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Pharmacologic Category
Dosing: Adult
Bowel evacuation, constipation: Oil: Oral: 15 to 60 mL as a single dose
* See Dosage and Administration in AHFS Essentials for additional information.
Dosing: Geriatric
Refer to adult dosing.
Dosing: Pediatric
Note: Produces bowel evacuation in 6 to 12 hours. Use of castor oil has generally been replaced with other laxatives (eg, PEG solutions, lactulose) less likely to cause adverse effects (eg, electrolyte disturbances) (Tabbers 2014):
Constipation, occasional: Oral:
Children 2 to 11 years: 5 to 15 mL as a single daily dose as needed
Children ≥12 years and Adolescents: 15 to 60 mL as a single daily dose as needed
Dosing: Renal Impairment: Pediatric
There are no dosage adjustments provided in the manufacturer’s labeling.
Dosing: Hepatic Impairment: Pediatric
There are no dosage adjustments provided in the manufacturer’s labeling.
Use: Labeled Indications
Bowel evacuation/constipation: Temporary relief of occasional constipation.
* See Uses in AHFS Essentials for additional information.
Administration: Oral
Do not administer at bedtime because of rapid onset of action. Should be administered on an empty stomach with juice or carbonated beverages.
Administration: Pediatric
Oral: Do not administer at bedtime because of rapid onset of action; chill or administer with milk, juice, or carbonated beverage to improve palatability; administer on an empty stomach for quicker onset (Brunton 2006)
Dietary Considerations
Should be taken on an empty stomach with juice or carbonated beverages.
Storage/Stability
Protect from heat.
Medication Patient Education with HCAHPS Considerations
• Discuss specific use of drug and side effects with patient as it relates to treatment. (HCAHPS: During this hospital stay, were you given any medicine that you had not taken before? Before giving you any new medicine, how often did hospital staff tell you what the medicine was for? How often did hospital staff describe possible side effects in a way you could understand?)
• Educate patient about signs of a significant reaction (eg, wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; or swelling of face, lips, tongue, or throat). Note: This is not a comprehensive list of all side effects. Patient should consult prescriber for additional questions.
Intended Use and Disclaimer: Should not be printed and given to patients. This information is intended to serve as a concise initial reference for healthcare professionals to use when discussing medications with a patient. You must ultimately rely on your own discretion, experience and judgment in diagnosing, treating and advising patients.
Warnings/Precautions
Other warnings/precautions:
• Appropriate use: Do not use for longer than 1 week or when abdominal pain, nausea, vomiting, or rectal bleeding are present unless directed by health care provider.
* See Cautions in AHFS Essentials for additional information.
Geriatric Considerations
Not a drug of first choice for constipation in the elderly.
Elderly are often predisposed to constipation due to disease, immobility, drugs, low residue diets, and a decreased fluid intake usually due to a decreased "thirst reflex" with age. Avoid stimulant cathartic use on a chronic basis if possible. Use osmotic, lubricant, stool softeners, and bulk agents as prophylaxis. Patients should be instructed for proper dietary fiber and fluid intake as well as regular exercise. Monitor closely for fluid/electrolyte imbalance, CNS signs of fluid/electrolyte loss, and hypotension. Strong and chronic purging may cause severe fluid and electrolyte loss which may affect mental function (CNS).
Pregnancy Considerations
Ingestion of castor oil may be associated with induction of labor. Use of castor oil as a laxative during pregnancy should be avoided (Cullen, 2007; Hall, 2011; Wald, 2003).
Briggs' Drugs in Pregnancy & Lactation
Adverse Reactions
Frequency not defined.
Cardiovascular: Hypotension
Central nervous system: Dizziness, pelvic congestion syndrome
Endocrine & metabolic: Electrolyte disturbance
Gastrointestinal: Abdominal cramps, diarrhea, nausea
* See Cautions in AHFS Essentials for additional information.
Metabolism/Transport Effects
None known.
Drug Interactions Open Interactions
There are no known significant interactions.
Dosage Forms: US
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Oil, Oral:
GoodSense: (118 mL)
Generic: (59 mL, 118 mL, 177 mL, 473 mL)
Anatomic Therapeutic Chemical (ATC) Classification
- A06AB05
Generic Available (US)
No
Pricing: US
Oil (Castor Oil Oral)
100% (per mL): $0.02
Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided as reference price only. A range is provided when more than one manufacturer's AWP price is available and uses the low and high price reported by the manufacturers to determine the range. The pricing data should be used for benchmarking purposes only, and as such should not be used alone to set or adjudicate any prices for reimbursement or purchasing functions or considered to be an exact price for a single product and/or manufacturer. Medi-Span expressly disclaims all warranties of any kind or nature, whether express or implied, and assumes no liability with respect to accuracy of price or price range data published in its solutions. In no event shall Medi-Span be liable for special, indirect, incidental, or consequential damages arising from use of price or price range data. Pricing data is updated monthly.
Mechanism of Action
Acts primarily in the small intestine; hydrolyzed to ricinoleic acid which reduces net absorption of fluid and electrolytes and stimulates peristalsis
Pharmacodynamics/Kinetics
Onset of action: 1 to 3 hours (Brunton 2006) but may take up to 12 hours
Local Anesthetic/Vasoconstrictor Precautions
No information available to require special precautions
Effects on Dental Treatment
No significant effects or complications reported
Effects on Bleeding
No information available to require special precautions
Related Information
Index Terms
Oleum Ricini
References
Castor Oil [prescribing information]. Texarkana, TX: Humco Holding Group, Inc; October 2013.
Castor oil liquid [prescribing information]. Landover, MD: Foodhold U.S.A. LLC; January 2017.
Cullen G, O'Donoghue D. Constipation and pregnancy. Best Pract Res Clin Gastroenterol. 2007;21(5):807-818.[PubMed 17889809]
Brunton LL, Chabner BA, Knollmann BC, eds. Goodman & Gilman’s The Pharmacological Basis of Therapeutics. 11th ed. New York, NY: McGraw-Hill Medical; 2006.
Hall HG, McKenna LG, Griffiths DL.Complementary and alternative medicine for induction of labour. Women Birth. 2012;25(3):142-148.[PubMed 21524953]
Humco castor oil liquid [prescribing information]. Texarkana, TX; Humco; October 2013.
Tabbers MM, DiLorenzo C, Berger MY, et al. Evaluation and treatment of functional constipation in infants and children: evidence-based recommendations from ESPGHAN and NASPGHAN. J Pediatr Gastroenterol Nutr. 2014;58(2):258-274.[PubMed 24345831]
Wald A. Constipation, diarrhea, and symptomatic hemorrhoids during pregnancy. Gastroenterol Clin North Am. 2003;32(1):309-322.[PubMed 12635420]
Brand Names: International
Laxatrol (PH); Oleum Ricini (BG, EE)
Last Updated 9/25/19
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