Table 4Laxatives: recommended doses

LaxativesRecommended doses
Macrogols
Polyethylene glycol 3350 + electrolytesPaediatric formula: oral powder: macrogol 3350 (polyethylene glycol 3350)a 6.563 g; sodium bicarbonate 89.3 mg; sodium chloride 175.4 mg; potassium chloride 25.1 mg/sachet.
Disimpaction
  • Child under 1 year: ½ to 1 sachet daily (non-BNFC recommended dose)
  • Child 1–5 years: 2 sachets on 1st day, then 4 sachets daily for 2 days, then 6 sachets daily for 2 days, then 8 sachets daily (non-BNFC recommended dose)
  • Child 5–12 years: 4 sachets on 1st day, then increased in steps of 2 sachets daily to maximum of 12 sachets daily (Non-BNFC recommended schedule)
Ongoing maintenance (chronic constipation, prevention of faecal impaction)
  • Child under 1 year: ½ to 1 sachet daily (non-BNFC recommended dose)
  • Child 1–6 years: 1 sachet daily; adjust dose to produce regular soft stools (maximum 4 sachets daily) (for children under 2, non-BNFC dose)
  • Child 6–12 years: 2 sachets daily; adjust dose to produce regular soft stools (maximum 4 sachets daily)
Adult formula: oral powder: macrogol 3350 (polyethylene glycol 3350) 13.125 g; sodium bicarbonate 178.5 mg; sodium chloride 350.7 mg; potassium chloride 46.6 mg/sachet (unflavoured).
Disimpaction
  • Child/young person 12–18 years: 8 sachets daily
Ongoing maintenance (chronic constipation, prevention of faecal impaction)
  • Child/young person 12–18 years: 1–3 sachets daily in divided doses usually for up to 2 weeks; maintenance, 1–2 sachets daily
Osmotic laxatives
Lactulose
  • Child 1 month to 1 year: 2.5 ml twice daily, adjusted according to response
  • Child 1–5 years: 2.5–10 ml twice daily, adjusted according to response (non-BNFC recommended dose)
  • Child/young person 5–18 years: 5–20 ml twice daily, adjusted according to response (non-BNFC recommended dose)
Stimulant laxatives
Sodium picosulfatebNon-BNFC recommended doses
Elixir (5 mg/5 ml)
  • Child 1 month to 4 years: 2.5–10 mg once a day
  • Child/young person 4–18 years: 2.5–20 mg once a day
Non-BNFC recommended doses
Perlesc (1 tablet = 2.5 mg)
  • Child/young person 4–18 years: 2.5–20 mg once a day
BisacodylNon-BNFC recommended doses
By mouth
  • Child/young person 4–18 years: 5–20 mg once daily By rectum (suppository)
  • Child/young person 2–18 years: 5–10 mg once daily
SennadSenna syrup (7.5mg/5ml)
  • Child 1 month to 4 years: 2.5–10 ml once daily
  • Child/young person 4–18 years: 2.5–20 ml once daily
Senna (non-proprietary) (1 tablet =7.5mg)
  • Child 2–4 years: ½—to 2 tablets once daily
  • Child 4–6 years: ½—to 4 tablets once daily
  • Child/young person 6–18 years: 1–4 tablets once daily
Docusate sodiume
  • Child 6 months–2 years: 12.5 mg three times daily (use paediatric oral solution)
  • Child 2–12 years: 12.5–25 mg three times daily (use paediatric oral solution)
  • Child/young person 12–18 years: up to 500 mg daily in divided doses

All drugs listed above are given by mouth unless stated otherwise.

Unless stated otherwise, doses are those recommended by the British National Formulary for Children (BNFC) 2009. Informed consent should be obtained and documented whenever medications/doses are prescribed that are different from those recommended by the BNFC.

a

At the time of publication (May 2010) Movicol Paediatric Plain is the only macrogol licensed for children under 12 years that includes electrolytes. It does not have UK marketing authorisation for use in faecal impaction in children under 5 years, or for chronic constipation in children under 2 years. Informed consent should be obtained and documented. Movicol Paediatric Plain is the only macrogol licensed for children under 12 years that is also unflavoured.

b

Elixir, licensed for use in children (age range not specified by manufacturer). Perles not licensed for use in children under 4 years. Informed consent should be obtained and documented.

c

Perles produced by Dulcolax should not be confused with Dulcolax tablets which contain bisacodyl as the active ingredient

d

Syrup not licensed for use in children under 2 years. Informed consent should be obtained and documented.

e

Adult oral solution and capsules not licensed for use in children under 12 years. Informed consent should be obtained and documented.

At the time of publication (May 2010) Movicol Paediatric Plain is the only macrogol licensed for children under 12 years that includes electrolytes. It does not have UK marketing authorisation for use in faecal impaction in children under 5 years, or for chronic constipation in children under 2 years. Informed consent should be obtained and documented. Movicol Paediatric Plain is the only macrogol licensed for children under 12 years that is also unflavoured.

Elixir, licensed for use in children (age range not specified by manufacturer). Perles not licensed for use in children under 4 years. Informed consent should be obtained and documented.

Perles produced by Dulcolax should not be confused with Dulcolax tablets which contain bisacodyl as the active ingredient

Syrup not licensed for use in children under 2 years. Informed consent should be obtained and documented.

Adult oral solution and capsules not licensed for use in children under 12 years. Informed consent should be obtained and documented.

From: 1, Guidance summary

Cover of Constipation in Children and Young People
Constipation in Children and Young People: Diagnosis and Management of Idiopathic Childhood Constipation in Primary and Secondary Care.
NICE Clinical Guidelines, No. 99.
National Collaborating Centre for Women's and Children's Health (UK).
London: RCOG Press; 2010.
Copyright © 2010, National Collaborating Centre for Women's and Children's Health.

No part of this publication may be reproduced, stored or transmitted in any form or by any means, without the prior written permission of the publisher or, in the case of reprographic reproduction, in accordance with the terms of licences issued by the Copyright Licensing Agency in the UK [www.cla.co.uk]. Enquiries concerning reproduction outside the terms stated here should be sent to the publisher at the UK address printed on this page.

The use of registered names, trademarks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant laws and regulations and therefore for general use.

PubMed Health. A service of the National Library of Medicine, National Institutes of Health.