From the FDA Drug Label
Purpose Stool softener The patient is looking for a replacement stool softener, and docusate (PO) is a stool softener, making it a potential replacement for MiraLAX.
- Docusate is used for the same purpose as MiraLAX, which is to soften stool, but its effect on bowel movements may differ from MiraLAX. 1
From the Research
For a patient who cannot tolerate MiraLAX due to diarrhea, docusate sodium (Colace) would be a good alternative stool softener, as it works by increasing water absorption into the stool, making it softer without typically causing diarrhea, as noted in the management of constipation in older adults 2. The typical dosage is 100 mg taken orally once or twice daily. Other options include:
- docusate calcium (Surfak) at 240 mg daily
- methylcellulose (Citrucel), which may cause less gas and bloating than other fiber supplements, as seen in the study on the efficacy and complications of polyethylene glycols for treatment of constipation in children 3. If the patient needs something stronger, they might consider bisacodyl (Dulcolax) 5-10 mg daily, but this is a stimulant laxative rather than a pure stool softener and could potentially cause cramping, as highlighted in the review of long-term treatment with stimulant laxatives 4. It's essential for the patient to stay well-hydrated while using any stool softener and to consult with their healthcare provider if constipation persists beyond a week or if they experience abdominal pain or other concerning symptoms, as recommended in the study on the use of polyethylene glycol in functional constipation and fecal impaction 5.