A person known to The Institute authors the text here, but who wishes to be anonymous. Many players like the way another can take control by the use of laxative, or see it as a kind of punishment. As long as you do not overdo it, it should be fairly safe. As always, think about what you do. Read as much in medical books and be sure that it is safe. Comments are welcome, and I will add them to these pages. Please mail them to Phenolthalein There are actually two versions, Phenolthalein, and yellow Phenolthalein. The latter is somewhat more effective. This drug is common used in chocolate candy and chewing gum laxatives. It generally takes 4-6 hours to produce results. It works by inhibiting re-absorption of digestive secretions, and is slightly irritating to the bowel. It is best taken on an empty stomach, about 30 minutes before a meal. The meal causes a dramatic increase in the secretion of digestive chemicals into the bowel, and since the fluid cannot be re-absorbed because of the action of the drug, the results are pretty obvious. These drugs are quite ineffective when combined with a bulking agent like psyllium seed. The psyllium seed just absorbs the water. The usual dose is 100 to 200 mg of the drug, although much larger doses are still probably safe (up to several grams). You often hear of people taking whole boxes of phenolthalein based drugs without any result, other than the obvious. Higher doses generally do not increase the effectiveness. Full blockage of the enzyme that controls re-abortion probably occurs in most people at about 250mg, so higher doses do not accomplish much. There are two problems with this drug. First, some people are allergic to it, and break out in a rash. The second is in high doses, it is often absorbed, and recycle it through the liver in the bile. When this occurs, the drug can produce results every time you eat for several days. While this drug is very easy to administer, it often fails to produce the urgency or discomfort that many of your readers are looking for. This drug depends upon to some degree on the overall efficacy of the digestive tract. As a result it tends to be most effective in children over about the age of 2 through adolescence, and in young adults. Their digestive systems are the most responsive to food, and as a result the drug produces the most effect in them. Common products using this drug: Ex-Lax, Feenamint, Laxettes, Correctol, Brooklax Castor Oil This is probably not anyone's favourite to receive. It is extremely effective in even the most uncooperative patients if you can get it into them. Dosage for complete cleansing is about 60ml. Often smaller doses are quite effective. Because of the way Castor oil works, overdose is just about impossible. The digestive process breaks down the oil, some of the components are very irritating. Depending upon your system, it takes from 2 to 12 hours to produce results. Very simply when enough of the irritating components have been released, it is going to take effect, and the effect will expel the remaining oil. As long as enough of the oil is administered, the results will be about the same regardless of dose. At high doses cramping is common, and can be severe. It also tends to produce results with considerable urgency. Accidents at the higher dosage levels are common. The longer the drug remains in your system, the more of the irritating components of the oil are released and the more spectacular the results will be. It is also available as an emulsion, which hides the taste and texture. Castor Oil is toxic to some degree, although LD50 (The dose at which 50% of those given it would die) is on the order of 50ml/kg, so most people would have to take literally litres to be poisoned. Given the taste and texture, that isn't very likely. Senna compounds This is a long time favourite, and a natural vegetable product. The dosage is expressed in two forms. Either the crude drug, where dosage is typically 500mg to 1 gram, although for special procedures such as X-ray examinations, up to 3.5 grams can be given. The second form is senosides A&B. These are the active ingredients in the crude drug. Senekot is about 9mg per tablet. Most people will respond to about 25mg or more. Doses of about 140mg is used prior to x-ray examination This drug typically takes 6 to 8 hours to work. It is unusual in that it is actually absorbed in the small bowel, and effects the muscles of the large bowel by reaching