Bisacodyl 10mg Suppositories
It is used to treat constipation.
Drug Class
Laxative, Stimulant
Pharmacologic Class
Diphenylmethane derivative
Pregnancy Category
C
FDA Approved
Jan 1970
DEA Schedule
Not Controlled
Overview
What is this medicine?
Bisacodyl suppositories are a type of laxative that you insert into your rectum. They work by stimulating your bowel muscles to help you have a bowel movement, usually within an hour. They are used for short-term relief of constipation or to prepare your bowel for medical procedures.
How to Use This Medicine
Taking Your Medication
To use this medication correctly, follow your doctor's instructions and read all the information provided. When using the suppository, insert it rectally, washing your hands before and after handling. Remove the foil wrapper and gently push the suppository into the rectum, pointed end first, taking care not to handle it excessively.
Storing and Disposing of Your Medication
Store this medication at room temperature in a dry location, avoiding bathrooms. Keep all medications in a secure place, out of reach of children and pets. Dispose of unused or expired medications properly. Do not flush them down the toilet or pour them down the drain unless instructed to do so. If you have questions about disposal, consult your pharmacist, who can also inform you about potential drug take-back programs in your area.
Missing a Dose
If you take this medication regularly, take a missed dose as soon as you remember. However, if it's close to the time for your next dose, skip the missed dose and resume your regular schedule. Avoid taking two doses at once or extra doses. If you take this medication as needed, do not take it more frequently than your doctor advises.
To use this medication correctly, follow your doctor's instructions and read all the information provided. When using the suppository, insert it rectally, washing your hands before and after handling. Remove the foil wrapper and gently push the suppository into the rectum, pointed end first, taking care not to handle it excessively.
Storing and Disposing of Your Medication
Store this medication at room temperature in a dry location, avoiding bathrooms. Keep all medications in a secure place, out of reach of children and pets. Dispose of unused or expired medications properly. Do not flush them down the toilet or pour them down the drain unless instructed to do so. If you have questions about disposal, consult your pharmacist, who can also inform you about potential drug take-back programs in your area.
Missing a Dose
If you take this medication regularly, take a missed dose as soon as you remember. However, if it's close to the time for your next dose, skip the missed dose and resume your regular schedule. Avoid taking two doses at once or extra doses. If you take this medication as needed, do not take it more frequently than your doctor advises.
Lifestyle & Tips
- Increase fluid intake (water, juices) to help soften stools and prevent dehydration.
- Increase dietary fiber (fruits, vegetables, whole grains) to promote regular bowel movements.
- Engage in regular physical activity to stimulate bowel function.
- Do not use for more than 7 days without consulting a doctor.
- Do not use if you have severe abdominal pain, nausea, vomiting, or a sudden change in bowel habits lasting more than 2 weeks.
Available Forms & Alternatives
Available Strengths:
Dosing & Administration
Adult Dosing
Standard Dose:
10 mg rectally once daily
Dose Range:
10 - 10 mg
Condition-Specific Dosing:
constipation:
10 mg rectally once daily for acute constipation or bowel preparation. Do not use for more than 7 days without medical advice.
Pediatric Dosing
Neonatal:
Not established
Infant:
Not established (generally not recommended for infants without medical supervision)
Child:
6 to <12 years: 5 mg rectally once daily. Not recommended for children under 6 years without medical supervision.
Adolescent:
âĨ12 years: 10 mg rectally once daily
Dose Adjustments
Renal Impairment:
Mild:
No specific adjustment needed
Moderate:
No specific adjustment needed
Severe:
Use with caution; prolonged use may exacerbate fluid/electrolyte imbalances. Consult physician.
Dialysis:
Use with caution; prolonged use may exacerbate fluid/electrolyte imbalances. Consult physician.
Hepatic Impairment:
Mild:
No specific adjustment needed
Moderate:
No specific adjustment needed
Severe:
No specific adjustment needed
Confidence:
Medium
Pharmacology
Mechanism of Action
Bisacodyl is a stimulant laxative that acts directly on the colonic mucosa to stimulate sensory nerve endings, which increases peristaltic contractions. It also increases fluid and electrolyte secretion into the colon, leading to increased stool volume and softening, facilitating defecation.
Pharmacokinetics
Absorption:
Bioavailability:
Minimal systemic absorption (less than 5%) from rectal administration.
Tmax:
Not applicable for local action; systemic absorption is negligible.
FoodEffect:
Not applicable for rectal administration.
Distribution:
Vd:
Not available (primarily local action)
ProteinBinding:
Not available (minimal systemic absorption)
CnssPenetration:
No
Elimination:
HalfLife:
Not available (minimal systemic absorption)
Clearance:
Not available
ExcretionRoute:
Primarily fecal (unabsorbed drug and metabolites); small amounts of absorbed metabolites are excreted renally.
