LAXATIVE PROTOCOL
Patients on regularly dosed narcotic analgesics (i.e. codeine, Tylox, Percodan, MS Contin, etc.)eventually suffer from constipation. Your physician recommends a daily bowel regimen that is followed just as carefully as your other medication. The overall goal is for each patient to have a bowel movement at least every two days. Because each patient and his response can vary, use the guidelines below to find a regimen that works best for you. If at any time your analgesic dosage is changed, you may also need to increase or decrease your daily dosage of laxative. BEGIN THIS PROTOCOL THE SAME DAY YOU START TAKING YOUR NARCOTIC PAIN MEDICATION, IRON SUPPLEMENTATION OR IF YOU ARE ON CHEMOTHRAPY AND HAVE NOT HAD A BOWEL MOVEMENT IN 2 DAYS.
1. Take two (2) Senokot S tablets at bedtime.
If you do not have a bowel movement in the morning,
2. Take two (2) Senokot S tablets after breakfast.
If you do not have a bowel movement by evening,
3. Take three (3) Senokot S tablets at bedtime.
Dose is now three (3) Senokot S tablets twice a day.
If you do not have a bowel movement in the morning,
4. Add two (2) tablespoons of Milk of Magnesia after breakfast and dinner while continuing Senokot
Senokot S tablets.
Dose is now three (3) Senokot S tablets with two (2) tablespoons of Milk of Magnesia, after breakfast and at bedtime.
If there is no bowel movement within 48 hours of beginning this protocol,
5. Add one (1) heaping tablespoon of Miralax (dissolved in 8oz of water or juice) with each Milk of Magnesia and Senokot S dose.
Dose is now three (3) Senokot S tabs, two (2) tablespoons of Milk of Magnesia and one (1) heaping tablespoon of Miralax, after breakfast and at bedtime.
If there is no bowel movement within 72 hours after beginning this protocol,
6. Add a Dulcolax suppository, 10 mg or Fleet Enema.
Dose is now three (3) Senokot S tabs, two tablespoons of Milk of Magnesia, one (1) heaping tablespoon of Miralax and either a 10 mg Dulcolax suppository of a Fleet Enema.
7. You may repeat Step 6 the next day if necessary.
After having started bowel movements, use the previous step as your daily laxative protocol. For example, if you achieved a bowel movement after Step 4, use Step 3 (i.e., Three (3) Senokot S tablets twice a day as your daily regimen.
Remember, your physician recommends that each patient have a bowel movement at least every two (2) days.