Bisacodyl

(bye-sah-koh-dil)

Trade/other name(s): Alophen Pills, Bisac-Evac, Bisacodyl Uniserts, Carter's Little Pills, Correctol, Dulcolax, Evac-Q-Kwik Kit, Feen-A-Mint, Dulcolax Bowel Prep Kit

Why would this drug be used?

Bisacodyl is used to treat constipation. You can buy it over the counter, without a prescription. A time-released form of bisacodyl is also used in combination with another type of laxative to clean out the bowel before colonoscopies, barium enemas, and other procedures. This combination requires a prescription.

How does this drug work?

Bisacodyl belongs to the group of drugs called stimulant laxatives. It stimulates (irritates) the smooth muscle of the intestines. This increases the normal forward movement of the intestines (peristalsis). It also draws more water into the colon, which usually causes a bowel movement.

Before taking this medicine

Tell your doctor…

• If you are allergic to anything, including medicines, dyes, additives, or foods.
• If you have nausea, vomiting, rectal bleeding, unexplained abdominal pain, blocked intestine, or any disease of the stomach or intestine. Something other than constipation may be causing your problem, and laxatives may worsen it.
• About any other prescription or over-the-counter medicines you are taking, including vitamins and herbs. In fact, keeping a written list of each of these medicines (including the doses of each and when you take them) with you in case of emergency may help prevent complications if you get sick.

Interactions with other drugs

Antacids or acid-blocking drugs may cause bisacodyl to dissolve too quickly and irritate the stomach. Do not take bisacodyl tablets within an hour of taking an acid blocker or antacid.

Other medicines may not work as well if taken at the same time as laxatives. Do not take this medicine within 2 hours of your other medicines.

Check with your doctor, nurse, or pharmacist about other medicines, vitamins, herbs, and supplements, and whether alcohol can cause problems with this medicine.

Interactions with foods

Milk can cause bisacodyl tablets to dissolve too quickly and irritate the stomach. Take bisacodyl at least an hour before or after milk.

Although bisacodyl works faster when taken on an empty stomach, no serious interactions with food are known at this time. Check with your doctor, nurse, or pharmacist about whether specific foods may be a problem.

Tell all the doctors, dentists, nurses, and pharmacists you visit that you are taking this drug.

How is this drug taken or given?

Bisacodyl can be taken as a pill or as a rectal suppository. The dose of the pill will depend on why you are taking it and how often you use laxatives. The pill should be taken on an empty stomach, more than 1 hour before or after taking antacids or drinking milk. Do not crush, chew, or dissolve the pill.

The suppository comes in only one dose. To insert the suppository, first open the package and dip the tip in cold water. If you are right-handed, lie down on your left side, bring your knees up near your chest, and slowly insert the suppository in your rectum about an inch. Try to keep it there for a few minutes, then get up and wash your hands well.

Take this drug exactly as your doctor tells you to or follow directions on the label. If you do not understand the instructions, your doctor or nurse can explain them to you. Store the medicine in a tightly closed container and away from children and pets.

Precautions

You will probably feel as if you have to move your bowels 6 to 10 hours after taking the pills, and 15 minutes to 1 hour after taking the suppository.

Sometimes bisacodyl can cause diarrhea. It is important to replace the fluid that you lose through diarrhea. Try to drink 2 to 3 quarts of fluid a day. Fluids with electrolytes, such as chicken broth or sports drinks, help replace potassium and salt that are lost in diarrhea.

To help avoid constipation, try to drink 2 to 3 quarts of fluid a day. Increase the amount of fiber you eat in foods by eating fruits, vegetables, beans, peas, and whole-grain breads and cereal. Talk to your doctor about what kind of exercise may help you.

If you are taking opioid pain relievers, you will need to take laxatives regularly to counter the opioid action on the bowel. This helps prevent severe complications such as impaction. Let your doctor or nurse know if you haven't had a bowel movement for 3 days.

When over-used, stimulant laxatives can cause diarrhea and serious loss of electrolytes such as potassium. This can cause confusion, unusual tiredness or weakness, irregular heart beat, and muscle cramps. If you notice these symptoms, call your doctor.

If you are not taking opioid pain medicine and you use laxatives all the time, your body may forget how to move your bowels normally and you come to depend on laxatives. Talk to your doctor if this is a problem for you.

Possible side effects

You will probably not have most of the following side effects, but if you have any talk to your doctor or nurse. They can help you understand the side effects and cope with them.

Common

• mild rectal burning as suppository is absorbed
• stomach cramps
• loss of normal bowel response when used on a long-term basis*

Less common

• diarrhea*
• upset stomach

Rare

• dehydration due to fluid loss in diarrhea*
• loss of electrolytes due to diarrhea, usually with over-use*

*See "Precautions" section for more detailed information.

There are other side effects not listed above that can also occur in some patients. Tell your doctor or nurse if you develop these or any other problems.

FDA approval

This drug appears to pre-date the current FDA approval process, which would mean it was not required to get formal FDA approval.

Disclaimer: This information does not cover all possible uses, actions, precautions, side effects, or interactions. It is not intended as medical advice, and should not be relied upon as a substitute for talking with your doctor, who is familiar with your medical needs.