bisacodyl (OTC)

Brand and Other Names:Dulcolax, Correctol, more...BisacEvac, Bisacolax, Codulax, Alophen, Feen A Mint, Fleet Stimulant Laxative, Laxit, Modane, Dulcolax for Women
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

tablet, delayed release

  • 5mg

Constipation

5-15 mg PO once daily; if complete evacuation required, 30 mg PO once daily

Dosage Forms & Strengths

tablet

  • 5mg

Constipation

<6 years: PO administration not recommended, because of requirement to swallow tablets

6-12 years: 5 mg or 0.3 mg/kg PO at bedtime or before breakfast  

>12 years: 5-15 mg PO at bedtime

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Interactions

Interaction Checker

and bisacodyl

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      Serious - Use Alternative

        Significant - Monitor Closely

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            Contraindicated (0)

              Serious - Use Alternative (3)

              • sodium sulfate/?magnesium sulfate/potassium chloride

                sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of bisacodyl by Other (see comment). Avoid or Use Alternate Drug. Comment: Coadministration of stimulant laxatives and sodium sulfate/magnesium sulfate/potassium chloride may increase the risk of mucosal ulceration or ischemic colitis.

              • sodium sulfate/potassium sulfate/magnesium sulfate

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of bisacodyl by Other (see comment). Avoid or Use Alternate Drug. Comment: Coadministration of stimulant laxatives and sodium sulfate/magnesium sulfate/potassium chloride may increase the risk of mucosal ulceration or ischemic colitis.

              • sodium sulfate/potassium sulfate/magnesium sulfate/polyethylene glycol

                bisacodyl, sodium sulfate/potassium sulfate/magnesium sulfate/polyethylene glycol. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Stimulant laxatives may increase the risk of mucosal ulceration or ischemic colitis when coadministered with bowel preps.

              Monitor Closely (3)

              • deflazacort

                bisacodyl and deflazacort both decrease serum potassium. Use Caution/Monitor.

              • dichlorphenamide

                dichlorphenamide and bisacodyl both decrease serum potassium. Use Caution/Monitor.

              • potassium citrate

                bisacodyl decreases levels of potassium citrate by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

              Minor (2)

              • potassium acid phosphate

                bisacodyl decreases levels of potassium acid phosphate by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • potassium chloride

                bisacodyl decreases levels of potassium chloride by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

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              Adverse Effects

              Frequency Not Defined

              Abdominal cramping

              Electrolyte and fluid imbalance

              Excessive diarrhea

              Nausea

              Rectal burning

              Vertigo

              Vomiting

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              Warnings

              Contraindications

              Hypersensitivity

              Obstruction or severe impaction

              Symptoms of appendicitis or acute surgical abdomen

              Vomiting

              Rectal bleeding

              Cautions

              Avoid chronic use; may cause laxative dependence

              Avoid using in patients with gastroenteritis

              Do not chew tablet; swallow whole

              Not for use within 1 hour of taking antacid or milk

              Not recommended for children < 6 years because of requirement to swallow tablets

              Not to be used for >1 week

              Some dosage forms may contain benzyl alcohol, which has been associated with fatal toxicity in neonates; avoid dosage forms containing benzyl alcohol derivatives in neonates

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              Pregnancy & Lactation

              Pregnancy

              Plasma concentrations of the active metabolite BHPM are low following doses of 10 mg/day for 7 days; short term use is generally considered safe in pregnancy; avoid long term use

              Lactation

              Not detected in excreted milk following administration of 10 mg/day for 7 days; use with caution

              Pregnancy Categories

              A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

              B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

              C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

              D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

              X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

              NA: Information not available.

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              Pharmacology

              Mechanism of Action

              Irritates smooth muscle of intestine and possibly colonic intramural plexus, thus in turn increasing peristalsis

              Increases intestinal fluid accumulation and laxation by altering water and electrolyte secretion

