Laxatives to avoid or use with caution for elderly patients
| LAXATIVE | PRECAUTIONS |
|---|---|
| Docusate | • Lacks evidence for prevention and treatment of constipation (ie, no harm, but ineffective) |
| Magnesium | • Avoid in individuals with cardiac or renal dysfunction |
| Mineral oil | • Oral mineral oil should be avoided for older adults owing to concerns about aspiration (safer alternatives are available) |
| Soapsuds enema | • Risk of colonic mucosa irritation |
| Sodium phosphate enema | • As a purgative, avoid owing to serious electrolyte, renal, cardiovascular, and neurological concerns |
| • As a laxative, avoid in individuals with dehydration, renal impairment, cardiac dysfunction, or electrolyte disturbances | |
| Picosulfate, magnesium oxide, and citric acid | • Risk of electrolyte imbalance |
| • Avoid for patients with renal impairment (creatinine clearance < 30 mL/min) | |
| Polyethylene glycol 3350 with electrolytes | • Avoid if patient has impaired gag reflex, is prone to aspiration or regurgitation, is semiconscious, has a risk of electrolyte imbalance, has severe renal dysfunction (creatinine clearance < 30 mL/min), or has congestive heart failure |
Data from Kosar and Schuster.42