them via the blood circulation. If taken at night one of two things happens, either it wakes you up in about 6 hours, or you sleep through and nothing happens until about 1 hour after you get up. It directly drives the muscles of the large bowel, and in large doses cramping and urgency are the rule. The margin of safety is quite high, although the discomfort from the cramps can also be very high. It may also darken the urine slightly. The drug is often compounded to improve the taste into products like syrup of figs, or chocolate granules you can put on cereals or into cookies. Getting someone to take Senna-based products is generally easy if you can find the right product to administer. If you want to slip someone a laxative that will produce great urgency, and not have the patient realise you have slipped him something, this is the drug of choice. This drug does nothing except drive the muscles of the large bowel, it does nothing to soften things up at all. As a result, the results can be very unpleasant to the severely constipated. It makes them move the 'rocks'. This drug is also available as a suppository in some places, or you can dissolve 8 Senokot tablets in 100ml of water and give as a retention enema. It generally produces effects within 2 hours. Both Senna and phenolthalein can be mixed with decussate (dioctyl sodium sulfosuccinate) which is a detergent intended for oral administration. The effect is synergistic, the results are considerably more than either drug given alone. The detergent allows additional water to penetrate the contents, and tends to soften things up considerable. The normal doses of docsate (common known as colace) is about 200mg, although up to 1 gram can be given. At 1 gram, it tends to work very well all by itself. Bisacodyl The last effective stimulant is bisacodyl. The trade name is dulcolax. It works in about 6 hours. Normal dose is 2 tablets (10mg), although up to 6 tablets (30 mg) is often used for complete cleaning. Considerable cramping and urgency is the rule with this stuff. It and the Senna can be very effective when given a few hours after a bulk laxative such as Metamucil. In most hospital settings, this has replaced castor oil as the laxative of choice for complete cleaning. It is much more pleasant to take, the results however are generally even less pleasant than castor oil. This is also available as a suppository, and in some places a water based suspension. Generally 12mg of the suspension in about 1 litre of water as enema will completely empty someone in about 30 minutes. It isn't a very pleasant experience, but is extraordinarily effective. Unpleasant reactions to the enema, or the tablets are fairly common. This drug directly stimulates the nerves of the bowel. It is given as a coated tablet to make sure it gets well down the digestive tract before the coating dissolves and releases the drug. If it dissolves in the small intestine, the results are cramps, discomfort, and often nausea and vomiting. The enema is a very potent bowel stimulant, which means it is extremely irritating. If administered to quickly, it often causes nausea and/or vomiting. If administered to slowly, you will never get the full dose in. Tablets work in about 6 hours, suppositories 15 minutes to an hour, the enema produces results in 5 to 10 minutes, but you will be on the toilet until it is entirely expelled, which is about 20 minutes. In doses of 3 or more tables, this is a chemical alarm clock. Take it, and you will be awakened by it in about 6 hours. If taken with a bulk laxative, it may imbed in the bulking agent, which may slow down the effect considerably. It works best taken on an empty stomach. The Hyperosmotics These are laxatives that work either by drawing water into the bowel from the surrounding tissues, or by preventing the absorption of water. The net result is to essentially turn the bowel contents into liquid. There only a couple ways to something can be absorbed across the bowel wall. If it is fat soluble, it can be dissolved and carried across, if it is an ion, it must be very small to fit through. The saline type hyperosmotics work because the Ion's they produce are generally too large to be absorbed, so osmotic pressure causes water to flow into the bowel to reduce the concentration of the ions on the other side. This make the contents of the bowel very fluid, and prevents re- absorption of the water. Until relatively recently, these drugs were all ionic, meaning they were composed of various inorganic salts. The best known are probably the magnesium compounds, magnesium sulphate (Epsom salts), Magnesium Citrate (citrate of magnesia), Milk of Magnesia (magnesium hydroxide). Magnesium Sulphate is very bitter, and Milk of Magnesia tastes like chalk. Magnesium Citrate is usually available as a 300ml (10 ounce) bottle that is either lemon or cherry flavoured. It can be easily mistaken for a diet soft drink. These drugs are most effective on an empty stomach, and usually produce results in 1 to 3 hours. 