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Clinical data across hundreds of participants shows serious adverse events are essentially nonexistent with topical use

It should be avoided or used only under clinician supervision in patients with kidney disease, older adults, or those at risk for electrolyte abnormalities , due to the risk of hypermagnesemia., Use sparingly: Stimulant laxatives (such as bisacodyl or senna) may be effective for intermittent rescue use , but they can cause cramping and are generally not needed for routine long-term management when osmotic agents are effective., Safety note: Regular stimulant laxative use that causes frequent loose stools may contribute to dehydration and electrolyte imbalance (including hypokalemia) and should therefore be intermittent unless clinician-directed . What about docusate (Colace)

As treatment continues and things are stable, the frequency may be reduced (for example, checks every 6 months)