The P-I-E-N-O Parkinsn's List Drug Database
bisacodyl / DulcolaxTM
LAXATIVE:
Description: Bisacodyl and bisacodyl tannex, derivatives of diphenylmethane, are stimulant laxatives used to treat constipation. Bisacodyl often is used to prepare patients for radiological examinations of the colon, sigmoidoscopy, and proctologic examinations. Bisacodyl was approved by the FDA in October 1957. It is administered either orally as a tablet or rectally as an enema or rectal suppository.
Mechanism of Action: Stimulant laxatives are believed to produce laxation by directly stimulating peristaltic movement of the intestine via local mucosal irritation, thus increasing motility. More recent studies suggest that bisacodyl promotes evacuation of the colon by altering intestinal fluid and electrolyte absorption. This causes a net intestinal fluid accumulation and produces laxation.
Pharmacokinetics: Bisacodyl is administered either orally or rectally. Bisacodyl is minimally absorbed (15%), and the onset of action of the drug begins 6-8 hours after an oral dose and 15- 60 minutes after rectal administration. Bisacodyl distributes locally, and the circulating drug undergoes hepatic metabolism and is then excreted in the urine.
CONTRAINDICATIONS/PRECAUTIONS: All laxatives are contraindicated in patients with appendicitis, GI obstruction, abdominal conditions requiring surgery, or undiagnosed abdominal pain.
Stimulant laxatives, such as bisacodyl, are the laxatives most likely to cause GI irritation, fluid and electrolyte loss, nausea, vomiting, or diarrhea.
Laxative dependence can occur with long-term or excessive laxative therapy.
Bisacodyl administration can exacerbate ulcerative colitis, rectal fissures, ulcerative lesions of the colon, and fecal impaction. Therefore, the drug is contraindicated in patients with these conditions.
Prolonged bisacodyl therapy can cause potassium depletion.
If multiple enemas are required, bisacodyl tannex should not be used because of the risk of increased absorption of tannic acid, leading to hepatotoxicity and possibly death. Recommended dosages of bisacodyl tannex should not be exceeded.
Bisacodyl tannex is contraindicated in patients under the age of 10 years because the risk of absorbing tannic acid has not been studied in this population.
The safety of bisacodyl usage during pregnancy has not been determined, so use of the drug should be avoided in women of childbearing age or during pregnancy, unless the potential benefits outweigh the risks.
DRUG INTERACTIONS: Concomitant use of bisacodyl oral tablets and antacids, milk, or other drugs that cause an increase in gastric pH levels can cause the enteric coating of the drug to dissolve prematurely, leading to possible gastric or intestinal irritation.
ADVERSE REACTIONS: Stimulant laxatives, such as bisacodyl, are the laxatives most likely to cause GI irritation, fluid and electrolyte loss, or diarrhea. Short-term usage (at normal dosages) typically results in abdominal pain or cramps, faintness, nausea/vomiting, or mild abdominal discomfort.
Prolonged bisacodyl therapy can cause hypokalemia.
Rectal suppositories of bisacodyl can cause burning and mild proctitis.
Prolonged use of stimulant laxatives can result in dependence, leading to constipation when use is interrupted.
PATIENT INFORMATION:
What do bisacodyl tablets do?
Bisacodyl (DulcolaxTM ) is a stimulant laxative, a medicine that empties the bowel. Bisacodyl treats constipation; empties and prepares the colon (bowel) for rectal or colon exams (diagnostic tests) or surgery. Generic bisacodyl tablets are available.
What should my doctor, dentist, or pharmacist know before I take bisacodyl?
They need to know if you have any of these conditions
How should I take this medicine?
Take bisacodyl tablets by mouth. Follow the directions on the prescription label. Swallow the tablets whole with a good drink of water; do not crush or chew. Take exactly as directed; do not exceed the recommended dose, and do not take more often than directed. Bisacodyl is not intended for long-term use.
Special precautions for use in children:
The tablet form of bisacodyl is not recommended for children under 6 years old.
What if I miss a dose?
This does not apply. Bisacodyl tablets are not for regular use, but are taken on an as needed basis.
What other medicines can interact with bisacodyl?
What side effects may I notice from taking bisacodyl?
Serious side effects with bisacodyl are more likely from over use of this medicine; they include:
Call your doctor as soon as you can if you get any of these side effects.
Minor side effects with bisacodyl include:
Let your doctor know about these side effects if they do not go away or if they annoy you.
What do I need to watch for while I take bisacodyl?
Do not use bisacodyl for more than one week without consulting your doctor. Long-term use or use of large doses also can lead to laxative dependence and chronic constipation.
Antacids and milk can destroy the protective coating on bisacodyl tablets and upset your stomach. Do not take antacids and milk within 1 to 2 hours of the bisacodyl dose.
Where can I keep my medicine?
Keep out of the reach of children in a container that small children cannot open.
Store at room temperature below 25C (77F). Protect from moisture. Throw away any unused medicine after the expiration date.
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