Adult Dosing

Constipation/Bowel preparation

• 10 mg PR qd
• Note: Retain for 15-20 mins; do not use > 1 wk

Pediatric Dosing

Constipation/Bowel preparation

• < 2 yrs: 5 mg PR qd
• 2-11 yrs: 5-10 mg PR qd
• > = 12 yrs: 10 mg PR qd
• Note: Retain for 15-20 mins; do not use > 1 wk

[Outline]

• Adult Dosing
• Pediatric Dosing

• Treatment of constipation
• Evacuation of the colon before procedures or examination
• Bowel preparation before surgery

• Hypersensitivity
• Acute abdomen
• Abdominal pain, undiagnosed
• GI perforation
• GI obstruction or ileus
• Gastroenteritis
• Toxic megacolon
• Rectal bleeding
• Appendicitis
• Nausea or vomiting (especially with fever or other signs of an acute abdomen)
• Hemorrhoids

Renal Dose Adjustment

• No dose adjustments

Hepatic Dose Adjustment

• No dose adjustments

• Long-term use may lead to laxative dependency. Long-term abuse results in cathartic colon. Do not use > 1 wk
• Rectal bleeding or failure to produce bowel movement may require medical attention
• Advise patients to incorporate high fiber foods in diet, increase fluid intake and increase or maintain exercise level

Cautions: Use cautiously in

• Severe cardiovascular disease
• Prolonged use
• Inflammatory bowel disease

Pregnancy Category:C

Breastfeeding: Safety unknown. Due to low systemic absorption, it would not be expected to be excreted in maternal serum or breast milk. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 7 May 2010).

• GI: Excessive bowel activity (diarrhea, nausea, vomiting), abdominal cramping, perianal irritation, bloating, flatulence, proctitis and inflammation
• CV: Palpitations
• CNS: Dizziness, fainting
• MISC: Sweating, weakness, proctitis and inflammation with long-term use; Fluid and electrolyte disturbance (metabolic alkalosis or acidosis, hypocalcemia)

• Mechanism of action: Stimulates peristalsis possibly by causing irritation of the intestinal smooth muscles; also, produces intestinal fluid accumulation
• ~ 15% systemic absorption
• Metabolism: liver; CYP450: unknown
• Half life – 16hrs
• Onset of action - 0.25-1 hour
• Primarily excreted in feces; minimal in urine

US Trade Name(s)

• Dulcolax
• Fleet Bisacodyl Enema

US Availability

bisacodyl (generic)

• SUPP: 10 mg
• ENEMA: 10 mg/30 mL

Dulcolax

• SUPP: 10 mg

Fleet Bisacodyl Enema

• ENEMA: 10 mg/30 mL

Canadian Trade Name(s)

• Bisacolax
• Dulcolax
• Silver Bullet Suppository
• Soflax-EX 10
• The Magic Bullet

Canadian Availability

bisacodyl (generic)

• SUPP: 10 mg

Bisacolax, Silver Bullet Suppository, Soflax-EX 10, The Magic Bullet

• SUPP: 10 mg

Dulcolax

• SUPP: 5, 10 mg

UK Trade Name(s)

• Dulcolax

UK Availability

bisacodyl (generic)

• SUPP: 5, 10 mg

Dulcolax

• SUPP: 5, 10 mg

Australian Trade Name(s)

• Bisalax Micro-enema
• Dulcolax
• Fleet laxative preparations

Australian Availability

bisacodyl (generic)

• SUPP: 10 mg

Bisalax Micro-enema

• ENEMA: 2 mg/mL (5 mL)

Dulcolax

• SUPP: 5, 10 mg

Fleet laxative preparations

• SUPP: 10 mg

[Outline]

Gastrointestinal

GI Agents; Miscellaneous

Stimulant Laxatives