.D.O.S. Disease Interaction
Major: inflammatory bowel disease, intestinal obstruction disorders
Elimination Route
D.O.S. is not absorbed systemically. As the actions of docusate are local and it is not absorbed, the pharmacokinetic parameters are not available.
Elimination Route
If docusate is systemically absorbed, it undergoes biliary excretion .
Pregnancy & Breastfeeding use
Pregnancy Category C. Either studies in animals have revealed adverse effects on the foetus (teratogenic or embryocidal or other) and there are no controlled studies in women or studies in women and animals are not available. Drugs should be given only if the potential benefit justifies the potential risk to the foetus.
Contraindication
Presence of abdominal pain, nausea, vomiting, intestinal obstruction. Perforation of ear drum or ear inflammation (otic).
Acute Overdose
Symptoms: Oral: Excessive loss of water and electrolytes. Otic: Skin irritation.
Management: Oral: Encourage patient to drink plenty of fluid. Replenish electrolyte loss where appropriate. Otic: Symptomatic treatment.
Storage Condition
Store between 15-30° C. Protect from freezing, heat, humidity and light.
Innovators Monograph
You find simplified version here D.O.S.
D.O.S. contains Docusate see full prescribing information from innovator D.O.S. Monograph, D.O.S. MSDS, D.O.S. FDA label
FAQ
What is D.O.S. used for?
D.O.S. is used to treat constipation. It helps to soften your poo and makes your bowel movements easier if you have problems pooing (constipation).
How does D.O.S. work?
D.O.S. works by increasing the amount of water the stool absorbs in the gut, making the stool softer and easier to pass.
How safe is D.O.S.?
Most adults and children aged 12 years and over can safely take docusate.
What are the common side effects of D.O.S.?
Common side effects of D.O.S. are include:
- Abdominal cramping.
- Stomach pain.
- Diarrhea.
- Excessive bowel activity.
- Intestinal obstruction.
- Throat irritation.
- Rash.
- Low electrolyte levels (excessive use)
Is D.O.S. safe during pregnancy?
D.O.S. has not been associated with adverse effects in pregnancy in a number of studies, and it is thus also considered safe to use.
Is D.O.S. safe during breastfeeding?
D.O.S. is usually safe to use this medicine while breastfeeding.
Can I drink alcohol with D.O.S.?
Yes, you can drink alcohol with D.O.S..
When should be taken of D.O.S.?
D.O.S. usually at bedtime with a full glass (8 ounces or 240 milliliters) of water or juice, or as directed by your doctor.
How many time can I take D.O.S. daily?
Capsules – the normal dose is 1 capsule, taken 3 times a day. Do not take more than 5 capsules in a day. Liquid – the normal dose is two or three 5ml spoonfuls.
Can I take D.O.S. on an empty stomach?
D.O.S. does not usually upset your stomach. You can take the capsules or liquid with or without food.
How long does D.O.S. take to work?
D.O.S. capsules and liquid normally take 1 or 2 days to work. The enema usually works after 5 to 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 does D.O.S. take to work?
The elimination half life of D.O.S. is 16 hours. This means that the bowel stimulant medication is metabolized in the body and roughly half is gone after 16 hours with half the remaining medicine gone after another 16 hours.
Can I take D.O.S. for a long time?
It's best to use D.O.S. occasionally and for a few days at a time. Using laxatives like D.O.S. for longer can lead to long term diarrhoea.
Who should not take D.O.S.?
You should not use D.O.S. if you are allergic to it. Ask a doctor or pharmacist if docusate is safe to use if you have: stomach pain; nausea;vomiting; or a sudden change in bowel habits that lasts over 2 weeks.
What happens if I miss a dose?
Since docusate is used when needed, you may not be on a dosing schedule. Skip any missed dose if it's almost time for your next dose. Do not use two doses at one time.
What happen if I overdose on D.O.S.?
Seek emergency medical attention. Overdose symptoms may include nausea, vomiting, stomach pain, or diarrhea. Nausea, vomiting, abdominal cramping, and diarrhea are the most common symptoms of a laxative overdose. Dehydration and electrolyte (body chemicals and minerals) imbalance are more common in children than adults.
What happen If I stop taking D.O.S.?
Do not take more D.O.S. than recommended or take for longer than seven days. Talk to your doctor before taking if you have any stomach pain, nausea, or vomiting, or have experienced a sudden change in bowel motions that has persisted for longer than two weeks.
Is D.O.S. safe for kidney patients?
D.O.S. is safe for patients with chronic kidney disease (CKD.
Can D.O.S. affects my liver?
There have been no cases of clinically apparent liver injury attributable to docusate published in the literature and, thus, significant liver injury from docusate must be exceedingly rare, if it occurs at all
Can D.O.S. cause irregular heartbeat?
You may be more likely to experience side effects such as headache, low blood pressure, irregular heartbeat, swelling, and fluid retention.
