Bisacodyl


Generic Medicine Info
Indications and Dosage
Oral
Bowel evacuation
Adult: For preparation of diagnostic procedures and in pre- and postoperative treatment: 10 mg for 2 doses given in the morning and evening, followed by 10 mg rectal supp/enema on the following morning.
Child: 4-10 years 5 mg in the evening, followed by 5 mg rectal supp on the following morning; >10 years Same as adult dose. Dosing recommendations may vary among individual products and between countries (refer to specific product guidelines).

Oral
Constipation
Adult: For short-term relief of occasional constipation, or either chronic or of recent onset, whenever a stimulant laxative is required: 5-10 mg once daily before bedtime. Alternatively, up to 15 mg daily.
Child: 4-10 years 5 mg once daily before bedtime; >10 years Same as adult dose. Dosing recommendations may vary among individual products and between countries (refer to specific product guidelines).

Rectal
Constipation
Adult: As supp or enema: 10 mg once daily.
Child: >4-10 years As supp: 5 mg daily; >10 years Same as adult dose. Dosing recommendations may vary among individual products and between countries (refer to specific product guidelines).
Administration
Should be taken on an empty stomach. Do not take w/in 1 hr of antacids, milk or other dairy products.
Contraindications
Ileus, intestinal obstruction, acute surgical abdominal conditions (e.g. appendicitis, acute inflammatory bowel disease, severe abdominal pain associated with nausea and vomiting), severe dehydration. Rectal: Anal fissures, proctitis or ulcerated haemorrhoids.
Special Precautions
Children. Pregnancy and lactation. Avoid prolonged use (>5 days).
Adverse Reactions
Significant: Fluid and electrolyte imbalance, hypokalaemia (prolonged use).
Gastrointestinal disorders: Abdominal pain, abdominal cramps, nausea, diarrhoea, vomiting, haematochezia, abdominal discomfort, anorectal discomfort, rectal burning (suppository). Rarely, colitis.
Metabolism and nutrition disorders: Rarely, dehydration.
Nervous system disorders: Dizziness. Rarely, syncope.
Patient Counseling Information
This drug may cause dizziness or syncope, if affected, do not drive or operate machinery.
Overdosage
Symptoms: Watery stools, abdominal cramps, fluid and electrolytes loss. Chronic case: Chronic diarrhoea, abdominal pain, hypokalaemia, secondary hyperaldosteronism, renal calculi, renal tubular damage, metabolic alkalosis, muscle weakness. Management: Perform gastric lavage or induce vomiting to minimise absorption. Fluid replacement and correction of electrolyte imbalance may be required.
Drug Interactions
High dose of bisacodyl may increase the risk of electrolyte imbalance with concomitant use of diuretics or adrenocorticosteroids. Enhanced gastrointestinal adverse effects with concomitant use of other laxatives. Decreased therapeutic effect and increased risk of dyspepsia and gastric irritation with concomitant use of antacids.
Food Interaction
Increased risk of dyspepsia and gastric irritation with milk products.
Action
Description: Bisacodyl, a diphenylmethane derivative, directly irritates the smooth muscle of the intestine, possibly the colonic intramural plexus, thereby stimulating peristalsis. It alters water and electrolyte secretion, producing net intestinal fluid accumulation and stimulates defaecation.
Onset: Laxative effect: 6-12 hours (oral); within 15-60 minutes (suppository); within 5-20 minutes (enema).
Pharmacokinetics:
Absorption: Systemic absorption: <5%.
Distribution: Volume of distribution: 289 L (BHPM).
Metabolism: Metabolised in the colon to active metabolite, bis-(-p-hydroxyphenyl)-pydidyl-2-methane (BHPM); further metabolised in the liver to a glucuronide salt.
Excretion: Via urine, bile (as BHPM). Elimination half-life: Approx 8 hours (BHPM).
Chemical Structure

Chemical Structure Image
Bisacodyl

Source: National Center for Biotechnology Information. PubChem Compound Summary for CID 2391, Bisacodyl. https://pubchem.ncbi.nlm.nih.gov/compound/Bisacodyl. Accessed June 28, 2022.

Storage
Tablet: Store below 25°C. Protect from humidity. Supp/Enema: Store below 30°C. Protect from light.
MIMS Class
Laxatives, Purgatives
ATC Classification
A06AB02 - bisacodyl ; Belongs to the class of contact laxatives.
References
Anon. Bisacodyl. AHFS Clinical Drug Information [online]. Bethesda, MD. American Society of Health-System Pharmacists, Inc. https://www.ahfscdi.com. Accessed 05/05/2022.

Anon. Bisacodyl. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 05/05/2022.

Biolax 5 mg Tablets (Chelonia Healthcare Limited). MHRA. https://products.mhra.gov.uk. Accessed 05/05/2022.

Buckingham R (ed). Bisacodyl. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 05/05/2022.

Dulcolax 10 mg Suppositories (Aventis Pharma Limited, trading as Sanofi). MHRA. https://products.mhra.gov.uk. Accessed 05/05/2022.

Dulcolax Adult 5 mg Gastro-resistant Tablets (Opella Healthcare UK Limited, trading as Sanofi). MHRA. https://products.mhra.gov.uk. Accessed 05/05/2022.

Dulcolax Suppository (Physicians Total Care, Inc.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed. Accessed 05/05/2022.

Dulcolax Tablets (Physicians Total Care, Inc.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed. Accessed 05/05/2022.

Fleet Bisacodyl Enema (C.B. Fleet Company, Inc.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed. Accessed 05/05/2022.

Joint Formulary Committee. Bisacodyl. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 05/05/2022.

Pharmacy Retailing (NZ) Limited trading as Healthcare Logistics. Dulcolax 5 mg Enteric Coated Tablets/10 mg Suppositories data sheet 20 December 2021. Medsafe. http://www.medsafe.govt.nz. Accessed 05/05/2022.

Viatris Ltd. Viatris 5 mg Enteric Coated Tablet data sheet 22 March 2022. Medsafe. http://www.medsafe.govt.nz. Accessed 05/05/2022.

Disclaimer: This information is independently developed by MIMS based on Bisacodyl from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2022 MIMS. All rights reserved. Powered by MIMS.com
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