Bisacodyl

Stimulant laxative, Diphenylmethane laxative

Bisacodyl

Dulcolax, Correctol, Bisac-Evac

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Summary

Classes

Stimulant laxative, Diphenylmethane laxative

Common uses

Acute or short-term constipation▲0▼, Bowel preparation before colonoscopy (with PEG)▲0▼

Pharmacy

Starting dose

5-15 mg PO once at bedtime; 10 mg PR for faster effect; bowel prep regimens use higher single doses

Preparations

5 mg enteric-coated tablets; 10 mg rectal suppositories; OTC and Rx

US FDA Max

30 mg/d for short-term use

Pharmacology

Routes

Oral, rectal

Onset

PO 6-12 hours; PR 15-60 minutes

Duration

Hours

Half-life

Variable; effect dependent on local intestinal action rather than systemic kinetics

Bioavailability

Low systemic absorption (enteric coating delivers drug to colon)

Pregnancy

Generally considered acceptable for short-term use.^{[citation needed]}

Legal status

OTC in US

Purported mechanism

Bisacodyl is a diphenylmethane stimulant laxative hydrolyzed by intestinal enzymes to its active form, which directly stimulates the colonic enteric nervous system to increase peristalsis and induces water and electrolyte secretion into the lumen.▲0▼ Chronic use is associated with cathartic colon (colonic dilation, loss of haustration), hypokalemia, and laxative dependence; reserved for short-term use or bowel prep with breaks between courses.