Bisacodyl 5mg EC Tablets
It is used to treat constipation.
Drug Class
Laxative
Pharmacologic Class
Stimulant laxative; Diphenylmethane derivative
Pregnancy Category
Not formally assigned for OTC, generally considered Category C (low risk for short-term use)
FDA Approved
Jan 1970
DEA Schedule
Not Controlled
Overview
What is this medicine?
Bisacodyl is a laxative that helps you have a bowel movement by making your intestines move more and by bringing more water into your stool. It's used for short-term relief of constipation.
How to Use This Medicine
Taking Your Medication Correctly
To get the most benefit from your medication, follow your doctor's instructions carefully. Read all the information provided with your prescription and follow the instructions closely. When taking your medication, be sure to:
Take it with a full glass of water
Swallow the tablet whole - do not chew, break, or crush it
Storing and Disposing of Your Medication
To keep your medication safe and effective:
Store it at room temperature in a dry place, away from the bathroom
Keep all medications in a safe location, out of the 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 by your pharmacist
Check with your pharmacist for guidance on the best way to dispose of your medication, or look into drug take-back programs in your area
What to Do If You Miss a Dose
If you take your medication on a regular schedule and miss a dose, take it as soon as you remember. However, if it's close to the time for your next dose, skip the missed dose and return to your normal schedule. Do not take two doses at the same time or take extra doses. If you take your medication as needed, do not take it more frequently than directed by your doctor.
To get the most benefit from your medication, follow your doctor's instructions carefully. Read all the information provided with your prescription and follow the instructions closely. When taking your medication, be sure to:
Take it with a full glass of water
Swallow the tablet whole - do not chew, break, or crush it
Storing and Disposing of Your Medication
To keep your medication safe and effective:
Store it at room temperature in a dry place, away from the bathroom
Keep all medications in a safe location, out of the 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 by your pharmacist
Check with your pharmacist for guidance on the best way to dispose of your medication, or look into drug take-back programs in your area
What to Do If You Miss a Dose
If you take your medication on a regular schedule and miss a dose, take it as soon as you remember. However, if it's close to the time for your next dose, skip the missed dose and return to your normal schedule. Do not take two doses at the same time or take extra doses. If you take your medication as needed, do not take it more frequently than directed by your doctor.
Lifestyle & Tips
- Drink plenty of fluids (6-8 glasses of water daily) to help prevent dehydration and soften stools.
- Increase dietary fiber intake (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 unless directed by a doctor.
- Take at bedtime for a morning bowel movement (usually within 6-12 hours).
- Do not take with milk, antacids, or acid-reducing medications (e.g., omeprazole, ranitidine) within 1 hour of taking bisacodyl, as this can cause stomach upset or premature dissolution of the enteric coating.
Available Forms & Alternatives
Available Strengths:
Dosing & Administration
Adult Dosing
Standard Dose:
5 mg to 15 mg orally once daily
Dose Range:
5 - 15 mg
Condition-Specific Dosing:
constipation:
5 mg to 15 mg orally once daily, typically at bedtime for morning effect. Do not exceed 30 mg/day.
Pediatric Dosing
Neonatal:
Not established
Infant:
Not established
Child:
6 to <12 years: 5 mg orally once daily. Do not exceed 5 mg/day. Not recommended for children under 6 years without physician consultation.
Adolescent:
âĨ12 years: 5 mg to 15 mg orally once daily, typically at bedtime for morning effect. Do not exceed 30 mg/day.
Dose Adjustments
Renal Impairment:
Mild:
No adjustment needed
Moderate:
No adjustment needed
Severe:
No adjustment needed (minimal systemic absorption)
Dialysis:
No specific considerations; minimal systemic absorption
Hepatic Impairment:
Mild:
No adjustment needed
Moderate:
No adjustment needed
Severe:
No adjustment needed (minimal systemic absorption)
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 (<5%)
Tmax:
Not applicable (primarily local action); for absorbed active metabolite (BHPM), Tmax is variable (4-10 hours)
FoodEffect:
Food does not significantly affect local action, but milk or antacids can dissolve the enteric coating prematurely, leading to gastric irritation.
