Description and Brand Names

US Brand Name

1. A-3 Revised
2. Alocass
3. Amitiza
4. Benefiber
5. Black-Draught
6. CeraLyte 70
7. Cholan-HMB
8. Citrate Of Magnesia
9. Citrucel
10. Colace
11. Colyte
12. Doc-Q-Lax
13. Docucal
14. Dulcolax
15. Fibercon
16. Fleet Mineral Oil
17. GaviLAX
18. GaviLyte-N with Flavor Pack
19. GlycoLax
20. Kristalose
21. Mag-Gel 600
22. Metamucil
23. Nulytely
24. Phillips Milk of Magnesia
25. Phospho-Soda
26. Pizensy
27. Prepopik
28. Purge
29. Reglan
30. Resource Benefiber
31. Rite Aid Senna
32. Senna-S
33. Senokot
34. Suflave
35. Suprep Bowel Prep Kit
36. Sutab
37. Unifiber

Canadian Brand Name

1. Acilac
2. Alpha-Lac
3. Aromatic Cascara Fluid Extract
4. Atoma ClearLax
5. Basic Care ClearLax
6. Basic Care Stool Softener
7. Biolax Cascara Sagrada
8. Biolax Sp
9. Bulk Fiber Therapy
10. CareOne Clearlax
11. Cascara Sagrada Aromatic Fluid Extract
12. Castor Oil

Descriptions

Oral laxatives are medicines taken by mouth to encourage bowel movements to relieve constipation.

There are several different types of oral laxatives and they work in different ways. Since directions for use are different for each type, it is important to know which one you are taking. The different types of oral laxatives include:

Bulk-formers—Bulk-forming laxatives are not digested but absorb liquid in the intestines and swell to form a soft, bulky stool. The bowel is then stimulated normally by the presence of the bulky mass. Some bulk-forming laxatives, like psyllium and polycarbophil, may be prescribed by your doctor to treat diarrhea.

Hyperosmotics—Hyperosmotic laxatives encourage bowel movements by drawing water into the bowel from surrounding body tissues. This provides a soft stool mass and increased bowel action.

There are three types of hyperosmotic laxatives taken by mouth—the saline, the lactulose , and the polymer types:

• The saline type is often called “salts.” They are used for rapid emptying of the lower intestine and bowel. They are not used for long-term or repeated correction of constipation. With smaller doses than those used for the laxative effect, some saline laxatives are used as antacids. The information that follows applies only to their use as laxatives. Sodium phosphate may also be prescribed for other conditions as determined by your doctor.
• The lactulose type is a special sugar-like laxative that works the same way as the saline type. However, it produces results much more slowly and is often used for long-term treatment of chronic constipation. Lactulose may sometimes be used in the treatment of certain medical conditions to reduce the amount of ammonia in the blood. It is available only with your doctor’s prescription.
• The polymer type is a polyglycol (polyethylene glycol), a large molecule that causes water to be retained in the stool; this will soften the stool and increase the number of bowel movements. It is used for short periods of time to treat constipation.

Lubricants—Lubricant laxatives, such as mineral oil, taken by mouth encourage bowel movements by coating the bowel and the stool mass with a waterproof film. This keeps moisture in the stool. The stool remains soft and its passage is made easier.

Stimulants—Stimulant laxatives, also known as contact laxatives, encourage bowel movements by acting on the intestinal wall. They increase the muscle contractions that move along the stool mass. Stimulant laxatives are a popular type of laxative for self-treatment. However, they also are more likely to cause side effects. One of the stimulant laxatives, dehydrocholic acid, may also be used for treating certain conditions of the biliary tract.

Stool softeners (emollients)—Stool softeners encourage bowel movements by helping liquids mix into the stool and prevent dry, hard stool masses. This type of laxative has been said not to cause a bowel movement but instead allows the patient to have a bowel movement without straining.

Combinations—There are many products that you can buy for constipation that contain more than one type of laxative. For example, a product may contain both a stool softener and a stimulant laxative. In general, combination products may be more likely to cause side effects because of the multiple ingredients. In addition, they may not offer any advantage over products containing only one type of laxative. If you are taking a combination laxative, make certain you know the proper use and precautions for each of the different ingredients.