Unchanged:
Not available
Pharmacodynamics
OnsetOfAction:
15-60 minutes (rectal)
PeakEffect:
Not distinctly defined, effect is typically within 1 hour.
DurationOfAction:
Variable, typically results in a single bowel movement within 1 hour.
Confidence:
Medium
Safety & Warnings
Side Effects
Urgent Side Effects: Seek Medical Help Right Away
If you experience any of the following symptoms, call your doctor immediately or seek emergency medical attention, as they may be signs of a severe and potentially life-threatening reaction:
- Signs of an allergic reaction, such as rash, hives, itching, red, swollen, blistered, or peeling skin (with or without fever), wheezing, tightness in the chest or throat, trouble breathing, swallowing, or talking, unusual hoarseness, or swelling of the mouth, face, lips, tongue, or throat.
Other Possible Side Effects
While most people taking this medication may not experience side effects or may only have mild ones, it's essential to be aware of the potential for other side effects. If you encounter any of the following or any other side effects that bother you or do not resolve, contact your doctor for advice:
- Stomach pain or cramps
- Burning
Note: This list does not include all possible side effects. If you have concerns about side effects, consult your doctor. For medical advice regarding side effects, contact your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
If you experience any of the following symptoms, call your doctor immediately or seek emergency medical attention, as they may be signs of a severe and potentially life-threatening reaction:
- Signs of an allergic reaction, such as rash, hives, itching, red, swollen, blistered, or peeling skin (with or without fever), wheezing, tightness in the chest or throat, trouble breathing, swallowing, or talking, unusual hoarseness, or swelling of the mouth, face, lips, tongue, or throat.
Other Possible Side Effects
While most people taking this medication may not experience side effects or may only have mild ones, it's essential to be aware of the potential for other side effects. If you encounter any of the following or any other side effects that bother you or do not resolve, contact your doctor for advice:
- Stomach pain or cramps
- Burning
Note: This list does not include all possible side effects. If you have concerns about side effects, consult your doctor. For medical advice regarding side effects, contact your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
Seek Immediate Medical Attention If You Experience:
- Rectal bleeding
- No bowel movement after using the suppository
- Severe abdominal pain or cramping
- Nausea or vomiting
- Signs of dehydration (e.g., dizziness, excessive thirst, decreased urination)
- Worsening constipation
Before Using This Medicine
Before Taking This Medication: Important Information to Share with Your Doctor
It is essential to inform your doctor about the following:
Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the allergic reaction and its symptoms.
Certain health conditions, including:
+ Bowel blockage
+ Abdominal pain
+ Upset stomach
+ Rectal bleeding
+ Vomiting
+ Changes in bowel habits that last longer than 2 weeks
This list is not exhaustive, and it is crucial to discuss all your health problems and medications with your doctor.
To ensure safe treatment, please disclose all of the following to your doctor and pharmacist:
All prescription and over-the-counter (OTC) medications you are taking
Any natural products or vitamins you are using
* All your health problems
Before starting, stopping, or changing the dose of any medication, including this one, you must consult with your doctor to confirm it is safe to do so.
It is essential to inform your doctor about the following:
Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the allergic reaction and its symptoms.
Certain health conditions, including:
+ Bowel blockage
+ Abdominal pain
+ Upset stomach
+ Rectal bleeding
+ Vomiting
+ Changes in bowel habits that last longer than 2 weeks
This list is not exhaustive, and it is crucial to discuss all your health problems and medications with your doctor.
To ensure safe treatment, please disclose all of the following to your doctor and pharmacist:
All prescription and over-the-counter (OTC) medications you are taking
Any natural products or vitamins you are using
* All your health problems
Before starting, stopping, or changing the dose of any medication, including this one, you must consult with your doctor to confirm it is safe to do so.
Precautions & Cautions
It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication.
Do not use this medication for more than 7 days without explicit instructions from your doctor to do so. Additionally, refrain from using other laxatives or stool softeners unless your doctor advises you to do so.
If you experience rectal bleeding or do not have a bowel movement after using this medication, it is crucial to consult with your doctor.
This medication is available in various forms, which may be suitable for children of different ages. Before administering this drug to a child, it is necessary to consult with your doctor to ensure the appropriate form and dosage are used.
If you are pregnant, planning to become pregnant, or are breastfeeding, you must discuss this with your doctor. Your doctor will help you weigh the benefits and risks of using this medication to ensure the best possible outcome for both you and your baby.
Do not use this medication for more than 7 days without explicit instructions from your doctor to do so. Additionally, refrain from using other laxatives or stool softeners unless your doctor advises you to do so.
If you experience rectal bleeding or do not have a bowel movement after using this medication, it is crucial to consult with your doctor.
This medication is available in various forms, which may be suitable for children of different ages. Before administering this drug to a child, it is necessary to consult with your doctor to ensure the appropriate form and dosage are used.
