Therapy	Dosage	Adverse effects
First-line osmotics
Polyethylene glycol (Miralax)*	0.4 to 1.5 g per kg up to 17 g per day	Anaphylaxis, flatulence
Second-line osmotics
Lactulose*	1 to 3 mL per kg per day in 2 divided doses	Abdominal cramps, flatulence
Milk of magnesia (magnesium hydroxide)	< 2 years: 0.5 mL per kg per day 2 to 5 years: 5 to 15 mL per day 6 to 11 years: 15 to 30 mL per day ≥ 12 years: 30 to 60 mL per day Medication may be given at bedtime or in divided doses	Infants are susceptible to magnesium overdose (hypermagnesemia, hyperphosphatemia, hypocalcemia)
Sorbitol (e.g., prune juice)*	1 to 3 mL per kg once or twice per day in infants	Similar to lactulose
Stimulants
Bisacodyl (Dulcolax)	3 to 12 years: 5 to 10 mg (1 to 2 tablets) once per day > 12 years: 5 to 15 mg (1 to 3 tablets) once per day	Abdominal cramps, diarrhea, hypokalemia, abnormal rectal mucosa, proctitis (rare), urolithiasis (case reports)
Senna*	1 to 2 years: 1.25 to 2.5 mL (2.2 to 4.4 mg) at bedtime; maximum of 5 mL or 8.8 mg per day 3 to 6 years: 2.5 to 3.75 mL (4.4 to 6.6 mg) or 0.5 tablet (4.3 mg) at bedtime; maximum of 7.5 mL or 1 tablet per day 7 to 12 years: 5 to 7.5 mL (8.8 to 13.2 mg) or 1 tablet (8.6 mg) at bedtime; maximum of 15 mL or 2 tablets per day > 12 years: 10 to 15 mL (26.4 mg) or 2 tablets (17.2 mg) at bedtime; maximum of 30 mL or 4 tablets per day	Idiosyncratic hepatitis, melanosis coli, hypertrophic osteoarthropathy, analgesic nephropathy
Lubricants
Mineral oil	1 to 3 mL per kg per day divided into 2 doses	Lipoid pneumonia if aspirated, theoretical interference with absorption of fat-soluble substances, foreign body reaction in intestine