300ml of Magnesium Citrate will effectively empty most people in a few hours. Some people find it quite irritating, and in those cases it may result in having to go the toilet with some urgency literally every few minutes until it is finished (which may take several hours). If you haven't tried this one before, try it when you have 5 or 6 hours and will be very close to toilet facilities. The others simply give you the runs. There are also a number of sodium and potassium based drugs in this class, Sodium Sulphate (Glauber's Salts), Potassium Sodium Tartrate (Rochelle Salts), Sodium phosphate, Sodium Biphosphate just to name a few. Sodium Phosphate/Sodium Biphosphate is a commercial product, Fleet's Phospho-Soda, (and is also the active ingredients in most commercial disposable enema's, like the Fleet's). These are all most effective on an empty stomach, and should all be taken with lots of water. They are often effective in an hour or so. A healthy dose of Phospho-soda given 30 minutes before breakfast and you probably will not get a chance to finish breakfast. None of these are especially tasty, in fact Sodium Phosphate has a reputation for being pretty vile. 45ml or 3 Tablespoons of Phospho-Soda are commonly used as part of preparation for X-ray examinations. It works quickly, and can produce considerable urgency and some cramping when used as a purgative. They are much more effective on an empty stomach, and if you drink 300ml of water every 30 minutes for a couple hours after you take one. All will produce spectacular results fairly quickly if taken at the recommended cathartic or purgative doses. The main problem with all of these drugs is they contain large amounts of magnesium, sodium and/or potassium. These can and do disrupt to electrolytes in your body to some extent. If you are on high blood pressure medication, or have any kind of kidney disorder, these drugs can cause serious side effects. Do not ever exceed the maximum suggested doses on these drugs. The electrolyte disturbances will correct themselves over a period of a few hours, but during that period you may have a headache, or be very irritable, or may experience cramps if you engage in exercise. Because these drugs work by increasing the water content in the bowel, they often do not work well in conjunction with bulk laxatives. They can however quickly clean you out otherwise. The second class of hyperosmotics drugs are non-ionic, and these are generally all of fairly recent development. Higher animals have digestive processes that are very specialised. For instance your system can recognise and process most naturally occurring sugars by breaking them down into very simple sugars, called mono-sacherides. There are very specific chemicals called enzymes that your body secretes to do this. This is like a lock and a key. The Complex sugar is the lock, the enzyme is the key. Each enzyme can process only 1 type of complex sugar molecule. The result is that if you introduce a sugar that is not identical to one of the known ones, the key doesn't fit, and the results are virtually identical to the ionic type chemicals described previously. There are several sugars and/or alcohol's that fall into this class. Sorbitol, which is often used in diet candy and other foods, is technically an alcohol, but your body in generally lacks the ability to break it down or absorb it. If you read the label on many diet candies carefully you will find a choice note that excessive consumption may have a laxative effect. Generally doses in excess of 25 grams are likely to produce the desire result. These products are virtually non-toxic, so they can be given in large quantities very safely. You can cook with them, use them to make cakes and cookies, even jelly's and jams, although sorbitol is not as sweet as sugar. The main problem with sorbitol is many people do have the ability to partially