Castor Oil (castor oil)

The usual adult dose of castor oil for constipation is 15 mL; however, castor oil usually should be reserved for total colonic evacuation, such as prior to surgery or radiologic, sigmoidoscopic, or proctoscopic procedures. For these purposes, the usual dose of castor oil is 15-60 mL for adults and children 12 years of age and older, 5-15 mL for children 2-11 years of age, or 1-5 mL for children younger than 2 years of age, administered as a single dose about 16 hours before the surgery or procedure. To prepare for colonic surgery or radiologic, sigmoidoscopic, or proctoscopic procedures, the patient should receive a residue-free diet one day before the surgery or procedure and a cleansing rectal enema (e.g., tap water, soap suds, saline laxative, bisacodyl) on the day of the examination. Additionally, standardized senna fruit extract may be administered 4 hours after castor oil.

Castor oil is administered orally. Emulsions or aromatic preparations somewhat mask the disagreeable taste of castor oil. Containers of castor oil emulsion should be shaken before using, and the emulsion may be mixed with 120-240 mL of water, milk, fruit juice, or soft drink before administration.

No dosing information is available for this tab.

No dosing information is available for this tab.

There is no enhanced messaging for this drug.

There are no contraindication interactions for this drug.

Severe Interaction: Action is required to reduce the risk of severe adverse interaction.

Laxatives/Trofinetide

SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction.

MECHANISM OF ACTION: Trofinetide commonly causes diarrhea of mild to moderate severity. Laxatives may increase the incidence or severity of diarrhea.(1)

CLINICAL EFFECTS: Concurrent use of laxatives with trofinetide may increase the risk of severe diarrhea.(1)

PREDISPOSING FACTORS: None determined.

PATIENT MANAGEMENT: Patients should stop laxatives before starting trofinetide. If diarrhea occurs, consider anti-diarrheal treatment and monitor hydration status. If severe diarrhea or dehydration occurs, interrupt, reduce dose, or discontinue trofinetide.(1)

DISCUSSION: In clinical trials, 85% of patients on trofinetide developed diarrhea. Concurrent use of laxatives may increase this risk.(1)

Laxatives; Stool Softeners/Tenapanor

SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction.

MECHANISM OF ACTION: Tenapanor commonly causes diarrhea of mild to moderate severity. Laxatives and stool softeners may increase the incidence or severity of diarrhea.(1)

CLINICAL EFFECTS: Concurrent use of laxatives or stool softeners with tenapanor may increase the risk of severe diarrhea.(1)

PREDISPOSING FACTORS: None determined.

PATIENT MANAGEMENT: The US manufacturer of tenapanor states that patients should be instructed to avoid stool softeners and laxatives with tenapanor. If severe diarrhea occurs, tenapanor should be discontinued.(1)

DISCUSSION: In clinical trials, 43-53% of CKD patients on dialysis treated with tenapanor developed diarrhea. Diarrhea usually occurred soon after treatment initiation and was severe in 5% of patients.(1)

There are no moderate interactions for this drug.

There is no enhanced messaging for this drug.

• Appendicitis
• Gastrointestinal obstruction
• Pregnancy

There are no severe contraindications for this drug.

There are no moderate contraindications for this drug.

There is no enhanced messaging for this drug.

Less Frequent

• Dehydration

Rare or Very Rare

• Disorder of electrolytes
• Syncope
• Ulceration of colon

Less Frequent

• Abdominal pain with cramps
• Diarrhea
• Dizziness
• Eructation
• Headache disorder
• Nausea

Rare or Very Rare

• Urine discoloration

No enhanced messaging available.

No enhanced messaging available.

No enhanced messaging available.

No enhanced messaging available.

No enhanced messaging available.