A stimulant laxative (dantron with poloxamer) for palliative care

Co-danthramer

A combination stimulant laxative used mainly for constipation in people receiving palliative care.

What is Co-danthramer?

Co-danthramer is a combination stimulant laxative made of dantron and poloxamer, used to relieve constipation. Its use is deliberately limited mainly to constipation in people who are terminally ill, because dantron has been linked to a possible cancer risk in long-term animal studies. It works by stimulating the bowel to move while also softening the stool. It often turns the urine red or pink, which is harmless, and in people who are incontinent it can cause skin soreness or burns if it stays in prolonged contact with the skin, so keeping the skin clean and dry is important.

Education and reference only. This is a plain-language guide to Co-danthramer — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.

Written by Meds Global Health Clinical Team · Clinically reviewed by Dr Muhammad Suffyan, MB BS, Founder & Clinical Director · Last reviewed · How we review
Class: Stimulant laxative combination (palliative care) → Brands: Codalax, Codalax Forte
Co-danthramer (Stimulant laxative combination (palliative care)) — Meds Global Health reference card
Co-danthramer — Stimulant laxative combination (palliative care).

What it is

Co-danthramer is a laxative that combines two ingredients: dantron, a stimulant that makes the bowel move, and poloxamer, which helps soften the stool. Together they relieve constipation. The key thing about co-danthramer is that its use is restricted: it is recommended mainly for constipation in people receiving palliative or end-of-life care, rather than for everyday constipation. This is because dantron has been linked, in long-term animal studies, to a possible risk of cancer. It is taken by mouth as a liquid or capsules and is prescribed by a doctor or specialist team.

How it works

Co-danthramer works in two ways. The dantron part is a stimulant laxative that encourages the muscles of the bowel wall to contract, moving the stool along, while the poloxamer part acts as a softener that lets water mix into the stool to make it easier to pass. This combination is helpful for the kind of constipation seen in palliative care, especially when strong painkillers such as opioids are slowing the bowel. Because dantron is the part linked to a possible cancer risk in long-term animal studies, its use is kept to situations where that concern is outweighed by the benefit, mainly in terminal illness.

Company & origin

Originated / developed by: Generic (long-established).

A combination stimulant laxative (dantron with poloxamer) used in the UK mainly for constipation in people receiving palliative or end-of-life care.

Practical use

How to take Co-danthramer

General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.

  • Take it by mouth as prescribed for constipation, usually in the evening.
  • Do not be alarmed if your urine turns red or pink; this is a harmless effect of dantron.
  • Keep the skin clean and dry, and change soiled pads promptly, to avoid skin soreness or burns from prolonged contact.
  • Use it only as prescribed, as it is reserved mainly for constipation in palliative care.
  • Drink enough fluids and tell your team if constipation does not improve.

Weighing it up

Advantages & disadvantages of Co-danthramer

Advantages

  • Relieves constipation by both stimulating the bowel and softening the stool.
  • Particularly useful for constipation caused by strong painkillers in palliative care.
  • Available as a liquid or capsules to suit different people.

Disadvantages

  • Use is limited mainly to palliative care because dantron has been linked to a possible cancer risk in long-term animal studies.
  • Can cause skin soreness or burns with prolonged skin contact in people who are incontinent.
  • Turns the urine red or pink, which is harmless but can be alarming.

Practical use

Good to know

There are three practical things to know about co-danthramer. First, its use is limited mainly to constipation in people who are terminally ill, because dantron has been linked to a possible cancer risk in long-term animal studies, so it is not a routine laxative for general use. Second, it commonly turns the urine red or pink; this is harmless and not a sign of bleeding, but it can be alarming if you are not expecting it. Third, and importantly, in people who are incontinent or who stay in contact with soiled skin, it can cause soreness or even skin burns where it touches the skin for a long time, so keeping the skin clean and dry and changing soiled pads promptly matters. It is helpful for opioid-related constipation in palliative care, where it is often used.

Who should not take it / use with caution

  • People who have had a serious allergic reaction to its ingredients should not use it.
  • It should not be used by people with a bowel blockage or undiagnosed tummy pain.
  • It is generally avoided in incontinent people where prolonged skin contact is likely, unless the skin can be kept clean and dry.
  • It is reserved mainly for palliative care rather than routine constipation, because of the dantron cancer-risk concern.

Monitoring

  • Checking that constipation is improving and the dose is right.
  • Watching for skin soreness in people who are incontinent.
  • Reviewing ongoing need, given its use is reserved mainly for palliative care.

Side effects

  • A harmless red or pink colouring of the urine.
  • Tummy cramps or griping pain, as with other stimulant laxatives.
  • Diarrhoea if the dose is too much.
  • Skin soreness or burns where it stays in prolonged contact with the skin in incontinent people.

Key interactions

  • It has few specific medicine interactions, but other laxatives can add to its effect.
  • Severe diarrhoea from overuse could affect fluid and salt balance and the action of some medicines.
  • Tell your team about all your medicines, particularly other bowel medicines.

Available as: An oral liquid (suspension) and capsules.

Answers

Co-danthramer: frequently asked questions

What is co-danthramer used for?

It is a combination stimulant laxative used mainly to relieve constipation in people receiving palliative or end-of-life care.

Why is its use restricted?

Dantron, one of its ingredients, has been linked to a possible cancer risk in long-term animal studies, so it is kept mainly for terminally ill patients.

Why has my urine turned red?

Co-danthramer commonly turns the urine red or pink; this is a harmless effect of dantron and is not a sign of bleeding.

Can it harm the skin?

In people who are incontinent it can cause skin soreness or burns where it stays in prolonged contact, so keeping the skin clean and dry is important.

Why is it good for palliative care constipation?

It both stimulates the bowel and softens the stool, which helps the constipation caused by strong painkillers such as opioids.

The wider class

About Stimulant laxative combination (palliative care)

Co-danthramer belongs to the stimulant laxative combination (palliative care) class. For how the class as a whole works, its shared safety principles and monitoring, see the full guide.

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Authoritative sources

  • BNF
  • NICE CKS

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