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Docusate sodium (dioctyl sodium sulfosuccinate) and docusate calcium (dioctyl calcium sulfosuccinate) act like detergents and are used to soften the stool when it is desirable to lessen the discomfort or the strain of defecation. These drugs are anionic surfactants that produce their effect by reducing the surface tension and allowing intestinal fluids and fatty substances to penetrate the fecal mass. They usually require 1 to 3 days to exert their full effect if used alone, but they may be combined with other laxatives in OTC preparations. These agents are not believed to interfere with the absorption of nutrients from the intestinal tract, and they are not appreciably absorbed. Docusate is frequently recommended for elderly patients because it is associated with so few side effects. Diarrhea and mild abdominal cramps are the only adverse effects reported.