A stimulant laxative
Sodium picosulfate
A stimulant laxative, usually taken at night, for short-term constipation or to clear the bowel before procedures.
What is Sodium picosulfate?
Sodium picosulfate is a stimulant laxative that encourages the bowel to push its contents along. Taken at night it typically works the next morning, and it is used for short-term constipation or, at higher strengths, to clear the bowel before tests or surgery. Because it can cause cramps and is meant for short-term use, it works best alongside plenty of fluids.
Education and reference only. This is a plain-language guide to Sodium picosulfate — 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.
What it is
Sodium picosulfate is a stimulant laxative, available as drops, an oral solution or tablets, sold under brands such as Dulcolax Pico and Laxoberal. In everyday use it treats short-term constipation. In a stronger combined preparation it is also used as bowel-cleansing preparation to empty the bowel before a colonoscopy, X-ray or surgery. It is intended for occasional, short-term use rather than as a long-term remedy.
How it works
Sodium picosulfate is activated by the natural bacteria in the large bowel into its active form. This stimulates the nerves in the bowel wall, increasing the muscular squeezing (peristalsis) that moves stool along, while also helping to keep water in the bowel so the stool stays soft. The combined effect is a softer stool that is moved out more readily. Taken in the evening, this stimulating action usually produces a result the following morning.
Company & origin
Originated / developed by: Sold in the UK under brands such as Dulcolax Pico and Laxoberal, plus generics..
Practical use
How to take Sodium picosulfate
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- For constipation, take it at night so it works the following morning.
- Measure liquid forms carefully with the supplied dropper or spoon, or swallow tablets with water.
- Drink plenty of fluids throughout the day while using it.
- Use it for a short time only; if constipation persists, get it reviewed rather than continuing long-term.
- For bowel-cleansing before a procedure, follow the timing, diet and fluid instructions exactly as given.
Weighing it up
Advantages & disadvantages of Sodium picosulfate
Advantages
- Reliable, predictable relief that usually works overnight for short-term constipation.
- Comes as drops, solution or tablets, so it suits people who struggle with tablets.
- Widely available and well established for both constipation and bowel preparation.
Disadvantages
- Can cause tummy cramps, urgency and diarrhoea.
- Not for long-term use, and the bowel can become reliant on stimulant laxatives if overused.
- Strong bowel-cleansing use can upset fluid and salt balance and cause dehydration if instructions are not followed.
Practical use
Good to know
Sodium picosulfate is usually taken at night so it works the next morning. It is for short-term use — ongoing constipation should be looked into rather than treated with stimulant laxatives indefinitely. Drink plenty of fluids while using it, as it can cause tummy cramps and, with overuse, dehydration. If you are using a bowel-cleansing preparation before a procedure, follow the specific dietary and fluid instructions closely, as fluid and salt balance matters.
Who should not take it / use with caution
- People with a suspected bowel obstruction or blockage, or severe inflammatory bowel conditions in a flare.
- People with severe dehydration, or unexplained, persistent change in bowel habit that has not been assessed.
- Anyone with severe abdominal pain, nausea or vomiting where a serious cause has not been ruled out.
Monitoring
- Generally none for short-term constipation use
- Fluid and salt balance with strong bowel-cleansing preparations, especially in older or frail people
- Review any constipation that does not settle or keeps returning
Side effects
- Tummy cramps, gripes and urgency.
- Diarrhoea, and with overuse dehydration or disturbance of body salts.
- Rarely, an allergic reaction; persistent or severe symptoms should be reviewed.
Key interactions
- Water tablets (diuretics) and steroids can add to the loss of body salts, especially with strong bowel-cleansing use.
- It may affect how well some other medicines are absorbed if the bowel empties quickly.
- For bowel preparation, careful timing around other regular medicines is advised — check with the team arranging your procedure.
Available as: Oral drops/solution and tablets; also part of combined bowel-cleansing sachets.
Answers
Sodium picosulfate: frequently asked questions
When should I take sodium picosulfate?
For constipation it is usually taken at night so it works the next morning. Taking it at bedtime fits its overnight action, meaning you are more likely to have a result after you wake rather than being caught out during the day.
How quickly does it work?
For constipation it generally works overnight, producing a bowel movement the following morning. When used as a bowel-cleansing preparation before a procedure it works faster and more completely, following the specific timed instructions you are given.
Can I take it every day?
It is meant for short-term use, not as an everyday remedy. Relying on stimulant laxatives long-term can make the bowel sluggish. If you are often constipated, it is better to look at diet, fluids, fibre and activity, and to get persistent constipation reviewed.
Will it give me cramps?
Some tummy cramping, gripes and urgency are common with stimulant laxatives. Drinking plenty of fluids can help. If cramps are severe, or you have significant pain, vomiting or no bowel movement at all, stop and seek advice.
What is the difference between Dulcolax Pico and Laxoberal?
Both contain the same active ingredient, sodium picosulfate, and work the same way — they are different brand names for the same stimulant laxative. Generic sodium picosulfate is also available.
The wider class
About Laxatives
Sodium picosulfate belongs to the laxatives class. For how the class as a whole works, its shared safety principles and monitoring, see the full guide.
Browse by body system
Authoritative sources
- BNF: Sodium picosulfate.
- NICE CKS: Laxatives.
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