Physical Medicine

Center of Marin

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Bowel health

Laxatives

Classification, dosage and availability of common laxatives, with newer prescription medicines.

Ask your health care provider or pharmacist which type, if any, is right for you. Prescription medicines are chosen and dosed by your prescriber, so no doses are given for them here.

Bulk (fiber supplements)

Increases stool volume.

Generic nameBrandDosageAvailability
Psyllium (natural)Metamucil, Konsyl1 tsp. up to three times a dayOver the counter
MethylcelluloseCitrucel1 tsp. up to three times a dayOver the counter
Calcium polycarbophilFibercon2 to 4 tablets a dayOver the counter

Osmotic / hyperosmotic

Decreases absorption of fluids and electrolytes from the intestine. Should not be used with a sodium-restricted diet, kidney problems, or high blood pressure.

Generic nameBrandDosageAvailability
Magnesium hydroxideMilk of Magnesia1 to 2 Tbs. a dayOver the counter
Magnesium citrateGenericFollow the package directionsOver the counter
Sodium phosphateFleet Phosphasoda8 to 16 oz. a dayOver the counter
LactuloseChronulac1 to 2 Tbs. a dayPrescription
SorbitolGeneric1 to 2 Tbs. a dayOver the counter
Polyethylene glycol 3350Miralax and genericsFollow the package directionsOver the counter
Polyethylene glycol with electrolytesGolytely8 to 32 oz. a dayPrescription
Glycerin suppositoryGenericUp to dailyOver the counter

Emollient

Contains a stool lubricant or softener to reduce straining.

Generic nameBrandDosageAvailability
Docusate sodiumColace100 mg twice a dayOver the counter
Docusate calciumSurfak240 mg a dayOver the counter
Mineral oilGeneric1 to 3 Tbs. a dayOver the counter

Stimulant

Works as an intestinal irritant. Use with caution, as it can cause dependence by decreasing bowel tone and sensation.

Generic nameBrandDosageAvailability
BisacodylDulcolax5 to 15 mg a dayOver the counter
Anthraquinones (senna)Senokot2 tablets a dayOver the counter
Docusate/casanthranolPericolace, Ex-Lax1 to 2 tablets a dayOver the counter
CascaraGeneric1 tsp. at bedtimeOver the counter

Enemas and rectal products

Work in the rectum, usually within minutes. Meant for occasional use, not every day.

Generic nameBrandHow usedAvailability
Sodium phosphate enemaFleet EnemaFollow the package directionsOver the counter
Mineral oil enemaFleet Mineral OilFollow the package directionsOver the counter
Bisacodyl suppositoryDulcolax suppositoryFollow the package directionsOver the counter

Newer prescription medicines

Used when fiber and the other options have not helped. Your prescriber chooses the medicine and the dose.

Generic nameBrandUsed forAvailability
LinaclotideLinzessChronic constipation; constipation-predominant IBSPrescription
PlecanatideTrulanceChronic constipation; constipation-predominant IBSPrescription
LubiprostoneAmitizaChronic constipation; constipation-predominant IBS in women; opioid-induced constipationPrescription
PrucaloprideMotegrityChronic constipationPrescription
TenapanorIbsrelaConstipation-predominant IBSPrescription
NaloxegolMovantikConstipation caused by opioid pain medicinesPrescription
MethylnaltrexoneRelistorConstipation caused by opioid pain medicinesPrescription
NaldemedineSymproicConstipation caused by opioid pain medicinesPrescription

Tell your provider about every medicine and supplement you take, and call if you have blood in your stool, severe pain, unexplained weight loss, or a sudden change in your bowel habits.

This handout is for education and does not replace advice from your own healthcare provider.

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