Laxative overdose

Definition 
Laxative poisoning is an overdose of a laxative.

Poisonous Ingredient 

     
  • Bisacodyl  
  • Carboxymethylcellulose  
  • Cascara sagrada  
  • Casanthranol  
  • Castor oil  
  • Dehydrocholic acid  
  • Docusate  
  • Glycerin  
  • Lactulose  
  • Magnesium citrate  
  • Magnesium hydroxide  
  • Magnesium oxide  
  • Magnesium sulfate  
  • Malt soup extract  
  • Methylcellulose  
  • Milk of magnesia  
  • Mineral oil  
  • Phenolphthalein  
  • Poloxamer 188  
  • Polycarbophil  
  • Potassium bitartrate and sodium bicarbonate  
  • Psyllium  
  • Psyllium hydrophilic mucilloid  
  • Senna  
  • Sennosides  
  • Sodium phosphate

Note: This list may not be all inclusive.

Where Found 

     
  • Bisacodyl (Dulcolax)  
  • Cascara sagrada  
  • Castor oil  
  • Docusate (Colace)  
  • Docusate and phenolphthalein (Correctol)  
  • Glycerin suppositories  
  • Lactulose (Duphalac)  
  • Magnesium citrate  
  • Malt soup extract (Maltsupex)  
  • Methylcellulose  
  • Milk of magnesia  
  • Mineral oil  
  • Phenolphthalein (Ex Lax)  
  • Psyllium  
  • Senna

Note: This list may not be all-inclusive.

Symptoms 

Bisacodyl:

     
  • Electrolyte imbalance  
  • Cramps  
  • Diarrhea

Senna , cascara sagrada:

     
  • Collapse  
  • Diarrhea  
  • Bloody stool

Castor oil:

     
  • GI irritation

Phenolphthalein:

     
  • Collapse  
  • Low blood sugar  
  • Dizziness  
  • Rash  
  • Diarrhea  
  • Drop in blood pressure

Sodium phosphate:

     
  • Pain  
  • Collapse  
  • Muscle weakness  
  • Vomiting  
  • Diarrhea

Magnesium-containing products:

     
  • Collapse  
  • Painful urination  
  • Flushing  
  • Thirst  
  • Coma  
  • Muscle weakness  
  • Slow respirations  
  • GI irritation  
  • Vomiting  
  • Abdominal pain  
  • Painful bowel movements  
  • Diarrhea (watery)  
  • Drop in blood pressure  
  • Death

Mineral oil:

Methylcellulose, carboxymethylcellulose, polycarbophil, or psyllium:

     
  • Choking (if taken with insufficient fluids)  
  • Intestinal obstruction (if taken with insufficient fluids)

Home Treatment 
DO NOT induce vomiting unless instructed to do so by Poison Control or by a physician.

Before Calling Emergency 
Determine the following information:

     
  • Patient’s age, weight, and condition  
  • The name of the product (ingredients and strengths if known)  
  • When it was swallowed  
  • The amount swallowed

Poison Control, or a local emergency number 
Call Poison Control or your local emergency number - they will instruct you if it is necessary to take the patient to the hospital. See Poison Control centers for telephone numbers and addresses. If possible, take the container with you to the emergency room.

What to expect at the emergency room 
Some or all of the following procedures may be performed:

     
  • Administering activated charcoal  
  • Monitoring vital signs ( blood pressure, pulse)  
  • Monitoring EKG (monitors heart function)  
  • Blood samples drawn to determine serum electrolyte levels  
  • Administering fluids and electrolytes through an IV

Expectations (prognosis) 
The patient’s outcome will depend on such factors as the type of laxative swallowed, how much was swallowed, and how much time passed before treatment was rendered.

Serious symptoms are most likely in patients who repeatedly use large amounts of laxatives for weight loss purposes. One-time exposures are rarely serious.

Johns Hopkins patient information

Last revised: December 4, 2012
by Harutyun Medina, M.D.

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All ArmMed Media material is provided for information only and is neither advice nor a substitute for proper medical care. Consult a qualified healthcare professional who understands your particular history for individual concerns.