Laxatives
Laxatives
There are different types of laxatives that customers can try.
Click on each flipcard to find out how they work, and how long they can take to be effective.
Bulk forming (e.g. ispaghula husk,
methylcellulose)
Bulk forming (e.g. ispaghula husk, methylcellulose)
- They increase the faecal mass by retaining fluid in it
- This stimulates peristalsis, allowing the bowel muscle to pass the stool
- Works in the same way as dietary fibre
- Adequate fluid intake is important to reduce the risk of intestinal obstruction7
- Useful first-line choice when it is difficult to get adequate dietary fibre8
- Not recommended for opioid-induced constipation (e.g. customers taking codeine-containing medicines)
2-3 days9
Stool softeners (e.g. docusate sodium)
Stool softeners (e.g. docusate sodium)
- Reduces the surface tension of the stool, allowing water to penetrate into it
- This softens and bulks the stool, making it easier to pass
- Useful when the stools are hard/dry
1-2 days10
Osmotic (e.g. macrogols, lactulose)
Osmotic (e.g. macrogols, lactulose)
- Draw water from the rest of the body into your bowel
- Softens and bulks the stool, which is easier to pass
- Advisable to drink an extra glass of water
- Can be used as well as, or instead of, a bulk-forming laxative to soften the stool, when stools are hard
- Can be recommended if a customer has opioid induced constipation (e.g. taking codeine)
1-3 days9,10
Stimulant (e.g. bisacodyl, senna)
Stimulant (e.g. bisacodyl, senna)
- Stimulate nerves in the muscles that line the gut, increasing intestinal motility
- This helps move stool along the bowel to the back passage
- Can add to a bulk-forming laxative where stools are soft, but still difficult to pass
- Can be recommended if a customer has opioid induced constipation (e.g. taking codeine) and an osmotic laxative has not been effective
6-12 hours9
Overuse of stimulant laxatives: Be aware of customers making regular, repeated requests for stimulant laxatives, as they can be abused and misused by some (e.g. those with eating disorders). If you are unsure whether a sale is appropriate, refer to your pharmacist.
Remember: if a customer is taking an opioid medicine (e.g. codeine), do not recommend a bulk-forming laxative. You should offer an osmotic laxative first, and then a stimulant laxative if that is not successful.7