              Absorption

              Onset: 6-10 hr

              Distribution

              Vd: 289 L

              Elimination

              Half-life: 8 hr

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              Images

              BRAND FORM. UNIT PRICE PILL IMAGE
              Fleet Bisacodyl rectal
              -
              10 mg/30 mL enema
              Alophen (bisacodyl) oral
              -
              5 mg tablet
              bisacodyl oral
              -
              5 mg tablet
              bisacodyl oral
              -
              5 mg tablet
              bisacodyl oral
              -
              5 mg tablet
              bisacodyl oral
              -
              5 mg tablet
              bisacodyl oral
              -
              5 mg tablet
              bisacodyl oral
              -
              5 mg tablet
              bisacodyl oral
              -
              5 mg tablet
              bisacodyl rectal
              -
              10 mg suppos
              bisacodyl rectal
              -
              10 mg suppos
              bisacodyl rectal
              -
              10 mg suppos
              bisacodyl rectal
              -
              10 mg suppos
              bisacodyl rectal
              -
              10 mg suppos
              Dulcolax (bisacodyl) rectal
              -
              10 mg suppos
              Dulcolax (bisacodyl) rectal
              -
              10 mg suppos
              Dulcolax (bisacodyl) rectal
              -
              10 mg suppos
              Gentle Laxative (bisacodyl) oral
              -
              5 mg tablet
              Gentle Laxative (bisacodyl) oral
              -
              5 mg tablet
              Gentle Laxative (bisacodyl) oral
              -
              5 mg tablet
              Gentle Laxative (bisacodyl) oral
              -
              5 mg tablet
              Gentle Laxative (bisacodyl) oral
              -
              5 mg tablet
              Gentle Laxative (bisacodyl) oral
              -
              5 mg tablet
              Gentle Laxative (bisacodyl) rectal
              -
              10 mg suppos
              Gentle Laxative (bisacodyl) rectal
              -
              10 mg suppos
              Correctol oral
              -
              5 mg tablet
              Dulcolax (bisacodyl) oral
              -
              5 mg tablet
              Dulcolax (bisacodyl) oral
              -
              5 mg tablet
              Dulcolax (bisacodyl) oral
              -
              5 mg tablet
              Women's Gentle Laxative (bisacodyl) oral
              -
              5 mg tablet

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              Patient Handout

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              Patient Education
              bisacodyl rectal

              BISACODYL ENEMA - RECTAL

              (bis-AK-oh-dil)

              USES: This product is used to clean stool from the intestines before surgery or certain bowel procedures (e.g., colonoscopy, radiography) usually with other products. It may also be used for relief of constipation. However, milder products (e.g., laxatives taken by mouth) should be used whenever possible for constipation.Bisacodyl is a stimulant laxative that works by increasing the amount of fluid/salts in the intestines. This effect usually results in a bowel movement within 15 to 60 minutes.This product is not recommended for use in children younger than 12 years unless directed by a doctor.

              HOW TO USE: This product is for rectal use only. Read and follow all directions on the product package at least 24 to 48 hours before your surgery/procedure, or use as directed by your doctor. If you have any questions, ask your doctor or pharmacist. Be sure to also follow any diet instructions given by your doctor or medical staff for your surgery/procedure. If you are using this product for constipation, use as directed by your doctor.Wash your hands before and after using this product. Shake the bottle well before removing the protective shield. Lie on your left side with knee bent. Instead, if you find it more comfortable, you may kneel, then lower your head and chest forward until the left side of the face is resting on the surface with your left arm folded comfortably. With steady pressure, gently insert enema tip into the rectum with a slight side-to-side movement, pointing the tip toward the navel. Do not force the enema tip into the rectum because doing so can cause injury. Squeeze the bottle until nearly all of the liquid is inside the rectum. It is not necessary to empty the bottle completely because it has more liquid than needed. Remove the bottle tip from the rectum. Stay in position for 15 to 20 minutes if possible until you feel a strong urge to have a bowel movement.If this product is used too frequently, it may cause loss of normal bowel function and an inability to have a bowel movement without using the product (laxative dependence). If you notice symptoms of overuse such as diarrhea, abdominal pain, decreased weight, or weakness, contact your doctor promptly.If you are using this product to prepare for surgery/bowel procedure, contact your doctor promptly if you do not have a bowel movement within 2 hours of using this product. He or she may need to give you other directions.Seek immediate medical attention if you think you may have a serious medical problem.

              SIDE EFFECTS: Rectal irritation/burning/itching, mild abdominal discomfort/cramps, or nausea may occur. If any of these effects persist or worsen, contact your doctor or pharmacist promptly.If your doctor has directed you to use this product, remember that he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this product do not have serious side effects.Tell your doctor right away if any of these unlikely but serious side effects occur: rectal bleeding/blisters, persistent diarrhea.Persistent diarrhea may result in dehydration. Contact your doctor promptly if you notice any symptoms of dehydration such as unusual decreased urination, unusual dry mouth/increased thirst, lack of tears, dizziness/lightheadedness, or pale/wrinkled skin.A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

              PRECAUTIONS: Before using bisacodyl, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.This product should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist if you have: intestinal blockage (obstruction).Before using this medication, tell your doctor or pharmacist your medical history, especially of: other bowel problems (e.g., ulcerative colitis, hemorrhoids, rectal bleeding), current stomach/abdominal symptoms (e.g., pain, cramping, persistent nausea/vomiting).During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.It is not known whether this drug passes into breast milk. Consult your doctor before breast-feeding.

              DRUG INTERACTIONS: Your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor or pharmacist first.Before using this medication, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use.Keep a list of all your medications with you, and share the list with your doctor and pharmacist.

              OVERDOSE: This medicine may be harmful if swallowed. If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.

              NOTES: To maintain normal bowel habits, it is important to drink plenty of fluids (four to six 8-ounce glasses daily), eat foods high in fiber, and exercise regularly.

              MISSED DOSE: Not applicable.

              STORAGE: Refer to storage information on the package label. If you have any questions about storage, ask your pharmacist. Protect from light and moisture. Do not store in the bathroom. Keep all drug products away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.

              Information last revised May 2021. Copyright(c) 2021 First Databank, Inc.

              IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

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              Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.