Prevention and treatment of chronic constipation. Prevention of hard, dry stools and reduction of straining at stools in the presence of conditions like haemorrhoids or anal fissures.

Adults and children 12 years and above:

Up to maximum of 500 mg should be taken daily in divided doses.

Treatment should be commenced with large doses such as 100 mg three times daily, which should be adapted to the treatment response.

Dulcoease is not recommended for use in children under the age of 12 years.

Duration of treatment

The patient should be advised to consult a physician when constipation persists or worsens during treatment or when laxatives are needed for a long period of time.

Method of administration

Oral use. The capsules should be swallowed whole with a glass of water.

Special populations

No specific dose adjustment is necessary for elderly patients.

Dulcoease is contraindicated in patients with:

- hypersensitivity to docusate or to any of the excipients

- abdominal pain if not constipation-related

- nausea and vomiting

- intestinal obstruction

Organic disorders should be excluded prior to the administration of any laxative.

Each 100 mg capsule contains approximately 19.3 mg of sorbitol, resulting in 96.5 mg sorbitol per maximum recommended daily dose for adults. Patients with hereditary fructose intolerance (HFI) should not take this medicine.

Dulcoease 100 mg Capsules contain E110 sunset yellow which may cause allergic reactions.

Dulcoease should not be taken concurrently with mineral oil laxatives such as liquid paraffin.

Pregnancy

There are no adequate data from the use of the drug in pregnant women. The potential risk for humans is unknown.

Nonclinical studies are insufficient with respect to effects on pregnancy and fetal development. Dulcoease should be used during pregnancy only if the benefits outweigh the risks.

Lactation

Non-clinical studies have shown excretion of docusate sodium and its metabolites into breast milk when administered systemically. Dulcoease should be used with caution in nursing mothers.

Fertility

There is insufficient data on the effect of docusate sodium on fertility.

None known.

The following CIOMS frequency rating is used, when applicable:

Very common ≥ 10 %; Common ≥ 1 and < 10 %; Uncommon ≥ 0.1 and <1%; Rare ≥ 0.01 and < 0.1%; Very rare < 0.01%; Not known (cannot be estimated from available data).

Gastrointestinal disorders

• Rare: Diarrhoea, nausea, abdominal cramps

Skin and subcutaneous tissue disorders

• Frequency unknown: Rash and pruritus

Reporting of suspected adverse reactions

Reporting suspected adverse reaction after authorisation of the medicinal product is important. It allows continued monitoring of the benefit / risk balance of the medicinal product. Healthcare professionals are asked to report any suspected adverse reactions via the Yellow Card Scheme at: www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store.

Overdose may cause excessive loss of fluid and electrolytes which require replacement.

ATC code: A06AA02 Laxatives, softeners, emollients

Docusate sodium is an anionic wetting agent, which acts as a faecal softener by lowering the surface tension and allowing penetration of accumulated hard dry faeces by water and salts.

Docusate sodium also possesses stimulant activity.

Docusate sodium exerts its clinical effect in the gastrointestinal tract. There is some evidence that docusate sodium is absorbed and is excreted in the bile. There is also evidence that docusate sodium is capable of enhancing absorption of certain compounds administered concomitantly

None stated

Macrogol 400

Propylene glycol

Gelatin 195 bloom

Purified water

Sorbitol special (E420)

Glycerol

Titanium dioxide E171

Quinoline yellow E104

Sunset yellow E110

Not applicable.

PVC/PVdC blister packs with aluminium foil: 18 months.

Polyethylene/polypropylene containers: 36 months.

Do not store above 25° C.

Store in the original package in order to protect from moisture.

PVC/PVdC blister packs with aluminium foil containing 10, 20, 30, 40, 50 or 60 capsules.

Polyethylene / polypropylene containers, e.g.: securitainers / tampertainers containing 30, 100 and 250 capsules.

Not all pack sizes may be marketed.

No special requirements.