Bisacodyl; Uses, Dosage, Side Effects, Interactions

Bisacodyl is a synthetic pyridinylmethylene-diacetate ester derivative stimulant laxative, Bisacodyl acts with a parasympathetic effect directly on mucosal sensory nerves, increasing peristaltic contractions. It is used for occasional constipation, in pre- and postoperative treatment, and in conditions that require facilitation of defecation. (NCI04)

Bisacodyl is a Stimulant Laxative. The physiologic effect of bisacodyl is by means of Increased Large Intestinal Motility, and Stimulation Large Intestine Fluid/Electrolyte Secretion. Bisacodyl is commonly used, an over-the-counter laxative used to treat constipation or bowel irregularity. Bisacodyl has not been associated with serum enzyme elevations during therapy or with a clinically apparent liver injury with jaundice.

Mechanism of Action of Bisacodyl

Bisacodyl is hydrolyzed by intestinal brush border enzymes and colonic bacteria to form an active metabolite [bis-(p-hydroxyphenyl) pyridyl-2 methane; (BHPM)] that acts directly on the colonic mucosa to produce colonic peristalsis. Bisacodyl is a synthetic pyridinylmethylene-diacetate ester derivative stimulant laxative, Bisacodyl acts with a parasympathetic effect directly on mucosal sensory nerves, increasing peristaltic contractions. It is used for occasional constipation, in pre- and postoperative treatment, and in conditions that require facilitation of defecation. (NCI04)

Indications of Bisacodyl

Therapeutic Uses

  • Oral bulk-forming, lubricant, and stool softener laxatives are indicated prophylactically in patients who should not strain during defecation, such as those with an episiotomy wound, painful thrombosed hemorrhoids, fissures or perianal abscesses, body wall and diaphragmatic hernias, anorectal stenosis, or postmyocardial infarction.
  • Oral laxatives are indicated for the short-term relief of constipation. Oral bulk-forming laxatives, stimulant laxatives, and carbon dioxide-releasing suppositories are indicated to facilitate defecation in geriatric patients with a diminished colonic motor response.
  • Bisacodyl is useful as a laxative for the occasional relief of constipation and in bowel cleansing preparation for x-ray or endoscopic examination. Bisacodyl may be used as a laxative in postoperative, antepartum, or postpartum care or in preparation for delivery
  • In severe cases of constipation, such as with fecal impaction, mineral oil and stool softener laxatives administered orally or rectally are indicated to soften the impacted feces. To help complete the evacuation of the impacted colon, a rectal stimulant or saline laxative may follow.

Contraindications of Bisacodyl

  • Structured data covering drug contraindications. Each contraindication describes a scenario in which the drug is not to be used. Includes restrictions on co-administration, contraindicated populations, and more.
  • Appendicitis
  • Stomach or intestine blockage
  • Unable to Control Bowel Movement
  • Hypersensitivity to the active substance or to any of the excipients
  • Bowel obstruction,
  • Inflammatory bowel disease
  • Intestinal obstruction disorders
  • Acute surgical abdomen
  • Diarrhea-predominant irritable bowel syndrome.
  • Ischemic bowel syndrome
  •  Allergies to Bisacodyl

Dosage of Bisacodyl

Strengths: 5 mg; 10 mg

Constipation

Oral:

  • TABLET: 5 to 15 mg orally once a day as needed
  • Duration of therapy: Up to 1 week

Rectal: Enema

  • 10 mg rectally once a day as needed

Suppository

  • 10 mg (1 suppository) rectally once a day as needed
  • Duration of therapy: Up to 1 week

Bowel Preparation

Oral: Tablet

  • 5 to 15 mg orally once a day as needed
  • Duration of therapy: Up to 1 week

Rectal: Enema

  • 10 mg rectally once a day as needed

Suppository

  • 10 mg (1 suppository) rectally once a day as needed
  • Duration of therapy: Up to 1 week.

Pediatric

Constipation

Oral:

  • Under 6 years: Dose adjustment(s) may be required; however, no specific guidelines have been suggested.
  • 6 to less than 12 years: 5 mg orally once a day as needed
  • 12 years and older: 5 to 15 mg orally once a day as needed
  • Duration of therapy: Up to 1 week

Rectal: Enema

  • Under 12 years: Not recommended.
  • 12 years and older: 10 mg rectally once a day as needed
  • Duration of therapy: Up to 1 week

SuppositoryUnder 6 years:

  • 6 to less than 12 years: 5 mg (0.5 suppository) rectally once a day as neede
  • 12 years and older: 10 mg (1 suppository) rectally once a day as needed
  • Duration of therapy: Up to 1 week

Bowel Preparation

Oral: Tablet

  • Under 6 years: Dose adjustment(s) may be required; however, no specific guidelines have been suggested.
  • 6 to less than 12 years: 5 mg orally once a day as needed
  • 12 years and older: 5 to 15 mg orally once a day as needed
  • Duration of therapy: Up to 1 week.

Rectal: Enema

  • Under 12 years: Not recommended.
  • 12 years and older: 10 mg rectally once a day as needed
  • Duration of therapy: Up to 1 week

Suppository

  • Under 6 years: 6 to less than 12 years: 5 mg (0.5 suppositories) rectally once a day as needed
  • 12 years and older: 10 mg (1 suppository) rectally once a day as needed
  • Duration of therapy: Up to 1 week.


Side Effects of Bisacodyl

The most common

More common

Rare

Drug Interactions of Bisacodyl

Do not take other medications 2 hours before or 2 hours after taking bisacodyl tablets. Bisacodyl tablets may reduce the effectiveness of other medications.

may interact with following drugs, supplements, & may change the efficacy of the drug

Pregnancy Category

FDA Pregnancy Risk Category: B 

Pregnancy

  • This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding

  • This medication does not pass into breast milk. It is therefore considered safe to use while breast-feeding. The safety and effectiveness of this medication have not been established for children less than 6 years old. Do not give this medication to children unless recommended by your doctor.


References

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Bisacodyl

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