The use of laxatives at a palliative care centre

Abstract

The drug charts of 100 inpatients with terminal cancer were reviewed to determine laxative use at the beginning of week 2. Sixty-two per cent of patients received an oral laxative regularly. Of these, 37 (60%) received codanthrusate or codanthramer, 14 (23%) received senna and 13 (21 %) lactulose. Eight patients received two laxative preparations concurrently. Thirty-seven patients needed rectal measures. About half of those not taking a strong opioid required a regular laxative, compared with three-quarters of those on a strong opioid. The median daily dose of codanthrusate was two capsules for patients not on an opioid and four capsules for patients on a strong opioid (range 1-6). There was no correlation between the dose of morphine and that of codanthrusate. All patients on a strong opioid who did not receive a regular laxative had a specific reason for not doing so.