II. Indications

  1. Functional Constipation
    1. Has been used historically as a Laxative, but has been replaced by newer agents

III. Mechanism

  1. Castor Oil is a vegetable oil pressed from castor bean (Ricinus communis) seeds
  2. Castor Oil acts as a Stimulant Laxative

IV. Precautions

  1. Avoid chronic use of Stimulant Laxatives (see adverse effects below)

V. Pharmacokinetics

  1. Not absorbed

VI. Dosing: Constipation

  1. Adult: Take 15 to 60 ml/day orally as needed for Constipation
    1. Historically, 30 to 60 ml was used 16 hours prior to Colonoscopy

VII. Pharmacokinetics

  1. Onset: 2 to 6 hours

VIII. Adverse Effects

  1. Unpalatable taste
    1. Better tolerated in emulsion form and when chilled
    2. May combine with juice or carbonated drinks to mask the taste

IX. Adverse Effects: Long-term use (Laxative abuse)

  1. See Stimulant Laxative
  2. Avoid prolonged use (habit forming)!
  3. Colonic denervation and atony (Cathartic colon)
    1. Decreased motility of right colon with secondary worsening Constipation
    2. Associated with Anthraquinone Laxatives
    3. Results from myenteric plexus injury
  4. Electrolyte and nutritional disturbance
    1. Hypokalemia
    2. Sodium overload
    3. Protein-losing Enteropathy
  5. Melanosis coli
    1. Benign darkening of colonic mucosa
    2. Macrophage deposition in lamina propria

X. Safety

  1. Pregnancy Category X
  2. Unknown safety in Lactation

XI. References

  1. Hamilton (2020) Tarascon Pocket Pharmacopoeia

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Related Studies

Cost: Medications

castor oil (on 3/1/2023 at Medicaid.Gov Survey of pharmacy drug pricing)
CASTOR OIL Generic OTC $0.02 per ml