III. Precautions

  1. Avoid chronic use of Stimulant Laxatives (see adverse effects below)

IV. Mechanism

  1. Simulant Laxative
  2. Bisacodyl is a Diphenylmethane, a synthetic pyridinylmethylene-diacetate ester derivative
  3. Direct parasympathetic effects at mucosal Sensory Nerves, increasing peristaltic contraction

V. Medications

  1. Various trade names including Dulcolax and Correctol
    1. Correctol was previously formulated with Phenolphthalein (off U.S. market as of 2009)
  2. Tablets: 5 mg
  3. Suppository: 10 mg

VI. Dosing: Oral

  1. See Colonoscopy Bowel Preparation
  2. See Constipation Prophylaxis in Chronic Opioid Use
  3. General
    1. Swallow tablets whole (do not chew)
    2. Avoid within 1 hour of milk or Antacids
    3. Onset in 6 to 10 hours
  4. Adult (and age >10 years)
    1. Take 5 to 15 mg orally daily after breakfast as needed
    2. Dose may be be titrated from 1 to 3 tablets orally (5 to 15 mg)
    3. Constipation Prophylaxis in Chronic Opioid Use uses doses as high as 3 tabs twice daily
  5. Child (3 to 10 years old)
    1. Give 5 mg orally after breakfast as needed
    2. May increase to 10 mg orally per day

VII. Dosing: Rectal

  1. Onset in 60 minutes
  2. Adult (and age >10 years)
    1. Take 10 mg per Rectum once daily or up to 3 times per week
  3. Child (2 to 10 years)
    1. Give 5 mg per Rectum daily as needed
    2. May increase to 10 mg rectally per day

VIII. Pharmacokinetics

  1. Onset of activity
    1. Oral: 6 to 10 hours
    2. Rectal: 60 minutes

IX. Adverse Effects: Short-Term

  1. Nausea
  2. Vomiting
  3. Abdominal Cramping

X. Adverse Effects: Long-Term (Laxative abuse)

  1. See Stimulant Laxative
  2. Avoid prolonged use (habit forming)!
  3. Colonic denervation and atony (Cathartic colon)
    1. Decreased motility of right colon with secondary worsening Constipation
    2. Associated with Anthraquinone Laxatives
    3. Results from myenteric plexus injury
  4. Electrolyte and nutritional disturbance
    1. Hypokalemia
    2. Sodium overload
    3. Protein-losing Enteropathy
  5. Melanosis coli
    1. Benign darkening of colonic mucosa
    2. Macrophage deposition in lamina propria

XI. Safety

  1. Pregnancy Category C
  2. Unknown safety in Lactation

XIII. References

  1. (2023) Management of Constipation, Presc Lett, #390108

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Related Studies

Cost: Medications

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)