Distribution:
Vd:
Not available (minimal systemic distribution)
ProteinBinding:
Not available (minimal systemic absorption)
CnssPenetration:
No
Elimination:
HalfLife:
Not applicable (primarily local action); for BHPM, terminal half-life is approximately 16.5 hours
Clearance:
Not available
ExcretionRoute:
Mainly fecal (unabsorbed drug and metabolites); small amounts of glucuronidated BHPM excreted renally.
Unchanged:
Not available (minimal systemic absorption)
Pharmacodynamics
OnsetOfAction:
Oral: 6-12 hours (enteric-coated tablets)
PeakEffect:
Not precisely defined due to local action; effect typically occurs within 6-12 hours.
DurationOfAction:
Effect resolves after defecation, typically within 12-24 hours.
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, difficulty breathing, swallowing, or talking, unusual hoarseness, or swelling of the mouth, face, lips, tongue, or throat.
Other Possible Side Effects
Like all medications, this drug can cause side effects, although not everyone will experience them. Many people have either no side effects or only mild ones. If you encounter any of the following side effects, or if any other side effects bother you or do not go away, contact your doctor for advice:
- Stomach pain or cramps.
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, difficulty breathing, swallowing, or talking, unusual hoarseness, or swelling of the mouth, face, lips, tongue, or throat.
Other Possible Side Effects
Like all medications, this drug can cause side effects, although not everyone will experience them. Many people have either no side effects or only mild ones. If you encounter any of the following side effects, or if any other side effects bother you or do not go away, contact your doctor for advice:
- Stomach pain or cramps.
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:
- Severe abdominal pain, cramping, or nausea
- Rectal bleeding
- Failure to have a bowel movement after use
- Signs of dehydration (e.g., dizziness, decreased urination)
- New or worsening symptoms of 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
* If you have difficulty swallowing without chewing
This list is not exhaustive, and it is crucial to discuss all your medications (prescription, over-the-counter, natural products, and vitamins) and health problems with your doctor and pharmacist. They will help determine if it is safe to take this medication with your other medications and health conditions. Do not initiate, stop, or modify the dose of any medication without first consulting 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
* If you have difficulty swallowing without chewing
This list is not exhaustive, and it is crucial to discuss all your medications (prescription, over-the-counter, natural products, and vitamins) and health problems with your doctor and pharmacist. They will help determine if it is safe to take this medication with your other medications and health conditions. Do not initiate, stop, or modify the dose of any medication without first consulting your doctor.
Precautions & Cautions
It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication.
To ensure safe use, follow these guidelines:
- Do not use this medication for more than 1 week without your doctor's explicit instruction.
- Avoid 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, consult your doctor promptly.
- When taking this medication, refrain from consuming dairy products, calcium, or magnesium within 1 hour of administration.
- Additionally, do not take antacids within 1 hour before or 1 hour after taking this medication, as this may interfere with its effectiveness.
When considering use in children, note that different forms of this medication may be suitable for different age groups. Therefore, it is crucial to consult with your doctor before administering this drug to a child.
If you are pregnant, planning to become pregnant, or are breast-feeding, inform your doctor. It is necessary to discuss the potential benefits and risks of this medication to both you and your baby to make an informed decision.
To ensure safe use, follow these guidelines:
- Do not use this medication for more than 1 week without your doctor's explicit instruction.
- Avoid 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, consult your doctor promptly.
- When taking this medication, refrain from consuming dairy products, calcium, or magnesium within 1 hour of administration.
- Additionally, do not take antacids within 1 hour before or 1 hour after taking this medication, as this may interfere with its effectiveness.
When considering use in children, note that different forms of this medication may be suitable for different age groups. Therefore, it is crucial to consult with your doctor before administering this drug to a child.
If you are pregnant, planning to become pregnant, or are breast-feeding, inform your doctor. It is necessary to discuss the potential benefits and risks of this medication to both you and your baby to make an informed decision.
