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Medication Safety Issues

Sound-alike/look-alike issues:

Doxidan® may be confused with doxepin

Modane® may be confused with Matulane®, Moban®

Pronunciation

(bis a KOE dil)

U.S. Brand Names

• Alophen® [OTC]
• Bisac-Evac™ [OTC]
• Bisacodyl Uniserts® [OTC] [DSC]
• Biscolax™ [OTC]
• Correctol® Tablets [OTC]
• Dacodyl™ [OTC]
• Doxidan® [OTC]
• Dulcolax® [OTC]
• ex-lax® Ultra [OTC]
• Fematrol [OTC]
• Femilax™ [OTC]
• Fleet® Bisacodyl [OTC]
• Fleet® Stimulant Laxative [OTC]
• Veracolate [OTC]

Generic Available

Yes: Excludes enema

Canadian Brand Names

• Apo-Bisacodyl®
• Carter's Little Pills®
• Dulcolax®
• Gentlax®

Pharmacologic Category

• Laxative, Stimulant

Pharmacologic Category Synonyms

• Stimulant Laxative

Use: Labeled Indications

Treatment of constipation; colonic evacuation prior to procedures or examination

Pregnancy Risk Factor

C

Contraindications

Hypersensitivity to bisacodyl or any component of the formulation; abdominal pain or obstruction, nausea, or vomiting

Adverse Reactions

<1%:

Central nervous system: Vertigo

Endocrine & metabolic: Electrolyte and fluid imbalance (metabolic acidosis or alkalosis, hypocalcemia)

Gastrointestinal: Mild abdominal cramps, nausea, vomiting, rectal burning

Drug Interactions

Antacids: May diminish the therapeutic effect of Bisacodyl. Antacids may cause the delayed-release bisacodyl tablets to release drug prior to reaching the large intestine. Gastric irritation and/or cramps may occur. Risk D: Consider therapy modification

Ethanol/Nutrition/Herb Interactions

Food: Milk or dairy products may disrupt enteric coating, increasing stomach irritation.

Mechanism of Action

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

Pharmacodynamics/Kinetics

Onset of action: Oral: 6-10 hours; Rectal: 0.25-1 hour

Absorption: Oral, rectal: Systemic, <5%

Dosage

Children:

Oral: >6 years: 5-10 mg (0.3 mg/kg) at bedtime or before breakfast

Rectal suppository:

<2 years: 5 mg as a single dose

>2 years: 10 mg

Adults:

Oral: 5-15 mg as single dose (up to 30 mg when complete evacuation of bowel is required)

Rectal suppository: 10 mg as single dose

Administration: Oral

Administer with a glass of water on an empty stomach for rapid effect. Do not administer within 1 hour of milk, any dairy products, or taking an antacid, to protect the coating.

Dietary Considerations

Should not be administered within 1 hour of milk, any dairy products, or taking an antacid, to protect the coating. Should be administered with a glass of water on an empty stomach for rapid effect.

Geriatric Considerations

The chronic use of stimulant cathartics is inappropriate and should be avoided; although constipation is a common complaint from elderly, such complaints require evaluation; elderly are often predisposed to constipation due to disease, drugs, immobility, and a decreased fluid intake, partially because they have a blunted “thirst reflex” with aging; short-term use of stimulants is best; if prophylaxis is desired, this can be accomplished with bulk agents (psyllium), stool softeners, and hyperosmotic agents (sorbitol 70%); stool softeners are unnecessary if stools are well hydrated, soft, or “mushy”.

Dental Health: Effects on Dental Treatment

No significant effects or complications reported

Dental Health: Vasoconstrictor/Local Anesthetic Precautions

No information available to require special precautions

Mental Health: Effects on Mental Status

None reported

Mental Health: Effects on Psychiatric Treatment

None reported

Oncology: Emetic Potential

Very low (<10%)

Dosage Forms

Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product

Solution, rectal [enema]:

Fleet® Bisacodyl: 10 mg/30 mL (37 mL)

Suppository, rectal: 10 mg

Bisac-Evac™, Bisacodyl Uniserts® [DSC], Biscolax™, Dulcolax®: 10 mg

Tablet [enteric coated]: 5 mg

Alophen®, Bisac-Evac™, Correctol®, Dacodyl™, Dulcolax®, ex-lax® Ultra, Fematrol, Femilax™, Veracolate: 5 mg

Tablet, delayed release: 5 mg

Doxidan®, Fleet® Stimulant Laxative: 5 mg

Pricing: U.S. (www.drugstore.com)

Suppository (Bisacodyl)

10 mg (100): $18.99

International Brand Names

• Alaxa (IT)
• Alsylax (CN)
• Anan (JP)
• Anulax (EC)
• Atzirut X (IL)
• Bekunis B (LU)
• Bicolax (ID)
• Bioyl (TW)
• Bisacod (TH)
• Bisacodyl (PL)
• Bisakodils (EE)
• Bisalax (AU, BG)
• Contalax (FR)
• Correctol (HK)
• Dissilax (AE, BH, CY, EG, IL, IQ, IR, JO, KW, LB, LY, OM, QA, SA, SY, YE)
• Dulco Laxo (ES)
• Dulco-lax perles (GB)
• Dulcolan (VE)
• Dulcolax (AE, AR, AT, BB, BE, BF, BH, BJ, BM, BR, BS, BZ, CH, CI, CO, CY, DE, DK, EG, ET, FR, GB, GH, GM, GN, GR, GY, HK, HN, HR, ID, IL, IN, IQ, IR, IT, JM, JO, KE, KP, KW, LB, LR, LU, LY, MA, ML, MR, MU, MW, MX, MY, NE, NG, NL, NO, OM, PE, PH, PK, PT, PY, QA, SA, SC, SD, SE, SL, SN, SR, SY, TH, TN, TT, TW, TZ, UG, UY, YE, ZA, ZM, ZW)
• Extralax (CZ)
• Fenolax (CZ)
• Gencolax (TH)
• Johnlax (TW)
• Kadolax (TH)
• Lax-Tab (AU)
• Laxacod (ID)
• Laxadin (IL)
• Laxadyl (AE, BF, BH, BJ, CI, CY, EG, ET, GH, GM, GN, IL, IQ, IR, JO, KE, KW, LB, LR, LY, MA, ML, MR, MU, MW, NE, NG, OM, QA, SA, SC, SD, SL, SN, SY, TN, TZ, UG, YE, ZA, ZM, ZW)
• Laxamex (ID)
• Laxans-ratiopharm (LU)
• Laxcodyl (TH)
• Laxitab 5 (TH)
• Marcholax (HK)
• Medesup (ES)
• Moderlax (PT)
• Perilax (DK, ZA)
• Purgo-Pil (LU)
• Pyrilax (CZ, PL)
• Satolax-10 (JP)
• Tirgon N (LU)
• Toilax (DK, FI, IE, NL, NO, SE)
• Vacolax (TH)

Lexi-Comp.com

Last full review/revision August 2008

Content last modified August 2008