Version May 2024
Constipation: Rectal: Benzocaine 20 mg/docusate sodium 283 mg per 5 mL: 5 mL (1 unit) 1 to 3 times daily.
Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.
There are no dosage adjustments provided in the manufacturer's labeling.
There are no dosage adjustments provided in the manufacturer's labeling.
Refer to adult dosing.
(For additional information see "Benzocaine and docusate: Pediatric drug information")
Constipation: Children ≥12 years and Adolescents: Rectal: Enema (benzocaine 20 mg/docusate sodium 283 mg per 5 mL unit): 5 mL (1 unit) 1 to 3 times daily; produces a bowel movement within 2 to 15 minutes; may use up to 7 days or as directed by a physician. Note: If transitioning off bisacodyl product, allow 3 days before initiating benzocaine/docusate therapy; typically not used concomitantly with mineral oil.
Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.
There are no dosage adjustments provided in the manufacturer's labeling; however, dosage adjustment unlikely necessary due to low systemic absorption.
There are no dosage adjustments provided in the manufacturer's labeling; however, dosage adjustment unlikely necessary due to low systemic absorption.
There are no adverse reactions listed in the manufacturer's labeling. Also see Docusate monograph.
OTC labeling: When used for self-medication, do not use for longer than 7 days; when abdominal pain, nausea, or vomiting is present; or concomitantly with mineral oil (oral products only); hypersensitivity to benzocaine or any component of the formulation.
Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.
Dosage forms specific issues:
• Enema: For rectal use only; lubricate tip prior to insertion. Discontinue use and notify health care provider if rash around the anus/rectal irritation occurs or if resistance is encountered with insertion; forcing the tube may result in injury or damage to the rectum.
Other warnings/precautions:
• Self-medication (OTC use): When used for self-medication (OTC), patients should be instructed to discontinue use and notify a health care provider if rectal bleeding occurs, if a sudden change in bowel habits occurs and persists over 14 days, or if a bowel movement fails to occur after use.
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Enema, Rectal:
DocuSol Plus Mini-Enema: Benzocaine 20 mg and docusate sodium 283 mg (5 ea)
Enemeez Plus: Benzocaine 20 mg and docusate sodium 283 mg (5 mL)
No
Enema (DocuSol Plus Mini-Enema Rectal)
20-283 mg (per each): $4.30
Enema (Enemeez Plus Rectal)
20-283 mg (per mL): $0.86
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Rectal: For rectal use only. Lubricate tip prior to insertion by placing a few drops of the liquid from the enema on the shaft prior to insertion; may also apply a few drops of enema contents or lubricant to the anus prior to insertion. Gently insert lubricated applicator tip into rectum. Grasp bottle firmly and squeeze slowly to empty the contents. Discard after administration.
Rectal: For rectal use only. Lubricate tip prior to insertion by placing a few drops of the liquid from the enema on the shaft prior to insertion; may also apply a few drops of enema contents or lubricant to the anus prior to insertion. Gently insert lubricated applicator tip into rectum. Grasp bottle firmly and squeeze slowly to empty the contents. Keep the bottle squeezed until it is removed from the rectum. Discard after administration.
Constipation: Relief of occasional constipation (irregularity) in patients ≥12 years of age who experience painful bowel movements.
KIDs List: Benzocaine, when used in pediatric patients <2 years of age for teething or pharyngitis, is identified on the Key Potentially Inappropriate Drugs in Pediatrics (KIDs) list and should be avoided due to risk of methemoglobinemia (strong recommendation; high quality of evidence) (PPA [Meyers 2020]).
None known.
Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the Lexicomp drug interactions program by clicking on the “Launch drug interactions program” link above.
Dapsone (Topical): May enhance the adverse/toxic effect of Methemoglobinemia Associated Agents. Risk C: Monitor therapy
Local Anesthetics: Methemoglobinemia Associated Agents may enhance the adverse/toxic effect of Local Anesthetics. Specifically, the risk for methemoglobinemia may be increased. Risk C: Monitor therapy
Methemoglobinemia Associated Agents: May enhance the adverse/toxic effect of Local Anesthetics. Specifically, the risk for methemoglobinemia may be increased. Risk C: Monitor therapy
Nitric Oxide: May enhance the adverse/toxic effect of Methemoglobinemia Associated Agents. Combinations of these agents may increase the likelihood of significant methemoglobinemia. Risk C: Monitor therapy
Prilocaine: Methemoglobinemia Associated Agents may enhance the adverse/toxic effect of Prilocaine. Combinations of these agents may increase the likelihood of significant methemoglobinemia. Management: Monitor patients for signs of methemoglobinemia (e.g., hypoxia, cyanosis) when prilocaine is used in combination with other agents associated with development of methemoglobinemia. Avoid lidocaine/prilocaine in infants receiving such agents. Risk C: Monitor therapy
Sodium Nitrite: Methemoglobinemia Associated Agents may enhance the adverse/toxic effect of Sodium Nitrite. Combinations of these agents may increase the likelihood of significant methemoglobinemia. Risk C: Monitor therapy
Refer to individual monographs.
Refer to individual monographs.
Periodic rectal exams are recommended in patients with impaired rectal function, especially loss of sensation.
Docusate is a stool softener; benzocaine is a local anesthetic.
Onset of action: Rectal: 2 to 15 minutes.
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