Most laxatives (except saline laxatives) may be used to provide relief:

• during pregnancy.
• for a few days after giving birth.
• during preparation for examination or surgery.
• for constipation of bedfast patients.
• for constipation caused by other medicines.
• following surgery when straining should be avoided.
• following a period of poor eating habits or a lack of physical exercise in order to develop normal bowel function (bulk-forming laxatives only).
• for some medical conditions that may be made worse by straining, for example:
  • Heart disease
  • Hemorrhoids
  • Hernia (rupture)
  • High blood pressure (hypertension)
  • History of stroke

Saline laxatives have more limited uses and may be used to provide rapid results:

• during preparation for examination or surgery.
• for elimination of food or drugs from the body in cases of poisoning or overdose.
• for simple constipation that happens on occasion (although another type of laxative may be preferred).
• in supplying a fresh stool sample for diagnosis.

Laxatives are available both over-the-counter (OTC) and with your doctor’s prescription.

Importance of Diet

Laxatives are to be used to provide short-term relief only, unless otherwise directed by a doctor. A proper diet containing roughage (whole grain breads and cereals, bran, fruit, and green, leafy vegetables), with 6 to 8 full glasses (8 ounces each) of liquids each day, and daily exercise are most important in maintaining healthy bowel function. Also, for individuals who have problems with constipation, foods such as pastries, puddings, sugar, candy, cake, and cheese may make the constipation worse.

Make certain your health care professional knows if you are on any special diet, such as a low-sodium or low-sugar diet. Some laxatives have large amounts of sodium or sugars in them.

This product is available in the following dosage forms:

• Capsule, Liquid Filled
• Tablet, Chewable
• Tablet
• Capsule
• Flake
• Syrup
• Oil
• Packet
• Powder
• Liquid
• Solution
• Suspension
• Tablet, Delayed Release
• Tablet, Enteric Coated
• Powder for Solution
• Powder for Suspension
• Wafer

Before Using

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to medicines in this group or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Laxatives should not be given to young children (up to 6 years of age) unless prescribed by their doctor. Since children usually cannot describe their symptoms very well, they should be checked by a doctor before being given a laxative. The child may have a condition that needs other treatment. If so, laxatives will not help, and may even cause unwanted effects or make the condition worse.

Mineral oil should not be given to young children (up to 6 years of age) because a form of pneumonia may be caused by the inhalation of oil droplets into the lungs.

Also, bisacodyl tablets should not be given to children up to 6 years of age because if chewed they may cause stomach irritation.

Geriatric

Mineral oil should not be taken by bedridden elderly persons because a form of pneumonia may be caused by the inhalation of oil droplets into the lungs. Also, stimulant laxatives (e.g., bisacodyl or casanthranol), if taken too often, may worsen weakness, lack of coordination, or dizziness and light-headedness.

Polyethylene glycol 3350 should be discontinued if diarrhea occurs, especially in elderly persons in nursing homes.

Pregnancy

Although laxatives are often used during pregnancy, some types are better than others. Stool softeners (emollient) laxatives and bulk-forming laxatives are probably used most often. If you are using a laxative during pregnancy, remember that:

• Some laxatives (in particular, the bulk-formers) contain a large amount of sodium or sugars, which may have possible unwanted effects such as increasing blood pressure or causing water to be held in the body.
• Saline laxatives containing magnesium, potassium, or phosphates may have to be avoided if your kidney function is not normal.
• Mineral oil is usually not used during pregnancy because of possible unwanted effects on the mother or infant. Mineral oil may interfere with the absorption of nutrients and vitamins in the mother. Also, if taken for a long time during pregnancy, mineral oil may cause severe bleeding in the newborn infant.
• Stimulant laxatives may cause unwanted effects in the expectant mother if improperly used. Castor oil in particular should not be used as it may cause contractions of the womb.

Breastfeeding

Laxatives containing cascara and danthron may pass into the breast milk. Although the amount of laxative in the milk is generally thought to be too small to cause problems in the baby, your doctor should be told if you plan to use such laxatives. Some reports claim that diarrhea has been caused in the infant.