If you are pregnant, planning to become pregnant, or are breastfeeding, you must discuss this with your doctor. Your doctor will help you weigh the benefits and risks of using this medication to ensure the best possible outcome for both you and your baby.
Overdose Information
Overdose Symptoms:
- Severe abdominal cramps
- Diarrhea
- Significant fluid and electrolyte loss (especially potassium)
- Dehydration
- Hypotension (low blood pressure)
- Muscle weakness
What to Do:
Discontinue use immediately. Seek emergency medical attention or call Poison Control at 1-800-222-1222. Treatment is supportive, focusing on fluid and electrolyte replacement.
Drug Interactions
Contraindicated Interactions
- Patients with acute abdominal conditions (e.g., appendicitis, acute inflammatory bowel diseases)
- Patients with intestinal obstruction
- Patients with severe dehydration
Moderate Interactions
- Antacids, H2-receptor antagonists, proton pump inhibitors (oral bisacodyl, not typically relevant for suppositories, but general caution for GI irritation)
- Diuretics (potential for electrolyte imbalance with prolonged use)
- Corticosteroids (potential for electrolyte imbalance with prolonged use)
Monitoring
Baseline Monitoring
Bowel function assessment
Rationale: To determine the cause and severity of constipation and rule out contraindications.
Timing: Prior to initiation of therapy
Abdominal examination
Rationale: To rule out acute abdominal conditions or obstruction.
Timing: Prior to initiation of therapy
Routine Monitoring
Frequency and consistency of bowel movements
Frequency: Daily during use
Target: Regular, soft bowel movements
Action Threshold: No bowel movement after 1 hour, persistent constipation, or worsening symptoms
Signs of fluid/electrolyte imbalance (e.g., weakness, muscle cramps, dizziness)
Frequency: As needed, especially with prolonged or excessive use
Target: Absence of symptoms
Action Threshold: Presence of symptoms, indicating need for medical evaluation
Symptom Monitoring
- Abdominal cramping or pain
- Rectal irritation or burning
- Rectal bleeding
- Dizziness or lightheadedness (signs of dehydration)
- Nausea or vomiting
- No bowel movement after use
Special Patient Groups
Pregnancy
Bisacodyl is generally considered safe for short-term use during pregnancy, as systemic absorption is minimal. However, it should only be used if clearly needed and under medical advice.
Trimester-Specific Risks:
First Trimester:
Low risk, minimal systemic absorption.
Second Trimester:
Low risk, minimal systemic absorption.
Third Trimester:
Low risk, minimal systemic absorption. Avoid prolonged use due to potential for electrolyte imbalance.
Lactation
Bisacodyl and its active metabolite are minimally excreted into breast milk. It is considered compatible with breastfeeding for short-term use.
Infant Risk:
Low risk of adverse effects in breastfed infants due to minimal excretion into milk.
Pediatric Use
Not recommended for children under 6 years of age without medical supervision. For children 6 to <12 years, a lower dose (5 mg) is used. Prolonged use in children should be avoided.
Geriatric Use
Use with caution in elderly patients, as they may be more susceptible to fluid and electrolyte imbalances, especially with prolonged or excessive use. Ensure adequate hydration.
Clinical Information
Clinical Pearls
- Bisacodyl suppositories are effective for rapid relief of acute constipation or for bowel preparation.
- The suppository should be inserted pointed end first, and held in place for a few minutes to prevent expulsion.
- Patients should be advised not to use bisacodyl suppositories for more than 7 days without consulting a healthcare professional to avoid dependence and electrolyte disturbances.
- Rectal irritation or burning sensation can occur, especially with frequent use.
- Ensure patients are adequately hydrated when using laxatives.
Alternative Therapies
- Oral stimulant laxatives (e.g., senna, oral bisacodyl)
- Osmotic laxatives (e.g., polyethylene glycol, magnesium hydroxide, lactulose)
- Bulk-forming laxatives (e.g., psyllium, methylcellulose)
- Stool softeners (e.g., docusate sodium)
- Enemas (e.g., saline enema, mineral oil enema)
- Peripherally acting mu-opioid receptor antagonists (PAMORAs) for opioid-induced constipation
Cost & Coverage
Average Cost:
$5 - $20 per 12 suppositories
Generic Available:
Yes
Insurance Coverage:
OTC (Over-The-Counter), generally not covered by prescription plans unless prescribed for specific conditions or by certain plans.
General Drug Facts
If your symptoms or health issues persist or worsen, it's essential to contact your doctor for further guidance. To ensure your safety, never share your medication with others or take someone else's medication. Some medications may come with an additional patient information leaflet, so be sure to check with your pharmacist for more information. If you have any questions or concerns about your medication, don't hesitate to reach out to your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately call your local poison control center or seek medical attention. When seeking help, be prepared to provide details about the medication taken, the amount, and the time it happened.