Adult: For preparation of diagnostic procedures and in pre- and postoperative treatment: 10 mg for 2 doses given in the morning and evening, followed by 10 mg rectal supp/enema on the following morning. Child: 4-10 years 5 mg in the evening, followed by 5 mg rectal supp on the following morning; >10 years Same as adult dose. Dosing recommendations may vary among individual products and between countries (refer to specific product guidelines).
Oral Constipation
Adult: For short-term relief of occasional constipation, or either chronic or of recent onset, whenever a stimulant laxative is required: 5-10 mg once daily before bedtime. Alternatively, up to 15 mg daily. Child: 4-10 years 5 mg once daily before bedtime; >10 years Same as adult dose. Dosing recommendations may vary among individual products and between countries (refer to specific product guidelines).
Rectal Constipation
Adult: As supp or enema: 10 mg once daily. Child: >4-10 years As supp: 5 mg daily; >10 years Same as adult dose. Dosing recommendations may vary among individual products and between countries (refer to specific product guidelines).
Administration
Should be taken on an empty stomach. Do not take w/in 1 hr of antacids, milk or other dairy products.
Contraindications
Ileus, intestinal obstruction, acute surgical abdominal conditions (e.g. appendicitis, acute inflammatory bowel disease, severe abdominal pain associated with nausea and vomiting), severe dehydration. Rectal: Anal fissures, proctitis or ulcerated haemorrhoids.
Special Precautions
Children. Pregnancy and lactation. Avoid prolonged use (>5 days).
This drug may cause dizziness or syncope, if affected, do not drive or operate machinery.
Overdosage
Symptoms: Watery stools, abdominal cramps, fluid and electrolytes loss. Chronic case: Chronic diarrhoea, abdominal pain, hypokalaemia, secondary hyperaldosteronism, renal calculi, renal tubular damage, metabolic alkalosis, muscle weakness. Management: Perform gastric lavage or induce vomiting to minimise absorption. Fluid replacement and correction of electrolyte imbalance may be required.
Drug Interactions
High dose of bisacodyl may increase the risk of electrolyte imbalance with concomitant use of diuretics or adrenocorticosteroids. Enhanced gastrointestinal adverse effects with concomitant use of other laxatives. Decreased therapeutic effect and increased risk of dyspepsia and gastric irritation with concomitant use of antacids.
Food Interaction
Increased risk of dyspepsia and gastric irritation with milk products.
Action
Description: Bisacodyl, a diphenylmethane derivative, directly irritates the smooth muscle of the intestine, possibly the colonic intramural plexus, thereby stimulating peristalsis. It alters water and electrolyte secretion, producing net intestinal fluid accumulation and stimulates defaecation. Onset: Laxative effect: 6-12 hours (oral); within 15-60 minutes (suppository); within 5-20 minutes (enema). Pharmacokinetics: Absorption: Systemic absorption: <5%. Distribution: Volume of distribution: 289 L (BHPM). Metabolism: Metabolised in the colon to active metabolite, bis-(-p-hydroxyphenyl)-pydidyl-2-methane (BHPM); further metabolised in the liver to a glucuronide salt. Excretion: Via urine, bile (as BHPM). Elimination half-life: Approx 8 hours (BHPM).
Chemical Structure
Bisacodyl Source: National Center for Biotechnology Information. PubChem Compound Summary for CID 2391, Bisacodyl. https://pubchem.ncbi.nlm.nih.gov/compound/Bisacodyl. Accessed June 28, 2022.
Storage
Tablet: Store below 25°C. Protect from humidity. Supp/Enema: Store below 30°C. Protect from light.
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