Bisacodyl

Table of contents

  • Brand Names
  • Drug Combinations
  • Chemistry
  • Pharmacologic Category
  • Mechanism of Action
  • Therapeutic Use
  • Pregnancy and Lactation Implications
  • Contraindications
  • Warnings and Precautions
  • Adverse Reactions
  • Toxicological Effects
  • Drug Interactions
  • Nutrition/Nutraceutical Interactions
  • Dosage
  • Pharmacokinetics and Pharmacodynamics
  • Special Considerations

Brand Names

Europe

Austria: Dulcolax; Belgium: Bisacodyl, Bisolax, Carters, Dulcolax Bisacodyl, Henafurine, Mucinum, Purgo-Pil; Cyprus: Dissilax, Dulcolax, Laxadyl; Czech Republic: Bisacodyl, Dulcolax, Fenolax, Stadalax; Denmark: Dulcolax, Perilax, Toilax; Estonia: Bisakodil; Finland: Metalax, Toilax; France: Contalax, Dulcolax; Germany: Bisacodyl; Greece: Dulcolax, Manaron, Sedolax; Ireland: Dulcolax, Toilax; Italy: Alaxa, Dulcolax; Latvia: Bisacodyl, Bolax, Laxadin; Lithuania: Bisacodyl; Luxembourg: Bekunis B, Laxans, Purgo-Pil, Tirgon; Netherlands: Bisacodyl, Dulcolax, Kruidvat Laxeertabletten, Laxeerdragees, Laxeertabletten bisacodyl, Nourilax, Trekpleister Laxeertabletten; Poland: Bisacodyl, Pyrilax; Portugal: Bekunis Laxante Bisacodil, Dulcolax, Moderlax; Romania: Bisacodil, Dulcolax, Laxamag, Stadalax; Slovakia: Bisacodyl, Dulcolax, Fenolax, Stadalax; Slovenia: Dulcolax; Spain: Bekunis Complex, Dulco-Laxo, Laxabixal; Sweden: Dulcolax, Toilax; UK: Bisacodyl, Dulcolax.

North America

Canada: Bisacodyl, Carter’s Little Pills, Dulcolax, Gentlax; USA: Alophen, Bisac-Evac, Bisacodyl, Biscolax, Correctol, Dacodyl, Doxidan, Dulcolax, ex-lax Ultra, Fematrol, Femilax, Fleet Bisacodyl, Fleet Stimulant Laxative, Veracolate.

Latin America

Argentina: Dulcolax, Modatón; Brazil: Bisalax, Cronoplex, Dulcolax, Fideíne, Isilax, Plesonax; Mexico: Dulcolán, Dulcolax.

Asia

Japan: Ainsoft, Derderance, Satolax, Teleminsoft.

Drug combinations

Bisacodyl and Sodium Phosphate

Chemistry

Bisacodyl: C~22~H~19~NO~4~. Mw: 361.39. (1) Phenol, 4,4′-(2-pyridinylmethylene)bis-, diacetate (ester); (2) 4,4′-(2-Pyridylmethylene)diphenol diacetate (ester). CAS-603-50-9.

Bisacodyl Tannex: Water-soluble complex of bisacodyl and tannic acid. Phenol, 4,4′-(2-pyridinylmethylene)bis-, diacetate (ester), complex with tannic acid. CAS-1336-29-4 (1963).

Pharmacologic Category

Cathartics and Laxatives. (ATC-Code: A06AB02; A06AG02).

Mechanism of action

Promotes evacuation of the colon. Stimulates peristalsis by directly irritating the smooth muscle of the intestine, possibly the colonic intramural plexus. Alters water and electrolyte secretion producing net intestinal fluid accumulation and laxation. Action is independent of intestinal tone. The tannic acid present in the bisacodyl tannex complex precipitates protein and its astringent effect decreases mucus secretion in the large intestine and may facilitate adherence of contrast media to mucous membranes.

Therapeutic use

Treatment of occasional constipation. Colonic evacuation prior to procedures or examination. Has been used to facilitate flushing of colostomies (may eliminate the need for irrigations). Bisacodyl is added to barium sulfate enemas to aid in coating the intestinal mucosa.

Pregnancy and lactiation implications

Do not use during pregnancy (suppositories may be used to cleanse the colon in pregnant women prior to delivery if they are given at least 2 hours before onset of the second stage of labor) or lactation (may be distributed into milk; other laxatives are preferred for postpartum constipation).

Unlabeled use

Contraindications

Hypersensitivity to bisacodyl or any component of the formulation. Acute abdominal pain, nausea, vomiting, or other symptoms of appendicitis or undiagnosed abdominal pain or rectal bleeding. Intestinal obstruction. Do not use kits containing bisacodyl tablets, sodium phosphate enemas, and bisacodyl suppositories or enemas in megacolon, GI obstruction, ascites, congestive heart failure, renal disease or in children <5 years of age. Do not use during pregnancy or lactation. Do not use in children <10 years of age.

Warnings and precautions

Excessive use may lead to fluid and electrolyte imbalance. May result in laxative dependence and loss of normal bowel function (structural damage to the myenteric plexus, severe and permanent interference with colonic motility, and hypertrophy of the muscularis mucosae) with prolonged use. Discoloration of urine may occur. Factitious diarrhea may occur. Electrolyte disturbances including hypokalemia, hypocalcemia, metabolic acidosis or alkalosis, abdominal pain, diarrhea, malabsorption, weight loss, and protein-losing enteropathy may occur (on occasions osteomalacia, secondary aldosteronism, and tetany). «Cathartic colon» with atony and dilation of the colon may occur with habitual use. Do not give other sodium phosphate-containing preparations concomitantly. Antacid or milk should not be consumed within 2 hours of taking drug. Do not use if abdominal pain, nausea, or vomiting are present. Re-consider treatment if bleeding occurs or if constipation is not relieved. Caution in pre-existing diabetes mellitus since some preparations contain sugar.

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