Bisacodyl


Thông tin thuốc gốc
Chỉ định và Liều dùng
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.

Oral
Constipation
Adult: 5-10 mg once daily before bedtime. Max: 20 mg.
Child: >4-10 years 5 mg once daily before bedtime; >10 years Same as adult dose.

Rectal
Constipation
Adult: As supp or enema: 10 mg daily preferably in the morning.
Child: >4-10 years As supp: 5 mg daily preferably in the morning; >10 years Same as adult dose.
Cách dùng
Should be taken on an empty stomach. Do not take w/in 1 hr of antacids, milk or other dairy products.
Chống chỉ định
Severe dehydration, ileus, intestinal obstruction, acute abdominal conditions (e.g. appendicitis, acute inflammatory bowel disease, severe abdominal pain). Rectal: Anal fissures, proctitis or ulcerated haemorrhoids.
Thận trọng
Patient with inflammatory bowel disease. Renal impairment. Children. Pregnancy and lactation. Avoid prolonged use (>5 days).
Phản ứng phụ
Significant: Fluid and electrolyte imbalance e.g. metabolic acidosis or alkalosis, hypocalcaemia, hypokalaemia (prolonged use).
Gastrointestinal disorders: Abdominal pain, bloody diarrhoea, nausea, abdominal cramps, haematochezia, vomiting, abdominal discomfort, anorectal discomfort, rectal burning (suppository). Rarely, colitis.
Metabolism and nutrition disorders: Rarely, dehydration.
Nervous system disorders: Dizziness.
Thông tin tư vấn bệnh nhân
This drug may cause dizziness or syncope, if affected, do not drive or operate machinery.
Quá liều
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.
Tương tác
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 antacids.
Food Interaction
Increased risk of dyspepsia and gastric irritation with milk products.
Tác dụng
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 (active metabolite).
Metabolism: Metabolised in the colon to active metabolite, bis-(-p-hydroxyphenyl)-pydidyl-2-methane (BHPM), and further metabolised in the liver to a glucuronide salt.
Excretion: Via urine, bile (as BHPM). Elimination half-life: Approx 8 hours (BHPM).
Đặc tính

Chemical Structure Image
Bisacodyl

Source: National Center for Biotechnology Information. PubChem Database. Bisacodyl, CID=2391, https://pubchem.ncbi.nlm.nih.gov/compound/Bisacodyl (accessed on Jan. 21, 2020)

Bảo quản
Oral: Store between 20-25°C. Protect from humidity. Rectal: Store below 30°C.
Phân loại MIMS
Phân loại ATC
A06AB02 - bisacodyl ; Belongs to the class of contact laxatives.
References
Anon. Bisacodyl. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 02/10/2019.

Bisacodyl Enema (C.B. Fleet Company, Inc). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 02/10/2019.

Bisacodyl Enteric Coated Tablet (Major Pharmaceuticals). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 19/05/2016.

Bisacodyl Suppository (Pharmacy Value Alliance LLC). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 02/10/2019.

Buckingham R (ed). Bisacodyl. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 02/10/2019.

Dulcolax Tablet (Boehringer Ingelheim Pharmaceuticals, Inc). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 02/10/2019.

Joint Formulary Committee. Bisacodyl. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 19/05/2016.

McEvoy GK, Snow EK, Miller J et al (eds). Bisacodyl. AHFS Drug Information (AHFS DI) [online]. American Society of Health-System Pharmacists (ASHP). https://www.medicinescomplete.com. Accessed 19/05/2016.

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