Docusate

Last updated

Docusate
Docusate2DCSD.svg
Docusate sodium
Clinical data
Trade names Colace, Ex-Lax Stool Softener, others
Other namesDioctyl sulfosuccinate
AHFS/Drugs.com Monograph
MedlinePlus a601113
License data
Pregnancy
category
  • AU:A
Routes of
administration 		By mouth, rectal
Drug class Stool softener
ATC code
Legal status
Legal status
Pharmacokinetic data
Onset of action 12 hrs to 5 days [1]
Duration of action 3 days [1]
Identifiers
  • 1,4-bis(2-ethylhexyloxy)-1,4-dioxobutane-2-sulfonic acid
CAS Number
PubChem CID
DrugBank
ChemSpider
UNII
KEGG
ChEBI
ChEMBL
E number E480 (thickeners, ...) OOjs UI icon edit-ltr-progressive.svg
CompTox Dashboard (EPA)
ECHA InfoCard 100.008.553 OOjs UI icon edit-ltr-progressive.svg
Chemical and physical data
Formula C20H37O7S
Molar mass 421.57 g·mol−1
3D model (JSmol)
Density 1.1 g/cm3
Melting point 153 to 157 °C (307 to 315 °F) 173-179 °C
Solubility in water 1 in 70 parts mg/mL (20 °C)
  • CCCCC(CC)COC(=O)CC(C(=O)OCC(CC)CCCC)S(O)(=O)=O

  • as salt: [Na+].[O-]S(=O)(=O)C(C(=O)OCC(CC)CCCC)CC(=O)OCC(CC)CCCC
  • InChI=1S/C20H38O7S/c1-5-9-11-16(7-3)14-26-19(21)13-18(28(23,24)25)20(22)27-15-17(8-4)12-10-6-2/h16-18H,5-15H2,1-4H3,(H,23,24,25)
  • Key:HNSDLXPSAYFUHK-UHFFFAOYSA-N

  • as salt: InChI=1S/C20H38O7S.Na/c1-5-9-11-16(7-3)14-26-19(21)13-18(28(23,24)25)20(22)27-15-17(8-4)12-10-6-2;/h16-18H,5-15H2,1-4H3,(H,23,24,25);/q;+1/p-1
  • Key:APSBXTVYXVQYAB-UHFFFAOYSA-M

Docusate is the common chemical and pharmaceutical name of the anion bis(2-ethylhexyl) sulfosuccinate, also commonly called dioctyl sulfosuccinate (DOSS). [2] [3] [4]

Contents

Salts of this anion, especially docusate sodium, are widely used in medicine as laxatives and as stool softeners, by mouth or rectally. [1] Some studies claim that docusate is not more effective than a placebo for improving constipation. [5] [6] [7] [8] Other docusate salts with medical use include those of calcium and potassium. [9] [1] [2] Docusate salts are also used as food additives, emulsifiers, dispersants, and wetting agents, among other uses. [10]

It is on the World Health Organization's List of Essential Medicines. [11] In 2021, it was the 133rd most commonly prescribed medication in the United States, with more than 4 million prescriptions. [12] [13] In 2021, the combination with senna was the 275th most commonly prescribed medication in the United States, with more than 800,000 prescriptions. [12] [14]

History

Sodium docusate was patented in 1937 by Coleman R. Caryl and Alphons O. Jaeger for American Cyanamid, [3] which commercialized it for many years as a detergent under the brand name Aerosol OT.

Its use for the treatment of constipation was first proposed in 1955 by James L. Wilson and David G. Dickinson, [4] and quickly popularized under the name Doxinate. [15]

Medical use

Constipation

The main medical use of docusate sodium is to treat constipation, acting as a laxative and stool softener. In painful anorectal conditions such as hemorrhoid and anal fissures, it can help avoid pain caused by straining during bowel movements.

When administered by mouth, a bowel movement often occurs in 1 to 3 days, [1] while rectal use may be effective within 20 minutes. [16]

Sodium docusate is recommended as a stool softener for children. [1]

However, its effectiveness for constipation is poorly supported by evidence. [5] [6] Multiple studies have found docusate to be no more effective than a placebo for improving constipation. [5] [6] [7] [8] Others have found it to be less useful for the treatment of chronic constipation than psyllium. [8] [17] [18]

The medication may be given to people who are receiving opioid medication, although prolonged use may cause irritation of the gastrointestinal tract. [8] [18]

Other medical uses

Docusate sodium, when used with ear syringing, may help with earwax removal, particularly in the case of impaction. [19]

Sodium docusate is also used as a lubricant in the production of tablets and as an emulsifier in topical preparations and other suspensions. [20]

Precautions and contraindications

Docusate sodium is approved and recommended as safe during pregnancy and breastfeeding. [21] [22]

Docusate is not recommended in people with appendicitis, acute abdomen, or ileus. [18]

When taken by mouth it should be ingested with plenty of water.

