Multiple studies have found docusate to be no more effective than a placebo for improving constipation. Others have found it to be less useful for the treatment of chronic constipation than psyllium.The medication may be given to people who are receiving opioid medication, although prolonged use may cause irritation of the gastrointestinal tract. Other medical uses
Docusate sodium, when used with ear syringing, may help with earwax removal, particularly in the case of impaction.Sodium docusate is also used as a lubricant in the production of tablets and as an emulsifier in topical preparations and other suspensions. Precautions and contraindications
Docusate sodium is approved and recommended as safe during pregnancy and breastfeeding.Docusate is not recommended in people with appendicitis, acute abdomen, or ileus.When taken by mouth it should be ingested with plenty of water. Side effects
Side effects are uncommon and typically mild, and may include stomach pain, abdominal cramps or diarrhea, Efficacy decreases with long-term use, and may cause poor bowel function.Serious allergic reactions may occur with the drug. The most severe side effect of docusate, although very rare, is rectal bleeding. Interactions
Docusate might increase resorption of other drugs, for example, dantron (1,8-dihydroxyanthraquinone). Mechanism of action
Docusate is an anionic surfactant, which works by reducing the surface tension of the stool, allowing more intestinal water and fat to combine with the stool. This decreases the strain and discomfort associated with constipation.It does not stay in the gastrointestinal tract, but is absorbed into the bloodstream and excreted via the gallbladder after undergoing extensive metabolism.
Docusate is the common chemical and pharmaceutical name of the anion bis(2-ethylhexyl) sulfosuccinate, also commonly called dioctyl sulfosuccinate (DOSS). It is on the World Health Organizations List of Essential Medicines.Salts of this anion, especially  docusate sodium, are widely used in medicine as laxatives and as stool softeners, by mouth or rectally. In 2019, it was the 187th most commonly prescribed medication in the United States, with more than 3 million prescriptions. Some studies claim that docusate is not more effective than a placebo for improving constipation. Other docusate salts with medical use include those of calcium and potassium.Docusate salts are also used as food additives, emulsifiers, dispersants, and wetting agents, among other uses. History
Sodium docusate was patented in 1937 by Coleman R. Caryl and Alphons O. Jaeger for American Cyanamid, which commercialized it for many years as a detergent under the brand name Aerosol OT. Its use for the treatment of constipation was first proposed in 1955 by James L. Wilson and  David G. Dickinson, and quickly popularized under the name Doxinate. Medical use
Constipation
The main medical use of docusate sodium is to treat constipation, acting as a laxative and stool softener. In painful anorectal conditions such as hemorrhoid and anal fissures, it can help avoid pain caused by straining during bowel movements. When administered by mouth, a bowel movement often occurs in 1 to 3 days, while rectal use may be effective within 20 minutes.Sodium docusate is recommended as a stool softener for children.However, its effectiveness for constipation is poorly supported by evidence.