Usage
Calcium Dobesilate + Docusate is used for managing chronic venous insufficiency (CVI), varicose veins, hemorrhoids (piles), and diabetic retinopathy. It also helps relieve occasional constipation.
It’s classified as a combination of a vasoprotective agent (Calcium Dobesilate) and a laxative (Docusate Sodium).
Calcium Dobesilate improves microcirculation by reducing capillary permeability and fragility, and it decreases blood viscosity. Docusate Sodium softens the stool by enabling water and fats to penetrate it, thus making bowel movements easier and preventing straining, which is especially beneficial for patients with hemorrhoids.
Alternate Names
This drug combination may be referred to as Calcium Dobesilate + Docusate Sodium. A brand name in some regions is Smuth Capsule.
How It Works
Calcium Dobesilate:
- Pharmacodynamics: Affects the capillary walls, regulating their resistance and permeability. Lowers blood viscosity and improves blood flow. It has anti-inflammatory and anti-edema effects.
- Pharmacokinetics: Information on the absorption, distribution, metabolism, and elimination of Calcium Dobesilate is limited.
Docusate Sodium:
- Pharmacodynamics: Acts as a surfactant, facilitating the mixture of water and fatty substances in the stool, leading to softer stools and easier bowel movements.
- Pharmacokinetics: Orally administered Docusate salts have limited absorption. The drug appears to be absorbed to some extent in the duodenum and jejunum and is excreted in the bile. Absorption following rectal administration is not well established. The onset of action is typically within 1 to 3 days.
Mode of Action (at a Cellular/Molecular level):
Information on the exact molecular mechanisms of Calcium Dobesilate is limited. Docusate Sodium works by decreasing the surface tension of the stool, promoting water and lipid infiltration.
Receptor binding, enzyme inhibition, or neurotransmitter modulation:
This information is not available in the sources provided.
Elimination pathways:
Elimination pathways for Calcium Dobesilate are not well established. Docusate Sodium is partially absorbed in the small intestines, with some excretion in the bile.
Dosage
Dosage information is limited and should be determined by a healthcare professional. Please refer to the dosage guidelines as prescribed by your physician.
Standard Dosage
Adults:
- Calcium Dobesilate: 500mg - 1g daily, divided into 2-3 doses.
- Docusate Sodium: 50mg - 400mg daily.
- Combination products often contain 500mg Calcium Dobesilate and 100mg Docusate Sodium.
Children:
The combination is generally not recommended for children. Docusate, when used alone, can be prescribed with adjusted dosage based on age. Calcium Dobesilate usage in children is generally not established.
Special Cases:
- Elderly Patients: Dosage adjustments may be necessary. Start at the lower end of the adult range.
- Patients with Renal/Hepatic Impairment: Dosage modifications may be required.
- Patients with Comorbid Conditions: Consult current clinical guidelines.
Clinical Use Cases
The combination is generally not used in the clinical settings described (Intubation, Surgical Procedures, Mechanical Ventilation, ICU Use, Emergency Situations). Its usage is primarily for chronic conditions.
Dosage Adjustments
Specific adjustments are not available. Consult a physician for cases of renal/hepatic dysfunction, metabolic disorders, or genetic polymorphisms.
Side Effects
Common Side Effects:
Nausea, stomach cramps, diarrhea, fever, skin rash, headache, and vertigo. Mild gastrointestinal discomfort.
Rare but Serious Side Effects:
Allergic reactions (rash, itching, swelling, breathing difficulties), rectal bleeding. Low white blood cell count (rare).
Long-Term Effects:
Information on long-term effects is limited.
Adverse Drug Reactions (ADR):
Severe allergic reactions require immediate medical attention.
Contraindications
Hypersensitivity to any components, pregnancy, breastfeeding, appendicitis, intestinal obstruction, fecal impaction, undiagnosed rectal bleeding.
Drug Interactions
Docusate may interact with mineral oil. Calcium Dobesilate may interact with several medications like amlodipine, aspirin, and advair diskus. Consult your doctor about all medications and supplements being taken, including OTC drugs and herbal products. Alcohol should be avoided.
Pregnancy and Breastfeeding
Contraindicated in pregnancy and breastfeeding.
Drug Profile Summary
- Mechanism of Action: Calcium Dobesilate improves microcirculation; Docusate Sodium softens stool.
- Side Effects: Nausea, stomach cramps, diarrhea, skin rash, fever, headache, allergic reactions.
- Contraindications: Hypersensitivity, pregnancy, breastfeeding, appendicitis, bowel obstruction.
- Drug Interactions: Consult a doctor about concomitant medications.
- Pregnancy & Breastfeeding: Contraindicated.
- Dosage: As directed by a physician.
- Monitoring Parameters: Monitor for effectiveness and side effects.
Popular Combinations
Limited information on combination therapy outside of the docusate and calcium dobesilate combination is available. Sometimes, calcium dobesilate is used in combination with lignocaine for hemorrhoids.
Precautions
Pre-screening for allergies, metabolic disorders, and organ dysfunction is necessary. Consult a physician for use during pregnancy and breastfeeding, as well as in children and elderly patients. Avoid alcohol.
FAQs (Frequently Asked Questions)
Q1: What is the recommended dosage for Calcium Dobesilate + Docusate?
A: Dosage varies and should be determined by a physician. Typical adult dosage includes 500-1000 mg/day of calcium dobesilate and 50-400 mg/day of docusate.
Q2: What are the primary uses of this combination?
A: Primarily used for managing CVI, hemorrhoids, varicose veins, diabetic retinopathy, and occasional constipation.
Q3: Is this combination safe during pregnancy?
A: No, it’s contraindicated during pregnancy and breastfeeding.
Q4: Are there any specific dietary restrictions while taking this medication?
A: A high-fiber diet and adequate hydration are recommended to support bowel regularity.
Q5: How long does it take for Docusate to work?
A: Typically within 1 to 3 days.
Q6: What should a patient do if they experience side effects?
A: Contact their physician.
Q7: Can this combination be used for chronic constipation?
A: While it can provide relief from occasional constipation, consult a physician for chronic constipation management.
Q8: Is it safe to consume alcohol while on this medication?
A: No, alcohol should be avoided while taking this medication.
Q9: How does Calcium Dobesilate affect blood vessels?
A: It works by strengthening capillary walls, reducing their permeability, and improving blood flow.
Q10: Can this combination be used long-term?
A: Long-term use should be as directed by a physician.