Drug Interactions

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking any of these medicines, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using medicines in this class with any of the following medicines is not recommended. Your doctor may decide not to treat you with a medication in this class or change some of the other medicines you take.

• Aclidinium
• Amantadine
• Amiloride
• Amitriptyline
• Amoxapine
• Anisotropine
• Atropine
• Belladonna
• Benztropine
• Bepridil
• Biperiden
• Bornaprine
• Brompheniramine
• Burosumab-twza
• Butylscopolamine
• Canrenoate
• Canrenone
• Carbinoxamine
• Carisoprodol
• Chlorpheniramine
• Chlorpromazine
• Cimetropium
• Cisapride
• Clemastine
• Clidinium
• Clomipramine
• Clozapine
• Cyclobenzaprine
• Cyclopentolate
• Cyproheptadine
• Darifenacin
• Desipramine
• Dicyclomine
• Dimenhydrinate
• Diphenhydramine
• Doxepin
• Dronedarone
• Emepronium
• Eplerenone
• Fesoterodine
• Flavoxate
• Fluphenazine
• Glycopyrrolate
• Glycopyrronium Tosylate
• Homatropine
• Hydroxyzine
• Hyoscyamine
• Imipramine
• Ipratropium
• Isopropamide
• Levoketoconazole
• Loxapine
• Mebeverine
• Meclizine
• Mepenzolate
• Mesoridazine
• Methantheline
• Methixene
• Methscopolamine
• Nortriptyline
• Olanzapine
• Orphenadrine
• Oxitropium Bromide
• Oxybutynin
• Paroxetine
• Perphenazine
• Pimozide
• Pinaverium
• Pipenzolate Bromide
• Piperaquine
• Pirenzepine
• Prochlorperazine
• Procyclidine
• Promethazine
• Propantheline
• Propiverine
• Protriptyline
• Quetiapine
• Revefenacin
• Saquinavir
• Scopolamine
• Solifenacin
• Sparfloxacin
• Spironolactone
• Stramonium
• Terfenadine
• Terodiline
• Thioridazine
• Thiothixene
• Tiotropium
• Tizanidine
• Tolterodine
• Triamterene
• Trifluoperazine
• Trihexyphenidyl
• Trimethobenzamide
• Trimipramine
• Tropicamide
• Trospium
• Umeclidinium
• Valethamate
• Ziprasidone