Side effects

Side effects are uncommon and typically mild, [1] and may include stomach pain, abdominal cramps or diarrhea, [1] Efficacy decreases with long-term use, and may cause poor bowel function. [9]

Serious allergic reactions may occur with the drug. The most severe side effect of docusate, although very rare, is rectal bleeding. [23]

Interactions

Docusate might increase resorption of other drugs, for example, dantron (1,8-dihydroxyanthraquinone). [18]

Mechanism of action

Docusate is an anionic surfactant, which works by reducing the surface tension of the stool, allowing more intestinal water and fat to combine with the stool. [24] [9] [25] This decreases the strain and discomfort associated with constipation. [24]

It does not stay in the gastrointestinal tract, but is absorbed into the bloodstream and excreted via the gallbladder [18] after undergoing extensive metabolism.

The effect of docusate may not necessarily be all due to its surfactant properties. Perfusion studies suggest that docusate inhibits fluid absorption or stimulates secretion in the portion of the small intestine known as the jejunum.[ medical citation needed ]

Pharmaceutical brand names

In the U.S., docusate sodium for pharmaceutical use is available under multiple brand names: Aqualax, Calube, Colace, Colace Micro-Enema, Correctol Softgel Extra Gentle, DC-240, Dialose, Diocto, Dioctocal, Dioctosoftez, Dioctyn, Dionex, Doc-Q-Lace, Docu Soft, Docucal, Doculax, Docusoft S, DOK, DOS, Doss-Relief, DSS, Dulcolax - Stool Softener (not to be confused with another drug marketed under the Dulcolax brand, bisacodyl, which is a stimulant laxative), Ex-Lax Stool Softener, Fleet Sof-Lax, Genasoft, Kasof, Laxa-basic, Modane Soft, Octycine-100, Pedia-Lax, Preferred Plus Pharmacy Stool Softener, Regulax SS, Sulfalax Calcium, Sur-Q-Lax, Surfak Stool Softener, and Therevac-SB. Generic preparations are also available.

In the UK, dioctyl sodium sulfosuccinate is sold under the brand name Docusol (Typharm Ltd) and DulcoEase (Boehringer Ingelheim).

In Australia, dioctyl sodium sulfosuccinate is sold as Coloxyl and Coloxyl with senna.

In India, preparations include Laxatin by Alembic, Doslax by Raptakos Laboratories, Cellubril by AstraZeneca, and Laxicon by Stadmed.

Other uses

Dioctyl sodium sulfosuccinate is used as a surfactant in a wide range of applications, often under the name Aerosol-OT. [4] [26] It is unusual in that it is able to form microemulsions without the use of co-surfactants, and it has a rich variety of aqueous-phase behavior including multiple liquid crystalline phases. [27]

Food additive

Dioctyl sodium sulfosuccinate has been approved by the US FDA as a "generally recognized as safe" (GRAS) additive. [28] It is used in a variety of food products, as a surface active agent, stabilizer, thickener, wetting agent, processing aid, solubilizing agent, emulsifier, and dispersant. The highest amount found in food products is 0.5% by weight, which include pasteurized cheese spreads, cream cheeses and salad dressings. [29] The FDA also approved its use as a wetting agent or solubilizer for flavoring agents in carbonated and non-carbonated drinks at levels up to 10 parts per million. [28]

Microencapsulation

Sodium docusate is the most widely used surfactant in reverse micelle encapsulation studies. [30]

Non-medical brand names

As a surfactant, docusate sodium is or has been commercialized under many brand names, including DSSj Aerosol OT, Alphasol OT, Colace, Complemix, Coprol, Dioctylal, Dioctyl-Medo Forte, Diotilan, Diovac, Disonate, Doxinate, Doxol, Dulsivac, Molatoc, Molofac, Nevax, Norval, Regutol, Softili, Solusol, Sulfimel DOS, Vatsol OT, Velmol, and Waxsol [31]

Chemistry

Structure and properties

The structural formula of the docusate anion is R−O−C(=O)−CH(SO−3)−CH2−C(=O)−O−R, where R is the 2-ethylhexyl group H3C−(CH2)3−C(−CH2−CH3)H−CH2−. The conjugate acid can be described as the twofold carboxylate ester of sulfosuccinic acid with 2-ethylhexanol.

