- Docusate does not perform any better than placebo in studies.
- PEG, Senna should be our first line laxatives.
- Bisocodyl, MOM, fruits (kiwi powder, prunes), and possibly Psyllium are second line agents.
- Docusate should go away.
DS
Randomized, double-blind, placebo-controlled trial of oral docusate in the management of constipation in hospice patients – PubMed
Conclusion: There was no significant benefit of docusate plus sennosides compared with placebo plus sennosides in managing constipation in hospice patients. Docusate use should be considered on an individual basis.
Successful de-implementation of an ineffective practice: The fall of docusate – The American Journal of Surgery
Docusate has no efficacy yet is widely prescribed. A structured de-implementation strategy can drive systematic change by leveraging technology and applying multidisciplinary improvement efforts. Our work removed docusate from the inpatient formulary.