Using medicines in this class with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Acalabrutinib
• Aceclofenac
• Acemetacin
• Acenocoumarol
• Adagrasib
• Alacepril
• Alfuzosin
• Aliskiren
• Amiloride
• Amiodarone
• Amisulpride
• Amitriptyline
• Amoxapine
• Amphetamine
• Amtolmetin Guacil
• Amygdalin
• Anagrelide
• Ancrod
• Anisindione
• Antithrombin III Human
• Apomorphine
• Aripiprazole
• Aripiprazole Lauroxil
• Arsenic Trioxide
• Asenapine
• Aspirin
• Astemizole
• Atazanavir
• Azathioprine
• Azilsartan
• Azilsartan Medoxomil
• Azithromycin
• Baloxavir Marboxil
• Bedaquiline
• Benazepril
• Benzphetamine
• Bictegravir
• Bisacodyl
• Bivalirudin
• Bromfenac
• Bufexamac
• Bupivacaine
• Buprenorphine
• Buserelin
• Cabotegravir
• Candesartan
• Canrenoate
• Captopril
• Cefuroxime Axetil
• Celecoxib
• Ceritinib
• Chloroquine
• Chlorpromazine
• Chlortetracycline
• Choline Salicylate
• Cilazapril
• Ciprofloxacin
• Citalopram
• Clarithromycin
• Clofazimine
• Clomipramine
• Clonixin
• Clothiapine
• Clozapine
• Crizotinib
• Cyclobenzaprine
• Cyclosporine
• Dabrafenib
• Danaparoid
• Dasatinib
• Deferoxamine
• Defibrotide
• Degarelix
• Delafloxacin
• Delamanid
• Delapril
• Demeclocycline
• Dermatan Sulfate
• Desipramine
• Desirudin
• Deslorelin
• Deutetrabenazine
• Dexibuprofen
• Dexketoprofen
• Dexmedetomidine
• Dextroamphetamine
• Diclofenac
• Dicumarol
• Diflunisal
• Digoxin
• Dimercaprol
• Dipyrone
• Disopyramide
• Dofetilide
• Dolasetron
• Dolutegravir
• Domperidone
• Donepezil
• Doxycycline
• Droperidol
• Droxicam
• Efavirenz
• Eltrombopag
• Elvitegravir
• Enalapril
• Enalaprilat
• Encorafenib
• Enoxacin
• Entrectinib
• Eprosartan
• Eravacycline
• Erdafitinib
• Erythromycin
• Escitalopram
• Ethinyl Estradiol
• Etodolac
• Etofenamate
• Etoricoxib
• Etrasimod
• Felbinac
• Fenoprofen
• Fepradinol
• Feprazone
• Fexinidazole
• Fingolimod
• Flecainide
• Floctafenine
• Fluconazole
• Flufenamic Acid
• Fluoxetine
• Flurbiprofen
• Fondaparinux
• Formoterol
• Foscarnet
• Fosinopril
• Fostemsavir
• Gatifloxacin
• Gefitinib
• Gemifloxacin
• Gepirone
• Givinostat
• Glasdegib
• Gonadorelin
• Goserelin
• Granisetron
• Grepafloxacin
• Halofantrine
• Haloperidol
• Heparin
• Histrelin
• Hyaluronidase
• Hydroxychloroquine
• Hydroxyzine
• Ibuprofen
• Ibutilide
• Iloperidone
• Imidapril
• Imipramine
• Indomethacin
• Infigratinib
• Inotuzumab Ozogamicin
• Irbesartan
• Iron
• Itraconazole
• Ivabradine
• Ivosidenib
• Ketoconazole
• Ketoprofen
• Ketorolac
• Lamivudine
• Lapatinib
• Ledipasvir
• Lefamulin
• Lenvatinib
• Leuprolide
• Levofloxacin
• Levomethadyl
• Licorice
• Lisdexamfetamine
• Lisinopril
• Lofexidine
• Lomefloxacin
• Lonafarnib
• Lopinavir
• Lornoxicam
• Losartan
• Loxoprofen
• Lumefantrine
• Lumiracoxib
• Lymecycline
• Macimorelin
• Magnesium Sulfate
• Mavorixafor
• Meclocycline
• Meclofenamate
• Mefenamic Acid
• Mefloquine
• Meloxicam
• Memantine
• Mercaptopurine
• Methacycline
• Methadone
• Methamphetamine
• Metronidazole
• Mifepristone
• Minocycline
• Mirtazapine
• Mobocertinib
• Moexipril
• Morniflumate
• Moxifloxacin
• Mycophenolate Mofetil
• Mycophenolic Acid
• Nabumetone
• Nafarelin
• Naproxen
• Nepafenac
• Neratinib
• Niflumic Acid
• Nilotinib
• Nimesulide
• Nimesulide Beta Cyclodextrin
• Norfloxacin
• Nortriptyline
• Octreotide
• Ofloxacin
• Olanzapine
• Olmesartan
• Omadacycline
• Ondansetron
• Osilodrostat
• Osimertinib
• Oxaliplatin
• Oxaprozin
• Oxyphenbutazone
• Oxytetracycline
• Ozanimod
• Pacritinib
• Paliperidone
• Panobinostat
• Parecoxib
• Paroxetine
• Pasireotide
• Pazopanib
• Penicillamine
• Pentopril
• Pentosan Polysulfate Sodium
• Perindopril
• Phenindione
• Phenobarbital
• Phenprocoumon
• Phenylbutazone
• Phenytoin
• Piketoprofen
• Pimavanserin
• Piperaquine
• Piroxicam
• Pitolisant
• Polyethylene Glycol 3350
• Ponesimod
• Posaconazole
• Pranoprofen
• Primidone
• Procainamide
• Prochlorperazine
• Proglumetacin
• Promethazine
• Propafenone
• Propyphenazone
• Proquazone
• Protriptyline
• Quetiapine
• Quinapril
• Quinidine
• Quinine
• Quizartinib
• Raltegravir
• Ramipril
• Ranolazine
• Relugolix
• Ribociclib
• Rilpivirine
• Rofecoxib
• Rolitetracycline
• Rosuvastatin
• Salicylic Acid
• Salsalate
• Sarecycline
• Selpercatinib
• Senna
• Sertraline
• Sevoflurane
• Siponimod
• Sodium Picosulfate
• Sodium Polystyrene Sulfonate
• Sodium Salicylate
• Solifenacin
• Sorafenib
• Sotalol
• Sotorasib
• Sparfloxacin
• Sparsentan
• Spirapril
• Spironolactone
• St John’s Wort
• Sulindac
• Sulpiride
• Sunitinib
• Tacrolimus
• Telavancin
• Telithromycin
• Telmisartan
• Temocapril
• Tenoxicam
• Tetrabenazine
• Tetracycline
• Tiaprofenic Acid
• Tigecycline
• Tolfenamic Acid
• Tolmetin
• Toremifene
• Trandolapril
• Trazodone
• Triamterene
• Triclabendazole
• Trifluoperazine
• Trimipramine
• Triptorelin
• Trovafloxacin
• Vadadustat
• Valdecoxib
• Valsartan
• Vandetanib
• Vardenafil
• Vemurafenib
• Venlafaxine
• Vilanterol
• Vinflunine
• Vismodegib
• Voclosporin
• Voriconazole
• Warfarin
• Zofenopril
• Zuclopenthixol

