bisacodyl rectal (OTC)

Brand and Other Names:Fleet Bisacodyl Enema, Fleet Bisacodyl Suppository
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

enema

  • 10mg/30mL

suppository

  • 10mg

Constipation

Enema: Contents of 1 bottle (ie, 37 mL) rectally as a single dose

Suppository: Remove outer wrap and insert 1 suppository into rectum

Enema Administration

Patient should lie on left side with right knee bent

Gently insert enema tip into rectum using slight side-to-side movement; point enema tip toward navel (ease insertion by having patient bear down, as if having a bowel movement, to relax anal muscles)

Do not force enema tip into rectum

Squeeze bottle to deliver appropriate dose

Remove enema tip from rectum

Retain enema in accordance with doctor's instructions

Dosage Forms & Strengths

enema

  • 10mg/30mL

suppository

  • 10mg

Constipation

Enema

  • >12 years: As adults; contents of 1 bottle (ie, 37 mL) rectally as a single dose

Suppository

  • 6-12 years: Remove outer wrap and insert one-half suppository into rectum
  • >12 years: As adults; remove outer wrap and insert 1 suppository into rectum
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Interactions

Interaction Checker

and bisacodyl rectal

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    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

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            Contraindicated (0)

              Serious - Use Alternative (2)

              • sodium sulfate/?magnesium sulfate/potassium chloride

                sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of bisacodyl rectal 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 rectal 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.

              Monitor Closely (1)

              • deflazacort

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

              Minor (2)

              • potassium acid phosphate

                bisacodyl rectal 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 rectal 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

              Excessive diarrhea

              Electrolyte and fluid imbalance

              Rectal burning

              Vertigo

              Vomiting

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              Warnings

              Contraindications

              Hypersensitivity to drug or components

              Patients with ileus, intestinal obstruction, acute abdominal conditions like acute appendicitis, acute inflammatory bowel diseases, severe abdominal pain associated with nausea and vomiting

              Severe dehydration

              Hereditary conditions that may be incompatible with excipient (lactose or sucrose)

              Cautions

              For rectal use only

              Drug should not be taken on a continuous daily basis or for extended periods without investigating cause of constipation

              Prolonged excessive use may lead to fluid and electrolyte imbalance and hypokalemia

              Not for use in presence of abdominal pain, nausea, fever, or vomiting, or within two hours of another medicine since desired effect of other medicine may be reduced

              Intestinal loss of fluids can promote dehydration; symptoms may include thirst and oliguria

              In patients suffering from fluid loss where dehydration may be harmful (eg, renal insufficiency, elderly patients) drug should be discontinued and only be restarted under medical supervision

              Patients may experience hematochezia (blood in stool) that is generally mild and self-limiting

              Dizziness and/or syncope reported in patients who have taken this drug; details available for these cases suggest that events would be consistent with defecation syncope (or syncope attributable to straining at stool), or with a vasovagal response to abdominal pain related to constipation and not necessarily to administration of this drug itself

              The use of suppositories may lead to painful sensations and local irritation, especially in patients with anal fissures and ulcerative proctitis, and should be used in these conditions under medical advice or as directed by physician

              Stimulant laxatives including this drug do not help with weight loss

              Since extended use of any laxative can cause dependence for bowel function, do not take for more than one week unless directed by a health professional

              If used every day for a week does not result in a bowel movement, a doctor should be consulted immediately

              Children should not be given this drug without medical advice

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              Pregnancy & Lactation

              Pregnancy

              There are no adequate and well-controlled studies in pregnant women

              Recommended that medical advice from a physician first be obtained for use during pregnancy

              No studies on effect of human fertility conducted

              Lactation

              Clinical data show that neither the active moiety of bisacodyl, BHPM (bis-(p-hydroxyphenyl)-pyridyl-2-methane), nor its glucuronides are excreted into milk of healthy lactating human females; thus, this drug can be used during breast-feeding

              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

              May irritate the colonic intramural plexus of the intestine; alters water and electrolyte secretion, which in turn produces net intestinal fluid accumulation and laxation

              Pharmacokinetics

              Onset of action: 15-60 min

              Half-life: 8 hr (BHPM metabolite)

              Metabolism: Metabolized to BHPM in the colon

              Excretion: Urine (BHPM) and bile

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              Images

              BRAND FORM. UNIT PRICE PILL IMAGE
              Fleet Enema rectal
              -
              19-7 gram/118 mL enema
              Fleet Enema rectal
              -
              19-7 gram/118 mL enema
              Fleet Enema rectal
              -
              19-7 gram/118 mL enema
              Fleet Enema rectal
              -
              19-7 gram/118 mL enema
              Fleet Pediatric rectal
              -
              9.5-3.5 gram/59 mL enema
              Enema Disposable rectal
              -
              19-7 gram/118 mL enema
              Enema rectal
              -
              19-7 gram/118 mL enema

              Copyright © 2010 First DataBank, Inc.

