Drug Approvals
(British Approved Name, rINN)
Drug Nomenclature
Note. Compounded preparations of dantron may be represented by the following names:
Co-danthramer x/y (BAN) — where x and y are the strengths in milligrams of dantron and poloxamer respectively
Co-danthrusate (BAN) — dantron 5 parts and docusate sodium 6 parts (w/w).
Pharmacopoeias. In British.
British Pharmacopoeia. Unless otherwise specified, BP references areto the 2008 edition. (Dantron). An orange, odourless or almost odourless, crystalline powder. Practically insoluble in water very slightly soluble in alcohol soluble in chloroform slightly soluble in ether dissolves in solutions of alkali hydroxides.
Adverse Effects and Precautions
As for Senna. Dantron may colour the urine pink or red. Discoloration and superficial sloughing of perianal skin can occur after prolonged contact, therefore dantron should not be used in infants wearing nappies (diapers) and should be used with caution in incontinent patients. The mucosa of the large intestine may be discoloured with prolonged use or high dosage. In rodents, dantron has been associated with the development of intestinal and liver tumours. Consequently, its use has been restricted, see Uses and Administration, below.
References to adverse effects occurring with dantron-containing laxatives include individual cases of leucopenia with liver damage, greyish-blue skin discoloration, and orange vaginal discharge. There has also been a report of intestinal sarcoma in an 18-year-old girl with a history of pro longed use of a dantron-containing laxative. In May 2000 the UK CSM restricted the use of dantron to terminally ill patients on the grounds that pre-clinical evidence had increased and dantron was now established as a potential human carcinogen.
Breast feeding.
The American Academy of Pediatrics state that, although usually compatible with breast feeding, use of dantron by breast-feeding mothers has been reported to cause increased bowel activity in the infant.
Pharmacokinetics
Dantron is metabolised by bacteria in the colon. Dantron or its metabolites are absorbed from the gastrointestinal tract, as indicated by discoloration of urine in some patients. Dantron or its metabolites are excreted in the faeces and the urine, and also in other secretions including breast milk.
Uses and Administration
Dantron is an anthraquinone stimulant laxative but, unlike senna, it is not a glycoside. It is given orally to treat constipation and is effective within 6 to 12 hours. However, because of concern over rodent carcinogenicity it has been withdrawn in some countries, and its use restricted in others. In the UK, it may be used only in terminally ill patients. Dantron is given in doses of 25 to 75 mg when given with poloxamer 188 as co-danthramer, and in doses of 50 to 150 mg when given with docusate sodium as co-danthrusate. Doses are usually given at bedtime. For doses in children, see below.
Administration in children.
Children under 12 years have been given dantron 12.5 to 25 mg orally as co-danthramer or 50 mg as co-danthrusate. Doses are usually given at bedtime. Children aged 12 years and over may be treated with the adult dose (see Uses and Administration, above).
The BNFC recommends similar doses to these, but restricts the use of co-danthramer to children aged 2 years and over, and the use of co-danthrusate to those aged 6 years and over.
Dantron should not be used in infants wearing nappies (diapers) as it may cause discoloration and superficial sloughing of the skin.
Preparations
British Pharmacopoeia. Unless otherwise specified, BP references areto the 2008 edition: Co-danthrusate Capsules.
Proprietary Preparations
Multi-ingredient
Brazil: Fenogar †
Chile: Modane
Ireland: Ailax Codalax Cotron
Mexico: Modaton
New Zealand: Codalax Conthram †
United Kingdom: Ailax † Capsuvac Codalax Danlax Normax
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