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Sodium picosulfate oral

Updated 2 Feb 2023 | Stimulant laxatives


Oral formulations containing sodium picosulfate.

Drugs List

  • DULCOLAX PICO ADULT LIQUID 5mg/5ml oral solution
  • DULCOLAX PICO TWELVE PLUS 5mg/5ml liquid
  • sodium picosulfate 5mg/5ml oral solution sugar-free
  • Therapeutic Indications




    The onset of action is approximately 6 to 12 hours.


    Relief of constipation
    5mg to 10mg at night until regularity established, when the dose can be reduced or stopped.


    Relief of constipation
    Children aged over 12 years
    5mg to 10mg at night until regularity established, when the dose can be reduced or stopped.

    The following alternative dosing schedule may be suitable (not licensed for children under 12 years):
    Children aged 10 to 12 years (unlicensed)
    5mg to 10mg once daily at night.

    Children aged 4 to 10 years (unlicensed)
    2.5mg to 5mg once daily night.

    Children aged 1 month to 4 years (unlicensed)
    250micrograms/kg once daily at night (maximum dose 5mg).


    Abdominal pain of unknown cause
    Neonates under 1 month
    Acute inflammatory bowel disease
    Acute surgical abdomen
    Gastrointestinal obstruction
    Paralytic ileus
    Severe dehydration

    Precautions and Warnings

    Children aged 1 month to 12 years
    Epileptic disorder
    Hepatic disorder

    Advise ability to drive/operate machinery may be affected by side effects
    Not all available brands/formulations are licensed for use in children
    Restore electrolyte & fluid balance in case of dehydration
    Contains alcohol
    Contains hydroxybenzoate
    If daily use is required, investigate the cause of constipation
    Prolonged use may cause fluid/electrolyte imbalance and hypokalaemia
    Discontinue if severe nausea, vomiting or abdominal distress occurs
    Avoid long term use
    Advise patient to seek medical advice if symptoms persist for > 5 days

    Prolonged excessive use may lead to fluid and electrolyte imbalance, diarrhoea, hypokalaemia, and may precipitate rebound constipation. Intestinal loss of fluids can promote dehydration. Symptoms may include thirst and oliguria. Sodium picosulfate must be discontinued in patients suffering from fluid loss where dehydration may be harmful (e.g. renal insufficiency, elderly patients)

    Dizziness or syncope has been reported during the use of sodium picosulfate, consistent with defecation syncope (or syncope attributable to straining at stool), or with vasovagal response to abdominal pain which may be related to the constipation that prompted the use of laxatives.

    Sodium picosulfate should only be used if bulk-forming and osmotic laxatives are ineffective or contraindicated.

    The oral liquid contains ethanol 4.8% (up to 480mg per dose).

    Pregnancy and Lactation


    Use sodium picosulfate with caution during pregnancy.

    The manufacturer advises that at the time of writing there are no adequate and well-controlled studies in pregnant women. There is no evidence of undesirable or damaging effects with the use of sodium picosulfate during pregnancy.


    Sodium picosulfate is considered safe for use during breastfeeding.

    The manufacturer states that clinical data shows that neither the active moiety of sodium picosulfate nor its glucuronides are excreted into the milk of healthy lactating females.


    Advise patients to seek medical advice if they require treatment continuously for more than five days unless under medical supervision.

    Advise patient that a bowel movement is usually produced in 6 to 12 hours.

    Advise patient that their ability to drive or operate machinery may be affected by side effects such as dizziness and/or syncope.

    Advise patient to seek medical advice and stop treatment if they experience severe abdominal pain associated with nausea and vomiting.

    Side Effects

    Abdominal cramps
    Abdominal discomfort
    Abdominal pain
    Allergic reaction
    Hypersensitivity reactions
    Skin reactions


    It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.

    The following number will direct the caller to the relevant local centre (0844) 892 0111

    Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( ) or if this is unavailable at the backup site ( ).

    Further Information

    Last Full Review Date: February 2021

    Reference Sources

    Summary of Product Characteristics: Dulcolax Adult Pico Liquid, 5mg/5ml oral solution. Sanofi. Revised March 2020.

    Summary of Product Characteristics: Dulcolax Twelve Plus Pico Liquid, 5mg/5ml oral solution. Sanofi. Revised November 2021.

    NICE Evidence Services Available at: Last accessed: 09 September 2022

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