metabolise Sorbitol, which simply breaks off an end of the molecule, releasing hydrogen gas. It can release lots of hydrogen in fact, making you very 'windy'. The other obvious point here is that if you take these drugs, don't smoke on the toilet. Hydrogen is flammable! The other common versions are based upon variations of the lactose, or milk sugar molecule. Lactose is used in Dulphulac Syrup, Chronulac and Cephulac. This is a semi-synthetic sugar that the body cannot metabolise. To a certain extent the bacteria in the colour can break this down, into formic, acetic and lactic acids. These are slightly irritating, but the main effect is the osmotic pressure created, which adds a lot of water to bowel. The other common drug is lactitol monohydrate, used in Importal and some other products. In the USA these drugs are available only by prescription, outside the USA, these are generally available over the counter without prescription. They are used to treat chronic constipation, and certain serious liver disorders. One of the most serious clinical problems in liver failure is the inability to rid the body of ammonia, which is produced in the processing of proteins. The acids released by these drugs in the colon cause ammonia to diffuse into the colon, where it combines with these acids, and is then expelled. I am told that these drugs are surprisingly effective in reversing coma's caused by ammonia build up. In any event the dose on these drugs ranges from about 5 grams once a day to 45 grams 3 times a day. They are easiest to take if you add the syrup to cranberry, lemon, or grapefruit juice. (Add the dose to 250ml, or 8 oz of the juice) In the syrups, this is half a tablespoon a day to about 4.5 table spoons 3 times a day. My own suggestion is you try about 45 ml of the syrup or 25 grams of the powder initially. These drugs are effective in 2 to 4 hours, and can also produce a great deal of wind. The same problem with sorbitol, the wind is hydrogen, which is flammable. The syrup tends to be almost sickly sweet, although it makes a pretty good lemonade. The sweetness comes from the fact that syrup has fairly high levels of impurities,(about 30% in fact) such as Galactose and lactose, which are naturally occurring sugars that your body does recognise, taste and can process. The powder versions have much lower levels of impurities (about 5%), and are almost tasteless. The little taste they have is sweet, so it is possible to slip fairly large doses of the powder versions into drinks without the victim's knowledge. The need for a prescription in the USA is derived from the fact that these drugs can present a huge sugar load for diabetics. If the powder products were available in the USA, they probably would be over the counter. In general, if you are not a diabetic, these drugs are very very safe and have huge margins of safety. Doses of 60 to 90 ml often produce spectacular results with surprising speed. Since no ions are involved, serum electrolytes are largely unaffected by these drugs. The last drug is not strictly a hyperosmotic, but I would regard it as the drug of choice for the diaper crowd. These are isotonic solutions of polyethylene glycol 3550. The are sold under such names as Golytely, colonlytely, and glycoprep. These are packages of powder that are mixed with pure water. They contain Polyethylene Glycol 3550, and trace amounts of various ions (sodium, potassium, chloride, sulphate, and bicarbonate) in the same concentration as they occur in the body. The Polyethylene Glycol 3550 prevents the absorption of the water, just as the other drugs in this class do, however because the ion concentration in the solution is the same as it is in the body, there is not net gain or loss of essential minerals. This allows the solutions to given in truly large doses. Typically 4 litres is used to cleanse the bowels in preparation for an examination. This is taken 300 ml (about 10 oz) every 10-15 minutes. The patient should not eat anything for 4 hours prior to starting, and should not eat anything while taking the solution. It is best served cold, it has a slight salty taste, but is not unpleasant to take, and there are some flavoured versions. First motion generally occurs in about an hour, and will continue until about an hour after the last dose of the liquid is given. It is probably safe to consume up to about 10 litres. It can produce considerably urgency, and after the bowels are initially