II. Indications
III. Precautions
- Avoid chronic use of Stimulant Laxatives (see adverse effects below)
IV. Mechanism
- Simulant Laxative
- Bisacodyl is a Diphenylmethane, a synthetic pyridinylmethylene-diacetate ester derivative
- Direct parasympathetic effects at mucosal Sensory Nerves, increasing peristaltic contraction
V. Medications
- Various trade names including Dulcolax and Correctol
- Correctol was previously formulated with Phenolphthalein (off U.S. market as of 2009)
- Tablets: 5 mg
- Suppository: 10 mg
VI. Dosing: Oral
- See Colonoscopy Bowel Preparation
- See Constipation Prophylaxis in Chronic Opioid Use
-
General
- Swallow tablets whole (do not chew)
- Avoid within 1 hour of milk or Antacids
- Onset in 6 to 10 hours
- Adult (and age >10 years)
- Take 5 to 15 mg orally daily after breakfast as needed
- Dose may be be titrated from 1 to 3 tablets orally (5 to 15 mg)
- Constipation Prophylaxis in Chronic Opioid Use uses doses as high as 3 tabs twice daily
- Child (3 to 10 years old)
- Give 5 mg orally after breakfast as needed
- May increase to 10 mg orally per day
VII. Dosing: Rectal
VIII. Pharmacokinetics
- Onset of activity
- Oral: 6 to 10 hours
- Rectal: 60 minutes
X. Adverse Effects: Long-Term (Laxative abuse)
- See Stimulant Laxative
- Avoid prolonged use (habit forming)!
- Colonic denervation and atony (Cathartic colon)
- Decreased motility of right colon with secondary worsening Constipation
- Associated with Anthraquinone Laxatives
- Results from myenteric plexus injury
-
Electrolyte and nutritional disturbance
- Hypokalemia
- Sodium overload
- Protein-losing Enteropathy
-
Melanosis coli
- Benign darkening of colonic mucosa
- Macrophage deposition in lamina propria
XI. Safety
- Pregnancy Category C
- Unknown safety in Lactation
XII. Resources
- Bisacodyl Tablet (DailyMed)
- Bisacodyl Suppository (DailyMed)
XIII. References
- (2023) Management of Constipation, Presc Lett, #390108
Images: Related links to external sites (from Bing)
Related Studies
bisacodyl (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
BISACODYL 10 MG SUPPOSITORY | Generic OTC | $0.26 each |
BISACODYL EC 5 MG TABLET | Generic OTC | $0.03 each |
Ontology: Bisacodyl (C0005632)
Definition (NCI) | A synthetic pyridinylmethylene-diacetate ester derivative stimulant laxative, Bisacodyl acts with a parasympathetic effect directly on mucosal sensory nerves, increasing peristaltic contractions. It is used for occasional constipation, in pre- and postoperative treatment, and in conditions that require facilitation of defecation. (NCI04) |
Definition (MSH) | A diphenylmethane stimulant laxative used for the treatment of constipation and for bowel evacuation. (From Martindale, The Extra Pharmacopoeia, 30th ed, p871) |
Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
MSH | D001726 |
SnomedCT | 391851004, 13565005, 387075009 |
LNC | LP14916-8, MTHU002176 |
English | Bisacodyl, Phenol, 4,4'-(2-pyridinylmethylene)bis-, diacetate (ester), bisacodyl (medication), bisacodyl, Bisacodyl [Chemical/Ingredient], BISACODYL, Bisacodyl - chemical (substance), Bisacodyl - chemical, Bisacodyl (product), Bisacodyl (substance), Bisacodyl, NOS |
Swedish | Bisakodyl |
Czech | bisakodyl |
Finnish | Bisakodyyli |
Russian | BISAKODIL, БИСАКОДИЛ |
Japanese | ビサコジル |
Polish | Bisakodyl |
Spanish | bisacodilo (producto), bisacodilo (sustancia), bisacodilo, Bisacodilo |
French | Bisacodyl |
German | Bisacodyl |
Italian | Bisacodil |
Portuguese | Bisacodil |
Ontology: Dulcolax (C0591416)
Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
MSH | D001726 |
English | Dulco-lax, dulcolax, dulco-lax, Dulcolax, Boehringer Ingelheim Brand of Bisacodyl, Dulco Lax, Dulco lax perles, Dulco-Lax, Dulco-lax perles, Dulcolax perles, Durolax, Florisan N, Novartis Brand of Bisacodyl |
Ontology: Correctol laxative (C0618983)
Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
MSH | C038509 |
English | Correctol laxative, Correctol (obsolete), Correctol Capl (obsolete) |