Overdose Information
Overdose Symptoms:
- Severe abdominal cramps
- Diarrhea
- Significant fluid and electrolyte loss (especially potassium)
- Dehydration
- Hypotension
- Muscle weakness
What to Do:
Discontinue use. Provide supportive care, including fluid and electrolyte replacement. Monitor vital signs. In case of severe symptoms or suspected overdose, call a poison control center immediately (1-800-222-1222) or seek emergency medical attention.
Drug Interactions
Moderate Interactions
- Antacids
- H2-receptor antagonists (e.g., cimetidine, ranitidine)
- Proton pump inhibitors (e.g., omeprazole, lansoprazole)
- Milk
Monitoring
Routine Monitoring
Bowel movement frequency and consistency
Frequency: Daily during use
Target: Regular, soft stool
Action Threshold: No bowel movement after 12-24 hours, or persistent diarrhea/abdominal pain
Fluid and electrolyte balance (for prolonged/excessive use)
Frequency: As clinically indicated
Target: Normal serum electrolytes
Action Threshold: Signs of dehydration or electrolyte imbalance (e.g., muscle weakness, dizziness)
Symptom Monitoring
- Abdominal pain or cramping
- Nausea
- Diarrhea
- Rectal bleeding
- Dizziness or lightheadedness (signs of dehydration/electrolyte imbalance)
- Failure to produce a bowel movement
Special Patient Groups
Pregnancy
Generally considered safe for occasional, short-term use during pregnancy. Minimal systemic absorption limits fetal exposure. Consult a healthcare provider before use.
Trimester-Specific Risks:
First Trimester:
Low risk for occasional use.
Second Trimester:
Low risk for occasional use.
Third Trimester:
Low risk for occasional use.
Lactation
Considered compatible with breastfeeding. Minimal systemic absorption means very little drug is excreted into breast milk. Infant risk is low.
Infant Risk:
Low
Pediatric Use
Not recommended for children under 6 years of age without consulting a physician. Dosing for children 6-12 years is 5 mg once daily. Prolonged use can lead to laxative dependence and electrolyte imbalances.
Geriatric Use
Elderly patients may be more susceptible to fluid and electrolyte disturbances, especially with prolonged or excessive use. Start with the lowest effective dose and ensure adequate hydration. Avoid chronic use.
Clinical Information
Clinical Pearls
- Bisacodyl is an enteric-coated tablet; it should be swallowed whole and not crushed, chewed, or broken.
- Avoid taking bisacodyl within 1 hour of milk, antacids, or acid-reducing medications (e.g., H2 blockers, PPIs) to prevent premature dissolution of the enteric coating and gastric irritation.
- Best taken at bedtime to produce a bowel movement the following morning (6-12 hours later).
- Not intended for long-term use; chronic use can lead to laxative dependence, electrolyte imbalances, and damage to the colon.
- Encourage lifestyle modifications (dietary fiber, fluids, exercise) as primary constipation management strategies.
- If no bowel movement occurs after 12-24 hours or if severe abdominal pain/bleeding occurs, discontinue use and consult a healthcare provider.
Alternative Therapies
- Bulk-forming laxatives (e.g., psyllium, methylcellulose)
- Osmotic laxatives (e.g., polyethylene glycol, magnesium hydroxide, lactulose)
- Stool softeners (e.g., docusate sodium)
- Lubricant laxatives (e.g., mineral oil)
- Other stimulant laxatives (e.g., senna)
Cost & Coverage
Average Cost:
$5 - $20 per 30 tablets
Generic Available:
Yes
Insurance Coverage:
Generally not covered by prescription drug plans as it is an OTC medication. May be eligible for FSA/HSA reimbursement.
General Drug Facts
If your symptoms or health issues persist or worsen, it is essential to contact your doctor promptly. To ensure safe and effective treatment, never share your medication with others or take someone else's medication. Some medications may come with an additional patient information leaflet, so it is a good idea to check with your pharmacist for more information. If you have any questions or concerns about your medication, do not hesitate to discuss them with your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately call your local poison control center or seek emergency medical attention. When seeking help, be prepared to provide details about the overdose, including the medication taken, the amount, and the time it occurred.