The compound is a white, wax-like, plastic solid, with an odor suggestive of octyl alcohol. It starts to decompose at about 220 °C. [31]

Solubility of dioctyl sodium sulfosuccinate in water is 14 g/L at 25 °C, increasing to 55 g/L at 70 °C. [31] Solubility is better in less polar solvents: 1:30 in ethanol, 1:1 in chloroform and diethylether, and practically unlimited in petroleum ether (25 °C). It also is highly soluble in glycerol, although this is a rather polar solvent. It is also highly soluble in xylene, oleic acid, acetone, diacetone alcohol, methanol, isopropanol, 2-butanol, methyl acetate, ethyl acetate, furfurol, and vegetable oils. [31]

The ester groups are easily cleaved under basic conditions, but are stable against acids. [18]

Synthesis

Sodium dioctyl sulfosuccinate can be obtained by treating dioctyl maleate with sodium bisulfite. The bisulfite anion adds to the double bond:

−CH=CH− + HSO−3→−CH(−SO−3)−CH2−

Toxicity

Ingestion may cause the side effects described above, such as diarrhea, intestinal bloating, and occasionally cramping pains. Dioctyl sodium sulfosuccinate is not known to be carcinogenic, mutagenic, or teratogenic. [32]

Marine species

Dioctyl sodium sulfosuccinate is of low toxicity for crustaceans such as the hermit crab Clibanarius erythropus and the shrimp Crangon crangon . Toxicity for molluscs varies widely, with 48-hour LD50 found between 5 mg/L for the common limpet and 100 mg/L for the common periwinkle. Various species of phytoplankton have an LD50 around 8 mg/L.

In a 2010 study, dioctyl sodium sulfosuccinate exhibited higher toxicity against bacteria ( Vibrio fischeri , Anabaena sp.) and algae ( Pseudokirchneriella subcapitata ) than did a number of fluorinated surfactants (PFOS, PFOA, or PFBS). Measuring bioluminescence inhibition of the bacteria and growth inhibition of the algae, the LD50 were in the range of 43–75 mg/L. Combinations of the fluorinated compounds with dioctyl sodium sulfosuccinate showed mid to highly synergistic effects in most settings, meaning that such combinations are significantly more toxic than the individual substances. [33]

Freshwater species

The substance is highly toxic for rainbow trout with a median lethal concentration (LC50) of 0.56 mg/L after 48 hours for the pure substance. It is only slightly to moderately toxic for rainbow trout fingerlings, and slightly toxic for harlequin rasboras (LC50 27 mg/L of a 60% formulation after 48 hours).

Related Research Articles

<span class="mw-page-title-main">Enema</span> Injection of fluid into rectum, typically en route to the colon

An enema, also known as a clyster, is an injection of fluid into the lower bowel by way of the rectum. The word enema can also refer to the liquid injected, as well as to a device for administering such an injection.

<span class="mw-page-title-main">Surfactant</span> Substance that lowers the surface tension between a liquid and another material

Surfactants are chemical compounds that decrease the surface tension or interfacial tension between two liquids, a liquid and a gas, or a liquid and a solid. The word "surfactant" is a blend of surface-active agent, coined c. 1950. As they consist of a water-repellent and a water-attracting part, they enable water and oil to mix; they can form foam and facilitate the detachment of dirt.

<span class="mw-page-title-main">Constipation</span> Bowel dysfunction

Constipation is a bowel dysfunction that makes bowel movements infrequent or hard to pass. The stool is often hard and dry. Other symptoms may include abdominal pain, bloating, and feeling as if one has not completely passed the bowel movement. Complications from constipation may include hemorrhoids, anal fissure or fecal impaction. The normal frequency of bowel movements in adults is between three per day and three per week. Babies often have three to four bowel movements per day while young children typically have two to three per day.

<span class="mw-page-title-main">Laxative</span> Agents that relax and loosen the bowels and stools

Laxatives, purgatives, or aperients are substances that loosen stools and increase bowel movements. They are used to treat and prevent constipation.