emptied (generally takes about 3 litres), the results are essentially clear water, devoid of colour or odour. If you want to use this stuff, it works well, has few side effects, but you probably will want bloomers or waterproof pants. These products generally required prescription in the USA, they are over the counter in Canada and most of the rest of the world. It is possible to make these solutions, the Physicians Desk Reference (PDR) will tell what the exact constituents are, and the chemicals are readily available from any decent chemical supplier. A few comments however. Make sure you know what you are doing. Use only chemicals that are USP or better (meaning they are intended for human consumption). Polyethylene Glycol comes in many weights. Ethylene Glycol is a poison, you must use a high-grade polyethylene glycol, and it must be the correct molecular weight version. For the beginner, chemicals come in many grades. Technical being the crudest, and ACS (American Chemical Society) being the highest. Anything you are going to eat or drink, you want to be sure is safe to do so, and is of a high purity. That generally means USP (United States Pharmacopia) or better. None of these chemicals are controlled substances, or subject to any controls. They are in fact very very ordinary, in fact several are probably already present in most households. The Polyethylene Glycol based product produce very effective results very quickly, very cleanly, and very neatly. They quite literally wash you out, and can produce considerable urgency in doing so. Generic names (Common brand names): bisacodyl (Dulcolax, Clysodrast, Fleet Laxative, Bisco-Lax, Dulcagen) bisacodyl and docusate carboxymethylcellulose and docusate (Disoplex) carboxymethylcellulose and casanthranol and docusate (Disolan Forte) cascara sagrada (cascara sagrada fluid extract) cascara sagrada and aloe (Nature's Remedy) cascara sagrada and phenolphthalein (Caroid Laxative) casanthranol castor oil (Neoloid, Alphamul, Fleet Flavored Castor Oil, Purge, Emusoil) dehydrocholic acid (Cholan-HMB, Decholin) dehydrocholic acid and docusate (Bilax) dehydrocholic acid and docusate and phenolphthalein (Trilax) docusate (docusate calcium, docusate potassium, docusate sodium) docusate and phenolphthalein (Colax, Disolan, Docucal-P, Doxidan, Ex-Lax, Femilax, Gentlax, Phillip's LaxCaps, Senekot, Unilax) glycerin (glycerin-topical, glycerin-oral, glycerin-suppositories) lactulose (Cephulac, C-Cephulose, C-Chronulose, Cholac, Chronulac, Constilac, Constulose, Duphalac, Enulose, Generlac, Portalac) magnesium citrate (Citroma) magnesium hydroxide (Phillip's Milk of Magnesia) magnesium oxide (Uro-Mag, Mag-Ox 400, Maox) magnesium sulfate (Epsom Salt) malt soup extract (Maltsuprex, Maltsupex) malt soup extract and psyllium (Syllamalt) methylcellulose (Citrucel, Citrucel Sugar Free) milk of magnesia and mineral oil (Haley's MO) milk of magnesia and mineral oil and glycerin mineral oil (Duolube, Agoral Plain, Kondremul, Milkinol, Neo-Cultol) mineral oil and cascara sagrada (Kondremul with Cascara) mineral oil and phenolphthalein (Agoral, Agoral Raspberry, Agoral Marshmallow, Kondremul with Phenolphthalein, Phenolphthalein Petrogalar) mineral oil and glycerin and phenolphthalein phenolphthalein (Alophen Pills, Ex-Lax Unflavored, Lax Pills, Laxative Pills, Espotabs, Feen-a-mint, Modane, Prulet, Feen-a-mint Chocolated, Ex-Lax Chocolated, Evac-U-Gen, Medilax, Phenolax, Evac-U Lax Tablets, Feen- a-mint Gum) poloxamer 188 (Alaxin, Copolymer, Rheothrx) polycarbophil (FiberCon, Equalactin, Mitrolan, Fiber-Lax) potassium bitartrate and sodium bicarbonate (Ceo-Two) psyllium (Konsyl, Cillium, Siblin, Syllact, V-Lax) psyllium and senna (Perdiem) psyllium hydrophilic mucilloid (Fiberall, Hydrocil Instant, Konsyl-D, Metamucil, Metamucil Instant Mix, Metamucil Instant Mix, Orange Flaovr, Metamucil Orange Flavor, Metamucil Strawberry Flavor, Metamucil Sugar Free, Modane Bulk, Pro-Lax, Reguloid Orange, Reguloid Natural, Serutan, Versabran, Effer-syllium, Konsul-D) psyllium hydrophilic mucilloid and carboxymethylcelluose (Serutan Toasted Granules) psyllium hydrophilic mucilloid and senna psyllium hydrophilic mucilloid and sennosides (Prompt) senna (Black-Draught Lax-Senna, Fletcher's Castoria, Senexon, Senokot, Senolax, Senna-Gen, Senokotxtra) senna and docusate (Gentlax S, Senokot-S) sennosides (Nytilax, Ex-Lax Gentle Nature) sodium phosphate * This list may not include all brand names.