BISACODYL

(bis-a-koe'dill)

Apo-Bisacodyl

, Bisacolax, Bisco-Lax

, Dacodyl, Deficol, , Doxidan, Dulcolax, Fleet Bisacodyl, Laxit

, Theralax
Classifications: stimulant laxative;
Therapeutic: laxative
Pregnancy Category: C

Availability

5 mg tablets, enteric coated; 5 mg tablet, delayed release; 10 mg suppository; 10 mg/30 mL enema

Action

Expands intestinal fluid volume by increasing epithelial permeability.

Therapeutic Effect

Induces peristaltic contractions by direct stimulation of sensory nerve endings in the colonic wall.

Uses

Temporary relief of acute constipation and for evacuation of colon before surgery, proctoscopic, sigmoidoscopic, and radiologic examinations. Also used to cleanse colon before delivery and to relieve constipation in patients with spinal cord damage.

Contraindications

Acute surgical abdomen, nausea, vomiting, abdominal cramps, intestinal obstruction, fecal impaction; use of rectal suppository in presence of anal or rectal fissures, ulcerated hemorrhoids, proctitis, bowel obstruction or perforation, ileus; pregnancy (category C), children <1 y.

Cautious Use

Lactation.

Route & Dosage

Laxative
Adult: PO 5–15 mg prn (max: 30 mg for special procedures) PR 10 mg prn
Child: PO ≥6 y, 5–10 mg prn PR ≥2 y, 10 mg; <2 y, 5 mg

Administration

Oral

Give in the evening or before breakfast because of action time required.
Give enteric coated tablets whole to avoid gastric irritation; do not cut or crush. Patient should not chew tablets. Preferably give with a full glass (240 mL) of water or other liquid.
Do not give within 1 h of antacids or milk. These substances may cause premature dissolution of enteric coating; early release of drug in stomach may result in gastric irritation and loss of cathartic action.
Store tablets in tightly closed containers at temperatures not exceeding 30° C (86° F).

Rectal

Suppository may be inserted at time bowel movement is desired.
Storage is same as tablets.

Adverse Effects (≥1%)

Systemic effects not reported. Mild cramping, nausea, diarrhea, fluid and electrolyte disturbances (especially potassium and calcium).

Interactions

Drug: antacids will cause early dissolution of enteric coated tablets, resulting in abdominal cramping.

Pharmacokinetics

Absorption: 5–15% from GI tract. Onset: 6–8 h PO; 15–60 min PR. Metabolism: In liver. Elimination: In urine, bile, and breast milk.

Nursing Implications

Assessment & Drug Effects

Evaluate periodically patient's need for continued use of drug; bisacodyl usually produces 1 or 2 soft formed stools daily.
Monitor patients receiving concomitant anticoagulants. Indiscriminate use of laxatives results in decreased absorption of vitamin K.

Patient & Family Education

Add high-fiber foods slowly to regular diet to avoid gas and diarrhea. Adequate fluid intake includes at least 6–8 glasses/d.

Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; Canadian drug name; Prototype drug

(1106)