Castor oil is a multi-purpose vegetable oil that comes from the seeds of the castor oil plant, scientifically known as Ricinus communis. It has been used for centuries for various purposes, including medicinal, industrial, and cosmetic applications.

Castor oil is primarily used for constipation as it inhibits the reabsorption of fluid and electrolytes in the small intestine. It should be used as a temporary measure. Patients with rectal bleeding, abdominal pain, nausea, vomiting, and pregnant patients should avoid using it. Pregnant females at term use castor oil at home for the induction of labor and uterine contractions.

Other uses of castor oil:

Since it is a nutrient, and has vitamin E and some antifungal properties, it is widely used as a topical therapy for hair. Some people use it for weight loss as it is an anorexiant, has laxative properties and inhibits water reabsorption from the gut. Others have used castor oil for skin conditions and psoriasis because of its anti-inflammatory properties.

Castor oil Dose in Adults

Castor oil for Constipation in Adults:

• The typical dose is between 15 to 60 milliliters, which you take all at once.
• That's like one to four tablespoons.

Castor oil Dose in Children

Note: It's important to know that castor oil usually starts working within 6 to 12 hours after taking it. However, it's worth noting that nowadays, other types of laxatives are often preferred over castor oil because they're less likely to cause side effects like electrolyte imbalances.

Castor oil for Constipation in Children

For occasional constipation, the dosage of castor oil varies depending on age:

• For children aged 2 to 11 years old, the typical dose is between 5 to 15 milliliters, which is like one to three teaspoons, taken all at once as needed.
• For adolescents aged 12 years and older, as well as adults, the typical dose is between 15 to 60 milliliters, or one to four tablespoons, taken all at once as needed.

Pregnancy Category D

• It's important to avoid using castor oil as a laxative during pregnancy because it may trigger labor.
• Some studies suggest that ingesting castor oil could potentially induce labor, which is not safe during pregnancy.

Use during breastfeeding

• Lactating women should be cautious when using the drug.  

Castor oil Dose in Renal Disease:

Avoid using castor oil in patients with renal failure.

Castor oil Dose in Liver Disease:

Castor oil may be used with caution in patients with advanced liver disease.

Common Side Effects of Castor Oil Include:

• Cardiovascular:
  • Hypotension
• Endocrine & metabolic:
  • Electrolyte disturbance
• Central nervous system:
  • Dizziness
  • Pelvic congestion syndrome
• Gastrointestinal:
  • Abdominal cramps
  • Diarrhea
  • Nausea

Contraindications to Castor oil use:

• Castor oil should not be used to evacuate bowel obstruction or absolute constipation.
• It is best to avoid it during pregnancy, as it can cause abortions or preterm labour.

Warnings and Precautions 

• It is best to stop using it for more than one week. If you have abdominal pain, nausea or vomiting or if there are any rectal bleeding symptoms, don't use it.

Monitor:

Monitor vital signs, hydration status, Renal functions and electrolytes

How to administer Castor oil:

• Avoid taking castor oil right before bedtime because it works pretty quickly, and you might end up needing the bathroom during the night.
• Instead, take it on an empty stomach, like in the morning before eating anything.
• Some people mix it with juice or a carbonated beverage to make it easier to swallow.

Mechanism of action of Castor oil for constipation:

Castor oil primarily works in the small intestine. Once ingested, it gets broken down into ricinoleic acid. This acid helps reduce the absorption of fluid and electrolytes from the intestine and also stimulates peristalsis, which is the movement of the intestines that helps push food and waste through the digestive system. This combination of effects is what helps relieve constipation and promote bowel movements.

Onset of action:

• The onset of action for castor oil typically occurs within 1 to 3 hours after ingestion. 

International Brands of Castor oil:

• Laxatrol
• Oleum Ricini

Castor oil Brands in Pakistan: