bis·ac·o·dyl (b s- k  -dl, bs -k dl)n. An over-the-counter laxative taken by mouth or per rectum to treat constipation. |
bisacodyl
bisacodyl [bis-ak´o-dil]
bisacodyl (bisak´
dil),drug class: laxative, stimulant;
ac-tion: acts directly on intestine by increasing motor activity;
uses: short-term treatment of constipation, and bowel or rectal preparation for surgery or examination.
bisacodyl
Alophen, Apo-Bisacodyl (CA), Biolax (UK), Bisac-Evac, Carter's Little Pills (CA), Correctol, Doxidan, Dulcolax, Entrolax (UK), Femilax, Feen-a-Mint, Fleet Stimulant Laxative, Gentlax (CA), Laxit (CA), Modane Tablet
Pharmacologic class: Stimulant laxative
Therapeutic class: Laxative
Pregnancy risk category B
Action
Unclear. Thought to stimulate colonic mucosa, producing parasympathetic reflexes that enhance peristalsis and increase water and electrolyte secretion, thereby causing evacuation of colon.
Availability
Enema: 0.33 mg/ml, 10 mg/ml
Powder for rectal solution: 1.5 mg bisacodyl and 2.5 g tannic acid
Suppositories (rectal): 5 mg, 10 mg
Tablets (enteric-coated): 5 mg
⊘Indications and dosages
➣ Constipation; bowel cleansing for childbirth, surgery, and endoscopic examination
Adults and children ages 12 and older: 5 to 15 mg P.O. Maximum daily dosage is 30 mg/day P.O. or 10 mg P.R.
Children ages 3 to 11: 5 to 10 mg (0.3 mg/kg) P.O. as a single dose or 5 to 10 mg P.R. as a single dose
Children ages 2 and younger: 5 mg P.R. as a single dose
Contraindications
• Hypersensitivity to drug
• Intestinal obstruction
• Gastroenteritis
• Appendicitis
Precautions
Use cautiously in:
• hypersensitivity to tannic acid
• severe cardiovascular disease, anal or rectal fissures
• pregnant or breastfeeding patients.
Administration
• Make sure patient swallows tablets whole without chewing.
• Don't give tablets within 1 hour of dairy products or antacids (may break down enteric coating).
• Know that drug should be used only for short periods.
| Route | Onset | Peak | Duration |
| P.O. | 6-12 hr | Variable | Variable |
| P.R. | 15-60 min | Variable | Variable |
Adverse reactions
CNS: dizziness, syncope
GI: nausea, vomiting, diarrhea (with high doses), abdominal pain, burning sensation in rectum (with suppositories), laxative dependence, protein-losing enteropathy
Metabolic: hypokalemia, fluid and electrolyte imbalances, tetany, alkalosis
Musculoskeletal: muscle weakness (with excessive use)
Interactions
Drug-drug. Antacids: gastric irritation, dyspepsia
Drug-diagnostic tests. Calcium, magnesium, potassium: decreased levels
Phosphate, sodium: increased levels
Drug-food. Dairy products: gastric irritation
Patient monitoring
• Assess stools for frequency and consistency.
• Monitor patient for electrolyte imbalances and dehydration.
Patient teaching
• Instruct patient to swallow (not chew) enteric-coated tablets no sooner than 1 hour before or after ingesting antacids or dairy products. Tell him not to chew tablets.
• Advise patient not to use bisacodyl or other laxatives habitually because this may lead to laxative dependence.
• Suggest other ways to prevent constipation, such as by eating more fruits, vegetables, and whole grains to increase dietary bulk and by drinking 8 to 10 glasses of water daily.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, tests, and foods mentioned above.
bisacodyl
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