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              Patient Education
              sodium phosphates oral

              SODIUM PHOSPHATE MONOBASIC/DIBASIC SOLUTION - ORAL

              (SOE-dee-um FOS-fate MAW-no-BAY-sik/dye-BAY-sik)

              WARNING: Rarely, serious kidney problems have occurred with the use of this product. Heart failure, kidney disease, bowel problems (such as blockage, ulcerative colitis), or being older than 55 years can increase the risk. Taking certain medications that can affect the kidneys (see Drug Interactions section) can also increase the risk. If any of these cautions apply to you, talk with your doctor before using this drug.

              USES: This medication may be used to relieve occasional constipation. However, when treating constipation, you should use milder products (such as stool softeners, bulk-forming laxatives) whenever possible. Talk to your doctor or pharmacist about other treatment options. Your doctor may also prescribe this product (usually along with other products) to clean stool from the intestines before surgery or certain bowel procedures (such as colonoscopy, radiography). Use it only as directed by your doctor.Sodium phosphate is a saline laxative that is thought to work by increasing fluid in the small intestine. It usually results in a bowel movement after 30 minutes to 6 hours.Do not use this medication in children younger than 5 years of age unless directed by the doctor.

              HOW TO USE: Read and follow all directions on the product package. If you have any questions, ask your doctor or pharmacist. To improve the taste, this product may be chilled in the refrigerator before use. Do not freeze. Mix your dose in 8 ounces (240 milliliters) of liquid and drink the mixed solution. Since your bowel movements can be very large/watery, drink plenty of clear liquids so that you do not become dehydrated.If your doctor has directed you to use this product before surgery or a bowel procedure, your doctor should tell you how long before the surgery/procedure you should take this product. Follow your doctor's directions closely. After taking the medication, drink plenty of clear liquids as directed by your doctor. Doing so will help prevent serious side effects (such as kidney problems, dehydration). Talk with your doctor about types of liquids you can drink before your procedure.Dosage is based on your medical condition, procedure, age, and response to treatment. Do not take more of this medication than directed, use this medication more often than once in 24 hours, or use this medication for more than 3 days unless directed by your doctor. Also, do not use any other laxative products while using this product unless directed by your doctor. Doing so may increase your risk for severe side effects.If you are seeing a doctor for any medical problems, are on a salt-restricted diet, or if you are taking any other medications, do not use this medication to treat yourself for constipation without consulting your doctor.This medication may cause a condition known as laxative dependence, especially if it has been used regularly for a long time. In such cases, ongoing constipation and loss of normal bowel function may occur. For most people with occasional constipation, a bulk-forming laxative (such as psyllium) or a stool softener (such as docusate) is a better and safer product. To prevent laxative dependence, consult your doctor if you need to use this medication or other laxative products for more than 7 days.Stop using this product and contact your doctor promptly if you do not have a bowel movement within 6 hours of using this product, if you have symptoms of dehydration (see Side Effects section), if you bleed from the rectum, or if you think you may have a serious medical problem.

              SIDE EFFECTS: Mild abdominal discomfort/cramps, gas, or nausea may occur. If any of these effects last or get worse, contact 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.Diarrhea that doesn't go away may result in dehydration. This may cause serious side effects to the kidneys and heart. Contact your doctor promptly if you notice any symptoms of dehydration, such as unusual dry mouth/increased thirst, lack of tears, dizziness/lightheadedness, or pale/wrinkled skin.Tell your doctor right away if you have any serious side effects, including: stomach/abdominal pain that is severe or doesn't go away, diarrhea that doesn't go away, signs of kidney problems (such as change in the amount of urine), bloody stools, rectal bleeding, mental/mood changes (such as confusion, unusual drowsiness), muscle weakness/spasm, swelling of the hands/ankles/feet.Get medical help right away if you have any very serious side effects, including: chest pain, slow/irregular/fast heartbeat, seizures.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 taking sodium phosphate, 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 medication, tell your doctor or pharmacist your medical history, especially of: dehydration, high/low levels of certain minerals in the blood (such as potassium, calcium, sodium, phosphate), kidney disease, current stomach/abdominal symptoms (such as nausea/vomiting that doesn't stop, pain, cramping), bowel problems (such as blockage, ulcerative colitis, hemorrhoids), laxative use for constipation in the past week, heart disease (such as heart failure, chest pain, irregular heartbeat, edema), liver disease, sodium-restricted diet.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 daily for more than 1 week. These could be symptoms of a serious medical problem.Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).Young children may be more sensitive to the side effects of this drug, especially dehydration and kidney problems.Older adults may be more sensitive to the side effects of this drug, especially dehydration and kidney problems.During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.It is not known if 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 include: burosumab, other drugs that may affect the kidneys (for example, ACE inhibitors such as lisinopril, ARBs such as valsartan, diuretics/"water pills" such as furosemide/hydrochlorothiazide, NSAIDs such as ibuprofen/naproxen).The watery bowel movements from sodium phosphate may cause your body to absorb less of your regular medicines and get less benefit from them. Consult your doctor or pharmacist about how to reduce this effect.

              OVERDOSE: 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. Symptoms of overdose may include: muscle weakness, fast/slow/irregular heartbeat, mental/mood changes (such as confusion).

              NOTES: Keep all regular medical and laboratory appointments.Laboratory and/or medical tests (such as kidney tests, blood mineral levels) may be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details.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. Do not freeze. 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.

              Information last revised February 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.