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Generic

Bisacodyl

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At a glance

Bisacodyl is a stimulant laxative used in the treatment of constipation and for preparation of the colon prior to radiographic or endoscopic examination. It increases bowel motility to facilitate passage of stool.

Description

Bisacodyl is a diphenolic compound with a chemical structure similar to phenolphthalein. It is widely used as a laxative. Bisacodyl acts on the colon to stimulate peristalsis and on the small bowel and colon to increase intraluminal water and electrolytes. When applied to the caecum, it initiates a response in the entire colon.

Bisacodyl is used for the treatment of constipation and for bowel evacuation prior to radiographic or endoscopic examination of the colon. It is preferably taken at night as it requires 6-8 hours to show effect.

Indications
  • Treatment of constipation
  • Preparation for radiographic or endoscopic examination of the colon
  • Bowel evacuation prior to surgery
Therapeutic class

Stimulant Purgatives

Pharmacological class

Diphenolic Laxative

Pharmacology

Bisacodyl is a diphenolic compound with a chemical structure similar to phenolphthalein. It acts on the colon to stimulate peristalsis and on the small bowel and colon to increase intraluminal water and electrolytes. When applied to the caecum, it initiates a response in the entire colon.

Mechanism of action

Bisacodyl acts mainly in the large intestine by increasing its motility to effect bowel evacuation. It stimulates nerve endings in the colon to produce peristaltic contractions and increases intraluminal fluid and electrolytes, softening the stool and facilitating its passage.

Dosage

Adults:
Constipation: 5-10 mg at night; occasionally may be increased to 15-20 mg.
Before radiological/endoscopic examination: 10 mg orally at bedtime for 2 days before the examination.
Before surgery: 10-20 mg the night before the procedure followed by 10 mg rectal suppository the next morning; or 10 mg on each of the 2 nights before the procedure.

Children (4-10 years):
Constipation: 5 mg at night.
Before examination: 5 mg the night before the procedure and 5 mg rectal suppository the following morning.

Children >10 years: Same as adult dose.

Note: Do not use for more than 1 week (may cause dependence).

Administration

Take on an empty stomach (2 hours after other medicines). Swallow the tablet whole. Do not chew, crush or break it. For constipation, take at night (allows 6-8 hours to work). Follow the dose and duration as advised by your doctor.

Missed dose

If you miss a dose, skip it and continue with your normal schedule. Do not double the dose.

Side effects

Common:
Vomiting, bloating, nausea, stomach cramp.

With overuse:
Diarrhea, malabsorption, potassium depletion, fluid and electrolyte imbalance.

Precautions & warnings
  • May cause dizziness and/or syncope due to vasovagal response (e.g., abdominal spasm); avoid driving if symptoms occur.
  • Do not use for more than 1 week (may cause dependence on laxative action).
  • May interfere with absorption of other medicines; take 2 hours after other medicines.
  • A fiber-rich diet (fruits, vegetables, cereals), adequate fluids, and regular exercise are essential for maintaining healthy bowel function.
  • Do not take antacids or milk within 1 hour of taking the drug (may damage enteric coating).
  • May cause severe dehydration and electrolyte imbalance.
Contraindications
  • Acute surgical abdomen
  • Intestinal obstruction (ileus)
  • Acute appendicitis
  • Acute inflammatory bowel diseases
  • Severe dehydration
  • Faecal impaction
  • Chronic use
Drug interactions
  • Do not give antacids or milk within 1 hour of taking the drug (may damage enteric coating).
  • May interfere with absorption of other medicines; take 2 hours after other medicines.
Food interactions

It is not known whether it is safe to consume alcohol with Bisacodyl. Please consult your doctor. Avoid milk and antacids within 1 hour of taking the drug.

Use in pregnancy

May be unsafe during pregnancy (especially first trimester). Limited human studies available; animal studies have shown harmful effects on the developing baby. Your doctor will weigh the benefits and risks before prescribing. Consult your doctor.

Pregnancy Category: C — always consult a doctor before taking during pregnancy.

Use in lactation

Probably safe during breastfeeding (if prescribed). Limited human data suggests the drug does not pose significant risk to the baby. Use with caution.

Pediatric use
4-10 years: 5 mg at night for constipation; 5 mg the night before and 5 mg suppository the morning of the procedure.
>10 years: Same as adult dose.
Under 2 years: Safety not established; consult your doctor.
Geriatric use

No specific dose adjustment required for elderly, but caution is advised (monitor fluid and electrolyte balance).

Renal / hepatic impairment
Renal impairment: Limited information available on use in kidney disease. Generally not advised if associated with vomiting (fluid loss can be harmful to kidney function). Consult your doctor.

Hepatic impairment: Limited information available on use in liver disease. Consult your doctor.
Overdose effects

Overuse may cause diarrhea, malabsorption, potassium depletion, and fluid/electrolyte imbalance. Seek medical attention if severe symptoms occur.

Storage conditions

Store in a cool and dry place, protected from light. Keep below 30°C. Keep out of reach of children.

Chemical structure

Bisacodyl (Diphenolic Laxative)

Common questions

What is Bisacodyl used for?
It is used for the treatment of constipation and for bowel preparation before radiographic or endoscopic examination of the colon.
How does Bisacodyl work?
It increases motility of the large intestine to facilitate bowel evacuation and increases intraluminal fluid and electrolytes.
What is the dosage?
Adults: 5-10 mg at night (up to 15-20 mg if needed). Children: 5 mg at night.
What are the side effects?
Vomiting, bloating, nausea, and stomach cramp may occur. Overuse may cause diarrhea and electrolyte imbalance.
How long can it be used?
Generally not for more than 1 week (may cause dependence). Consult your doctor.
Can it be used during pregnancy?
Should be avoided during pregnancy (especially first trimester). Consult your doctor.
⚠️ This information is for educational purposes only — not a substitute for medical advice. Consult a registered physician before taking any medicine.