Table 2.

Laxatives to avoid or use with caution for elderly patients

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