TherapyDosageAdverse effects
Osmotics
Polyethylene glycol 3350 (Miralax)*0.5 to 0.8 g per kg up to 17 g per dayAnaphylaxis, flatulence
Lactulose1 mL per kg per day once or twice per day, single dose or in two divided dosesAbdominal cramps, flatulence
Magnesium hydroxide< 2 years: 0.5 mL per kg per dayInfants are susceptible to magnesium overdose (hypermagnesemia, hyperphosphatemia, hypocalcemia)
2 to 5 years of age: 5 to 15 mL per day
6 to 11 years of age: 15 to 30 mL per day
≥ 12 years: 30 to 60 mL per day
Medication may be given at bedtime or in divided doses
Sorbitol (e.g., prune juice)1 to 3 mL per kg once or twice per day in infantsSimilar to lactulose
Stimulants
Senna (Senokot)1 month to 2 years of age: 1.25 to 2.5 mL (2.2 to 4.4 mg) at bedtime (< 5 mL per day); 8.8 mg per dayIdiosyncratic hepatitis, melanosis coli, hypertrophic osteoarthropathy, analgesic nephropathy
2 to 6 years of age: 2.5 to 3.75 mL (4.4 to 6.6 mg) or ½ tablet (4.3 mg) at bedtime (< 7.5 mL or 1 tablet per day)
6 to 12 years of age: 5 to 7.5 mL (8.8 to 13.2 mg) or 1 tablet (8.6 mg) at bedtime (< 15 mL or 2 tablets per day)
> 12 years: 10 to 15 mL (26.4 mg) or 2 tablets (17.2 mg) at bedtime (< 30 mL or 4 tablets per day)
Bisacodyl (Dulcolax)> 2 years: 5 to 15 mg (1 to 3 tablets) once per dayAbdominal cramps, diarrhea, hypokalemia, abnormal rectal mucosa, proctitis (rare), urolithiasis (case reports)
Lubricants
Mineral oilChildren: 5 to 15 mL per dayLipoid pneumonia if aspirated, theoretical interference with absorption of fat-soluble substances, foreign body reaction in intestine
Adolescents: 15 to 45 mL per day