Encopresis is voluntary or involuntary passage of feces outside of toilet-trained contexts in children who are four years or older and after an organic cause has been excluded. Children with encopresis often leak stool into their undergarments.

<span class="mw-page-title-main">Lactulose</span> Treatment for constipation and hepatic encephalopathy

Lactulose is a non-absorbable sugar used in the treatment of constipation and hepatic encephalopathy. It is administered orally for constipation, and either orally or rectally for hepatic encephalopathy. It generally begins working after 8–12 hours, but may take up to 2 days to improve constipation.

<span class="mw-page-title-main">Fecal impaction</span> Medical condition

A fecal impaction or an impacted bowel is a solid, immobile bulk of feces that can develop in the rectum as a result of chronic constipation. Fecal impaction is a common result of neurogenic bowel dysfunction and causes immense discomfort and pain. Its treatment includes laxatives, enemas, and pulsed irrigation evacuation (PIE) as well as digital removal. It is not a condition that resolves without direct treatment.

<span class="mw-page-title-main">Polystyrene sulfonate</span> Drug class

Polystyrene sulfonates are a group of medications used to treat high blood potassium. Effects generally take hours to days. They are also used to remove potassium, calcium, and sodium from solutions in technical applications.

<span class="mw-page-title-main">Bisacodyl</span> Laxative

Bisacodyl (INN) is an organic compound that is used as a stimulant laxative drug. It works directly on the colon to produce a bowel movement. It is typically prescribed for relief of episodic and chronic constipation and for the management of neurogenic bowel dysfunction, as well as part of bowel preparation before medical examinations, such as for a colonoscopy.

<span class="mw-page-title-main">Lubiprostone</span> Medication used for constipation

Lubiprostone, sold under the brand name Amitiza among others, is a medication used in the management of chronic idiopathic constipation, predominantly irritable bowel syndrome-associated constipation in women and opioid-induced constipation. The drug is owned by Mallinckrodt and is marketed by Takeda Pharmaceutical Company.

<span class="mw-page-title-main">Polycarbophil calcium</span> Pharmaceutical drug

Polycarbophil calcium (INN) is a drug used as a stool stabilizer. Chemically, it is a synthetic polymer of polyacrylic acid cross-linked with divinyl glycol, with calcium as a counter-ion.

<span class="mw-page-title-main">Macrogol</span> Medication for constipation, classified as an osmotic laxative

Macrogol, also known as polyethylene glycol (PEG), is used as a medication to treat constipation in children and adults. It is also used to empty the bowels before a colonoscopy. It is taken by mouth. Benefits usually occur within three days. Generally it is only recommended for up to two weeks. It is also used as an excipient.

<span class="mw-page-title-main">Senna glycoside</span> Constipation and surgery medication

Senna glycoside, also known as sennoside or senna, is a medication used to treat constipation and empty the large intestine before surgery. The medication is taken by mouth or via the rectum. It typically begins working in around 30 minutes when given by rectum and within twelve hours when given by mouth. It is a weaker laxative than bisacodyl and castor oil.

Dulcolax may refer to:

<span class="mw-page-title-main">Prucalopride</span> Drug used to treat chronic constipation

Prucalopride, sold under brand names Resolor and Motegrity among others, is a medication acting as a selective, high affinity 5-HT4 receptor agonist which targets the impaired motility associated with chronic constipation, thus normalizing bowel movements. Prucalopride was approved for medical use in the European Union in 2009, in Canada in 2011, in Israel in 2014, and in the United States in December 2018. The drug has also been tested for the treatment of chronic intestinal pseudo-obstruction.

Solitary rectal ulcer syndrome or SRUS is a chronic, benign disorder of the rectal mucosa. It commonly occurs with varying degrees of rectal prolapse. The condition is thought to be caused by different factors, such as long term constipation, straining during defecation, and dyssynergic defecation. Treatment is by normalization of bowel habits, biofeedback, and other conservative measures. In more severe cases various surgical procedures may be indicated. The condition is relatively rare, affecting approximately 1 in 100,000 people per year. It affects mainly adults aged 30–50. Females are affected slightly more often than males. The disorder can be confused clinically with rectal cancer or other conditions such as inflammatory bowel disease, even when a biopsy is done.

Sodium citrate/sodium lauryl sulfoacetate/glycerol sold under the brandname Microlax and Micolette Micro enema, among others, is a small tube of liquid gel that is used to treat constipation.