Other Interactions

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Using medicines in this class with any of the following is not recommended. Your doctor may decide not to treat you with a medication in this class, change some of the other medicines you take, or give you special instructions about the use of food, alcohol, or tobacco.

• Ethanol

Other Medical Problems

The presence of other medical problems may affect the use of medicines in this class. Make sure you tell your doctor if you have any other medical problems, especially:

• Appendicitis (or signs of) or
• Rectal bleeding of unknown cause—These conditions need immediate attention by a doctor.

• Colostomy or
• Intestinal blockage or
• Ileostomy—The use of laxatives may create other problems if these conditions are present.

• Type 2 diabetes mellitus—Diabetic patients should be careful since some laxatives contain large amounts of sugars, such as dextrose, galactose, and/or sucrose.

• Heart disease or
• High blood pressure—Some laxatives contain large amounts of sodium, which may make these conditions worse.

• Kidney disease—Magnesium and potassium (contained in some laxatives) may build up in the body if kidney disease is present; a serious condition may develop.

• Swallowing difficulty—Mineral oil should not be used since it may get into the lungs by accident and cause pneumonia; also, bulk-forming laxatives may get lodged in the esophagus of patients who have difficulty in swallowing.

Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

For bulk-forming-containing

1. Difficulty in breathing
2. intestinal blockage
3. skin rash or itching
4. swallowing difficulty (feeling of lump in throat)

For hyperosmotic-containing

1. Confusion
2. dizziness or light-headedness
3. irregular heartbeat
4. muscle cramps
5. unusual tiredness or weakness

For stimulant-containing

1. Confusion
2. irregular heartbeat
3. muscle cramps
4. pink to red, red to violet, or red to brown coloration of alkaline urine (for cascara, danthron, and/or senna only)
5. skin rash
6. unusual tiredness or weakness
7. yellow to brown coloration of acid urine (for cascara, and/or senna only)

For stool softener (emollient)-containing

1. Skin rash

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

For hyperosmotic-containing

1. Bloating
2. cramping
3. diarrhea
4. nausea
5. gas
6. increased thirst

For lubricant-containing

1. Skin irritation surrounding rectal area

For stimulant-containing

1. Belching
2. cramping
3. diarrhea
4. nausea

For stool softener (emollient)-containing

1. Stomach and/or intestinal cramping
2. throat irritation (liquid forms only)

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

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