Bisacodyl
Encyclopedia
Bisacodyl is a stimulant laxative
Laxative
Laxatives are foods, compounds, or drugs taken to induce bowel movements or to loosen the stool, most often taken to treat constipation. Certain stimulant, lubricant, and saline laxatives are used to evacuate the colon for rectal and/or bowel examinations, and may be supplemented by enemas under...

 drug that works directly on the large colon to produce a bowel movement. It is typically prescribed for relief of constipation
Constipation
Constipation refers to bowel movements that are infrequent or hard to pass. Constipation is a common cause of painful defecation...

 and for the management of neurogenic bowel dysfunction as well as part of bowel preparation before medical examinations, such as for a colonoscopy
Colonoscopy
Colonoscopy is the endoscopic examination of the large bowel and the distal part of the small bowel with a CCD camera or a fiber optic camera on a flexible tube passed through the anus. It may provide a visual diagnosis and grants the opportunity for biopsy or removal of suspected...

. Bisacodyl is a diphenylmethane
Diphenylmethane
Diphenylmethane is an organic compound with the formula 2CH2. The compound consists of methane wherein two hydrogen atoms are replaced by two phenyl groups...

 (in fact, a modified triphenylmethane
Triphenylmethane
Triphenylmethane, or triphenyl methane, is the hydrocarbon with the formula 3CH. This colorless solid is soluble in nonpolar organic solvents and not in water. Triphenylmethane has the basic skeleton of many synthetic dyes called triarylmethane dyes, many of them are pH indicators, and some display...

) derivative and was first used as a laxative in 1953 due to its similarity to phenolphthalein
Phenolphthalein
Phenolphthalein is a chemical compound with the formula C20H14O4 and is often written as "HIn" or "phph" in shorthand notation. Often used in titrations, it turns colorless in acidic solutions and pink in basic solutions...

.

Available forms

Bisacodyl is sold under the trade names Dulcolax/Durolax, Fleet, Alophen, Correctol, and Carter's Little Pills (formerly Carter's Little Liver Pills
Carter's Little Liver Pills
Carter's Little Liver Pills, and Carter's Little Pills after 1959, were formulated as a patent medicine by Samuel J. Carter of Erie, Pennsylvania in 1868. The active ingredient is bisacodyl.-History:...

) as well being available generically
Generic drug
A generic drug is a drug defined as "a drug product that is comparable to brand/reference listed drug product in dosage form, strength, route of administration, quality and performance characteristics, and intended use." It has also been defined as a term referring to any drug marketed under its...

. It is usually sold as 5 mg tablets, 10 mg suppositories, or 5 mg pediatric suppositories. It is also available as a 1.25 fluid ounce prepackaged enema containing a 10 mg delivered dose of liquid bisacodyl.

Administration

When bisacodyl is administered orally, it is usually taken at bedtime. Oral administration is known to produce no action for more than eight hours and then to work suddenly and without much warning. This is especially true if more than 10 milligrams is taken at one time. Normally the dosage is 5 or 10 milligrams, but up to 30 milligrams can be taken for complete cleansing of the bowel before a procedure. If taken in the afternoon or early evening, the action of this drug will start during sleep with undesirable results. If taken at the maximum dosage, there will likely be a sudden, extremely powerful, uncontrollable bowel movement and so precautions should be taken.

When administered rectally in suppository form, it is usually effective in 15 to 60 minutes. Two suppositories can be taken at once if a very strong, purgative, enema-like result is needed. A few hours after the initial evacuation, there can be a secondary action which will continue as long as there is unexpelled bisacodyl.

As a small commercially prepared enema, it is usually effective in 5 to 20 minutes.

Mechanism of action

Bisacodyl works by stimulating enteric nerves to cause colonic mass movements. It is also a contact laxative; it increases fluid and NaCl secretion. Action of bisacodyl on small intestine is negligible; stimulant laxatives mainly promote evacuation of the colon.

External links

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