Plecanatide, sold under the brand name Trulance, is a medication for the treatment of chronic idiopathic constipation (CIC) and irritable bowel syndrome with constipation. It is being launched in India under the brand name "Plecasoft". Plecanatide is an agonist of guanylate cyclase-C. Plecanatide increases intestinal transit and fluid through a buildup of cGMP.

<span class="mw-page-title-main">Sodium sulfosuccinate esters</span>

Sodium sulfosuccinate esters are organic compounds with the formula NaO3SCH(CO2R')CH2CO2R where R and R' can be H or alkyl groups. They comprise a large class of surfactants and emulsifiers used in cosmetics, pharmaceuticals, and cleaning agents. They are colorless salts. These materials can be further classified into monoesters (R' = H, R = alkyl) and diesters (R and R' = alkyl).

Bis(2-ethylhexyl) maleate is the chemical compound with the structural formula (H3C 3−CH −CH2−O−C −CH=)2, where the two carboxylate groups are mutually cis. It can be described as the double ester of maleic acid with the alcohol 2-ethylhexanol. It is commonly called dioctyl maleate (DOM), reflecting the older usage of "octane" to refer to any 8-carbon alkane, straight-chained or branched.

References

  1. 1 2 3 4 5 6 7 8 "Docusate Salts". The American Society of Health-System Pharmacists. Archived from the original on 23 September 2015. Retrieved 11 August 2015.
  2. 1 2 American Society of Health-System Pharmacists (15 August 2011). "Stool Softeners". Archived from the original on 5 September 2015.
  3. 1 2 US 2181087,Caryl CR, Jaeger AO,"Detergent composition",issued 21 November 1939, assigned to American Cyanamid
  4. 1 2 3 Wilson JL, Dickinson DG (May 1955). "Use of dioctyl sodium sulfosuccinate (aerosol O.T.) for severe constipation". Journal of the American Medical Association. 158 (4): 261–3. doi:10.1001/jama.1955.02960040019006a. PMID   14367076.
  5. 1 2 3 Fakheri RJ, Volpicelli FM (February 2019). "Things We Do for No Reason: Prescribing Docusate for Constipation in Hospitalized Adults". Journal of Hospital Medicine. 14 (2): 110–113. doi: 10.12788/jhm.3124 . PMID   30785419.
  6. 1 2 3 "Dioctyl Sulfosuccinate or Docusate (Calcium or Sodium) for the Prevention or Management of Constipation: A Review of the Clinical Effectiveness". CADTH Rapid Response Reports. 26 June 2014. PMID   25520993.
  7. 1 2 Candy B, Jones L, Larkin PJ, Vickerstaff V, Tookman A, Stone P (May 2015). "Laxatives for the management of constipation in people receiving palliative care" (PDF). The Cochrane Database of Systematic Reviews. 13 (5): CD003448. doi:10.1002/14651858.CD003448.pub4. PMC   6956627 . PMID   25967924.
  8. 1 2 3 4 Ramkumar D, Rao SS (April 2005). "Efficacy and safety of traditional medical therapies for chronic constipation: systematic review". The American Journal of Gastroenterology. 100 (4): 936–71. doi:10.1111/j.1572-0241.2005.40925.x. PMID   15784043. S2CID   13869933.
  9. 1 2 3 2013 Nurse's Drug Handbook . Burlington, MA: Jones & Bartlett Learning. 2013. p.  366. ISBN   9781449642846.
  10. ↑ Ash M, Ash I (2004). Handbook of preservatives. Endicott, N.Y.: Synapse information resources. p. 375. ISBN   9781890595661.
  11. ↑ World Health Organization (2021). World Health Organization model list of essential medicines: 22nd list (2021). Geneva: World Health Organization. hdl: 10665/345533 . WHO/MHP/HPS/EML/2021.02.
  12. 1 2 "The Top 300 of 2021". ClinCalc. Archived from the original on 15 January 2024. Retrieved 14 January 2024.
  13. ↑ "Docusate - Drug Usage Statistics". ClinCalc. Archived from the original on 20 January 2024. Retrieved 14 January 2024.
  14. ↑ "Senna; Docusate - Drug Usage Statistics". ClinCalc. Archived from the original on 18 January 2024. Retrieved 14 January 2024.
