Bisacodyl

Products

Bisacodyl is commercially available in the form of enteric-coated tablets (dragées) and suppositories (Dulcolax, generics). It has been approved in many countries since 1957.

Structure and properties

Bisacodyl (C22H19NO4, Mr = 361.39 g/mol) exists as a white crystalline powder that is practically insoluble in water. It is a diphenylmethane and triarylmethane derivative. Bisacodyl is a prodrug that is hydrolyzed in the intestine to the active ingredient BHPM. This is also formed from sodium picosulfate.

Effects

Bisacodyl (ATC A06AB02) has laxative properties. It stimulates intestinal motility in the colon and results in increased secretion of water and electrolytes into the lumen. This softens the stool and makes it more slippery. Intestinal transit is accelerated and bowel emptying is stimulated.

Indications

  • For short-term treatment of constipation.
  • Preparation of diagnostic procedures, pre- and postoperative treatment. Complaints requiring facilitated bowel evacuation.

Dosage

According to the professional information. It is recommended to take the dragées in the evening before bedtime, so that the intestine can be emptied the next morning. Onset of action occurs after approximately 6 to 12 hours. When used rectally with the suppositories, the effect can be expected after 10 to 30 minutes.

Contraindications

  • Hypersensitivity
  • Intestinal obstruction, intestinal obstruction
  • Acute abdominal conditions such as acute appendicitis, acute inflammation of the bowel, as well as in cases of severe abdominal pain in combination with nausea and vomiting, which indicate severe disease.
  • Severe dehydration
  • Hypokalemia

For complete precautions, see the drug label.

Interactions

Interactions are possible with drugs that cause potassium loss. These include diuretics and glucocorticoids. Hypokalemia may increase sensitivity to cardiac glycosides. Drugs that increase gastric pH may cause premature dissolution of enteric-coated tablets.

Adverse Effects

The most common possible adverse effects include abdominal pain, abdominal cramps, nausea, and diarrhea. Improper and overdose use may result in potassium deficiency (hypokalemia) and disturbances of water and electrolyte balance.