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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            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
              Alophen (bisacodyl) oral
              -
              5 mg tablet
              Fleet Bisacodyl rectal
              -
              10 mg/30 mL enema
              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
              Dulcolax (bisacodyl) rectal
              -
              10 mg suppos
              Dulcolax (bisacodyl) rectal
              -
              10 mg suppos
              Dulcolax (bisacodyl) rectal
              -
              10 mg suppos
              Women's Gentle Laxative (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
              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

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              Patient Handout

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              Patient Education
              bisacodyl rectal

              BISACODYL SUPPOSITORY - RECTAL

              (bis-AK-oh-dil)

              COMMON BRAND NAME(S): Dulcolax, Fleet Bisacodyl, Magic Bullet

              USES: This product is used to treat constipation. However, milder products (such as 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.The normal frequency of bowel movements varies from once daily to 1 to 2 times weekly. Constipation is best treated by drinking plenty of fluids (four to six 8-ounce glasses daily), eating foods high in fiber, and exercising regularly.This product is not recommended for use in children younger than 6 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 or use as directed by your doctor. If you have any questions, ask your doctor or pharmacist. If the suppository is too soft to insert, chill in the refrigerator for 30 minutes or run cold water over it before removing the foil wrapper.Wash your hands before and after using this product. Remove the foil wrapper. If desired, the suppository may be moistened with lukewarm water. Do not use petroleum jelly or mineral oil. Doing so may cause the product to be less effective. Lie on your left side with the right knee slightly bent. Gently insert the suppository, pointed end first, toward the navel and well up into the rectum. After insertion, 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.Consult your doctor promptly if you do not have a bowel movement after using this product or 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 last or get worse, tell your doctor or pharmacist promptly.If your doctor has directed you to use this product, remember that your doctor 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 you have any serious side effects, including: diarrhea that doesn't stop, rectal bleeding/blisters.Diarrhea that doesn't stop 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, get medical help right away 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.Before using this product, tell your doctor or pharmacist your medical history, especially of: other bowel problems (such as blockage, ulcerative colitis, hemorrhoids, rectal bleeding), current stomach/abdominal symptoms (such as nausea/vomiting that doesn't stop, pain, cramping).Consult your doctor before using this product if you have had a sudden change in bowel habits lasting more than 2 weeks, or if you need to use a laxative for more than 1 week. These could be symptoms of a serious medical problem.This product may be used during labor/delivery to clean the bowels before the second stage of labor (pushing phase). At other times during pregnancy, this product 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: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Some products that may interact with this drug are: other laxatives (including castor oil, stool softeners, lubricants such as mineral oil).

              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: Laxatives should be used only temporarily if needed for constipation. High doses or frequent use can lead to ongoing constipation and laxative dependence. (See also How to Use section.)

              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 heat, direct light, and moisture. Do not store in the bathroom. Keep all medications 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.

              Information last revised April 2022. Copyright(c) 2022 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.