Palliative Care Guidelines - NHS Lanarkshire

Palliative Care Guidelines: ConstipationLaxative drug information chartOral laxative Starting dose Time to act CommentsBisacodyl tablets5mgSenna tabletsSenna liquidCodanthramercapsulesCodanthramersuspension(1 capsule = 5ml)Codanthramerstrong capsulesCodanthramerstrong suspension(2 capsules = 5ml)Docusate sodiumcapsules 100mgMacrogol (Movicol ® )1-2 nocte 6-12 hours • Can cause abdominal cramps.2-4 nocte10-20ml nocte1-2 nocte5-10ml nocte2 nocte5ml nocte8-12 hours • Tablets may be difficult to swallow.• Can cause abdominal cramps.6-12 hours • Combination laxative containing dantronand a softener.• Colours the urine red.• Licensed for use in terminally ill patients.• Avoid if patient is incontinent as cancause a local skin reaction.1 twice daily 24-36 hours • Mainly a softener.• Liquid preparation very unpalatable.1-3 sachetsdaily1-3 days • Made up in 125ml of water per sachet.• High dose (up to 8 sachets per day for1-3 days in impaction).• Available in half strength sachets.Rectal preparations Starting dose Time to act CommentsBisacodylsuppository 10mgSodium citratemicroenema10mg 15-60minutes1-2 30-60minutesPhosphate enema 1 15-30minutesGlycerol suppository 1 15-30minutesArachis oil enema 1 15-60minutes• Must be in contact with bowel wall to beeffective.• Can cause local irritation.• Warm to body temperature.• Combined irritant and softener.• Contains peanut oil; contraindicated innut allergy.• Warm to body temperature.© NHS Lothian Issue date: January 2009 Review date: March 20123