Informations for option: Co-Danthrusate Suspension, show other option

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1. Co-Danthrusate Suspension
2. Co-Danthrusate Suspension

1    NAME OF THE MEDICINAL PRODUCT

Co-danthrusate Suspension

2    QUALITATIVE AND QUANTITATIVE COMPOSITION

Each 5 ml containing 60 mg Sodium Docusate BP and 50 mg Dantron BP For excipients, see 6.1

3    PHARMACEUTICAL FORM

Suspension

4 CLINICAL PARTICULARS

4.1 Therapeutic indications

Constipation in terminally ill patients of all ages.

4.2 Posology and method of administration

Adults: One to three 5ml doses at bedtime Children One 5ml dose at bedtime Method of Administration: Oral

4.3 Contraindications

In common with all laxatives, ‘Normax’ or Co-danthrusate is contraindicated in cases of non-specific abdominal pain and when intestinal obstruction is suspected.

4.4 Special warnings and precautions for use

In experimental animals, Dantron has been associated with adenocarcinomas in the bowel and tumours in the liver. A theoretical risk of similar effects in humans cannot be excluded.

Dantron is excreted in the urine and metabolised dantron in the faeces. There is evidence that these may cause perineal erythema in patients with urinary and or faecal incontinence. It is recommended therefore that co-danthrusate should be used with caution in all incontinent patients.

Prolonged use is not recommended.

4.5 Interaction with other medicinal products and other forms of interaction

Docusate may enhance the gastrointestinal or hepatic cell uptake of other drugs potentiating their activity and possibly increasing their toxicity.

4.6 Fertility, Pregnancy and lactation

Co-danthrusate should not be used in pregnancy or lactation.

4.7    Effects on ability to drive and use machines

None known.

4.8    Undesirable effects

Occasionally an orange tint in the urine may be observed due to the Dantron component.

Skin rash may occur and reports of skin irritation, skin discolouration and superficial sloughing of the perianal skin have been reported after prolonged use of co-danthrusate.

Melanosis coli (discolouration of the colonic mucosa) after prolonged use or high doses of Co-Danthrusate.

Reporting of suspected adverse reactions

Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product. Healthcare professionals are asked to report any suspected adverse reactions via the Yellow Card Scheme at www.mhra.gov.uk/yellowcard.

4.9 Overdose

The patient should be encouraged to drink fluids. An anticholinergic preparation may be used to ease excessive intestinal motility if necessary.

5.1 Pharmacodynamic properties

ATC Code: A06A G10

Dantron is a mild peristaltic stimulant acting on the lower bowel to encourage normal bowel movement without causing irritation. Docusate sodium is a softening agent which prevents excessive colonic dehydration and hardening of stools.

5.2 Pharmacokinetic properties

Not available.

5.3 Preclinical safety data

No further information.

6    PHARMACEUTICAL PARTICULARS

6.1    List of excipients

Methylcellulose Xanthan Gum Glycerol

Propyl Parahydroxybenzoate Methyl Parahydroxybenzoate Sorbitol Powder (E200)

Saccharin Sodium

Disodium Hydrogen Orthophosphate (Anhydrous) Sodium Dihydrogen Orthophosphate Peppermint Oil Purified Water

6.2 Incompatibilities

Not known

6.3 Shelf life

36 month (200 ml) 24 month (30 ml)