  15. ↑ Friedman M (October 1956). "Dioctyl sodium sulfosuccinate (doxinate) in chronic functional constipation". American Practitioner and Digest of Treatment. 7 (10): 1588–91. PMID   13362832.
  16. ↑ "Docusate sodium". 18 December 2004. Archived from the original on 21 July 2011. Retrieved 6 March 2019.
  17. ↑ Portalatin M, Winstead N (March 2012). "Medical management of constipation". Clinics in Colon and Rectal Surgery. 25 (1): 12–9. doi:10.1055/s-0032-1301754. PMC   3348737 . PMID   23449608.
  18. 1 2 3 4 5 6 Dinnendahl V, Fricke U, eds. (2010). Arzneistoff-Profile (in German). Vol. 2 (23 ed.). Eschborn, Germany: Govi Pharmazeutischer Verlag. ISBN   978-3-7741-9846-3.
  19. ↑ "How effective is docusate as a cerumenolytic agent?". GlobalRPH.com. Archived from the original on 23 November 2010.
  20. ↑ Jasek W, ed. (2008). Austria-Codex Stoffliste (in German) (41st ed.). Vienna: Österreichischer Apothekerverlag. p. 316. ISBN   978-3-85200-190-6.
  21. ↑ Yaffe SJ (2011). Drugs in pregnancy and lactation : a reference guide to fetal and neonatal risk (9th ed.). Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins. p. 1651. ISBN   9781608317080.
  22. ↑ Mahadevan U, Kane S (July 2006). "American gastroenterological association institute medical position statement on the use of gastrointestinal medications in pregnancy". Gastroenterology. 131 (1): 278–82. doi: 10.1053/j.gastro.2006.04.048 . PMID   16831610.
  23. ↑ drugs.com: Docusate Archived 16 July 2010 at the Wayback Machine
  24. 1 2 Shaw D (2017). "Drugs Acting on the Gastrointestinal Tract". Pharmacology and Therapeutics for Dentistry (Seventh ed.). pp. 404–416. doi:10.1016/B978-0-323-39307-2.00028-X. ISBN   9780323393072 – via Elsevier Science Direct.
  25. ↑ Hamilton RJ (2013). Tarascon pocket pharmacopoeia : 2013 classic shirt-pocket edition (27 ed.). Burlington, Ma.: Jones & Bartlett Learning. p. 112. ISBN   9781449665869.
  26. ↑ Whiffen AJ (1946). "Aerosol OT in the preparation of microscopic mounts of fungi". Mycologia. 38: 346. doi:10.1080/00275514.1946.12024063. PMID   20983186.
  27. ↑ Nave S, Eastoe J, Penfold J (November 2000). "What Is So Special about Aerosol-OT? 1. Aqueous Systems". Langmuir . 16 (23): 8733–8740. doi:10.1021/la000341q.
  28. 1 2 "GRAS Notice Inventory Agency Response Letter GRAS Notice No. GRN 000006". Center for Food Safety and Applied Nutrition. 20 July 1998. Archived from the original on 31 October 2017. Retrieved 24 January 2020.
  29. ↑ "CFR - Code of Federal Regulations Title 21". www.accessdata.fda.gov. Retrieved 29 January 2020.
  30. ↑ Flynn PF (2004). "Multidimensional multinuclear solution NMR studies of encapsulated macromolecules". Prog. Nucl. Magn. Reson. Spectrosc. 45 (1–2): 31–51. doi:10.1016/j.pnmrs.2004.04.003.
  31. 1 2 3 4 Ahuja S, Cohen J (January 1973). "Dioctyl Sodium Sulfosuccinate". InAnalytical Profiles of Drug Substances. Vol. 2. Academic Press. pp. 199–219. doi:10.1016/S0099-5428(08)60040-4. ISBN   9780122608025.
  32. ↑ ScienceLab.com: Docusate sodium Material Safety Data Sheet Archived 17 October 2006 at the Wayback Machine
  33. ↑ Rosal R, Rodea-Palomares I, Boltes K, Fernández-Piñas F, Leganés F, Petre A (September 2010). "Ecotoxicological assessment of surfactants in the aquatic environment: combined toxicity of docusate sodium with chlorinated pollutants". Chemosphere. 81 (2): 288–93. Bibcode:2010Chmsp..81..288R. doi:10.1016/j.chemosphere.2010.05.050. PMID   20579683.
This page is based on this Wikipedia article
Text is available under the CC BY-SA 4.0 license; additional terms may apply.
Images, videos and audio are available under their respective licenses.