Gentle Laxative 10mg Suppositories
It is used to treat constipation.
Drug Class
Laxative
Pharmacologic Class
Stimulant Laxative
Pregnancy Category
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 directly stimulating the muscles in your colon to help you have a bowel movement quickly, usually within an hour. They are used for occasional constipation or to prepare for certain 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. Before and after handling the suppository, wash your hands thoroughly. 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 the 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. You may also want to inquire about drug take-back programs in your area.
Missing a Dose
If you take this medication regularly 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 resume your normal schedule. Avoid taking two doses at the same time or taking extra doses. If you take this medication as needed, do not take it more frequently than directed by your doctor.
To use this medication correctly, follow your doctor's instructions and read all the information provided. When using the suppository, insert it rectally. Before and after handling the suppository, wash your hands thoroughly. 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 the 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. You may also want to inquire about drug take-back programs in your area.
Missing a Dose
If you take this medication regularly 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 resume your normal schedule. Avoid taking two doses at the same time or taking extra doses. If you take this medication as needed, do not take it more frequently than directed by your doctor.
Lifestyle & Tips
- Drink plenty of fluids (water, juices) 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.
- Do not use if you have abdominal pain, nausea, or vomiting.
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:
One 10 mg suppository rectally once daily for acute constipation or bowel preparation.
Pediatric Dosing
Neonatal:
Not established
Infant:
Not established (generally not recommended for children under 2 years without medical supervision)
Child:
2-10 years: 5 mg rectally once daily. Over 10 years: 10 mg rectally once daily.
Adolescent:
10 mg rectally once daily
Dose Adjustments
Renal Impairment:
Mild:
No adjustment needed
Moderate:
No adjustment needed
Severe:
No adjustment needed (minimal systemic absorption)
Dialysis:
No adjustment needed
Hepatic Impairment:
Mild:
No adjustment needed
Moderate:
No adjustment needed
Severe:
No adjustment needed (minimal systemic absorption)
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 of the colon. It also promotes fluid and electrolyte accumulation in the colon, increasing stool volume and softening consistency.
Pharmacokinetics
Absorption:
Bioavailability:
Minimal systemic absorption (less than 5% from oral forms, even less from rectal)
Tmax:
Not applicable for systemic Tmax due to local action; onset of action is rapid.
FoodEffect:
Not applicable for suppositories.
Distribution:
Vd:
Not applicable (minimal systemic distribution)
ProteinBinding:
Not applicable (minimal systemic distribution)
CnssPenetration:
No
Elimination:
HalfLife:
Not well-defined due to minimal systemic absorption; active metabolite has a half-life of approximately 16 hours after oral administration.
Clearance:
Not applicable (minimal systemic clearance)
ExcretionRoute:
Primarily fecal (unabsorbed drug and active metabolite); small amounts of active metabolite are excreted renally after glucuronidation.
Unchanged:
Not applicable (prodrug)
Pharmacodynamics
OnsetOfAction:
15-60 minutes (rectal)
PeakEffect:
Not well-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
- Swelling of the mouth, face, lips, tongue, or throat
Other Possible Side Effects
Like all medications, this drug can cause side effects. While many people may not experience any side effects or only minor ones, it's essential to discuss any concerns with your doctor. Contact your doctor if you experience any of the following side effects or if they persist or bother you:
- Stomach pain or cramps
- Burning
Reporting Side Effects
This list does not include all possible side effects. If you have questions or concerns about side effects, consult your doctor. For medical advice about 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
- Swelling of the mouth, face, lips, tongue, or throat
Other Possible Side Effects
Like all medications, this drug can cause side effects. While many people may not experience any side effects or only minor ones, it's essential to discuss any concerns with your doctor. Contact your doctor if you experience any of the following side effects or if they persist or bother you:
- Stomach pain or cramps
- Burning
Reporting Side Effects
This list does not include all possible side effects. If you have questions or concerns about side effects, consult your doctor. For medical advice about 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 or cramping
- Rectal bleeding
- Failure to have a bowel movement after using the suppository
- Signs of dehydration (e.g., excessive thirst, dry mouth, decreased urination, dizziness)
- Muscle weakness or irregular heartbeat (signs of electrolyte imbalance from overuse)
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 issues, including:
+ Bowel blockage
+ Abdominal pain
+ Upset stomach
+ Rectal bleeding
+ Vomiting
+ Changes in bowel habits that persist for more 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, provide your doctor and pharmacist with a comprehensive list of:
All prescription and over-the-counter (OTC) medications you are taking
Natural products
Vitamins
Health problems
Carefully review your medications and health conditions with your doctor to confirm that it is safe to take this medication. Never start, stop, or adjust 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 issues, including:
+ Bowel blockage
+ Abdominal pain
+ Upset stomach
+ Rectal bleeding
+ Vomiting
+ Changes in bowel habits that persist for more 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, provide your doctor and pharmacist with a comprehensive list of:
All prescription and over-the-counter (OTC) medications you are taking
Natural products
Vitamins
Health problems
Carefully review your medications and health conditions with your doctor to confirm that it is safe to take this medication. Never start, stop, or adjust 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.
Do not use this medication for a period exceeding 1 week unless your doctor has specifically instructed you to do so. Additionally, refrain from using other laxatives or stool softeners concurrently with this drug, unless advised by your doctor.
If you experience rectal bleeding or fail to have a bowel movement after using this medication, it is crucial that you 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 currently breast-feeding, you must notify your doctor. Your doctor will need to discuss the potential benefits and risks of using this medication with you, taking into account the well-being of both you and your baby.
Do not use this medication for a period exceeding 1 week unless your doctor has specifically instructed you to do so. Additionally, refrain from using other laxatives or stool softeners concurrently with this drug, unless advised by your doctor.
If you experience rectal bleeding or fail to have a bowel movement after using this medication, it is crucial that you 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 currently breast-feeding, you must notify your doctor. Your doctor will need to discuss the potential benefits and risks of using this medication with you, taking into account the well-being of both you and your baby.
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. Call 911 or Poison Control (1-800-222-1222) immediately.
Drug Interactions
Moderate Interactions
- Antacids (oral bisacodyl): May cause gastric irritation or dyspepsia due to premature dissolution of enteric coating. Not relevant for suppositories.
- Milk (oral bisacodyl): May cause gastric irritation or dyspepsia due to premature dissolution of enteric coating. Not relevant for suppositories.
- Other laxatives: Concurrent use may lead to excessive fluid and electrolyte loss.
Monitoring
Routine Monitoring
Bowel movement frequency and consistency
Frequency: Daily, as needed
Target: Regular, soft stool
Action Threshold: Lack of bowel movement after 1 hour, or persistent constipation despite use.
Fluid and electrolyte balance (if prolonged/excessive use)
Frequency: As clinically indicated
Target: Normal serum electrolytes
Action Threshold: Signs of dehydration (e.g., dry mouth, decreased urination) or muscle weakness/cramps.
Symptom Monitoring
- Abdominal cramping
- Rectal irritation
- Dizziness or lightheadedness (signs of dehydration)
- Muscle weakness or cramps (signs of electrolyte imbalance)
- Persistent nausea or vomiting
Special Patient Groups
Pregnancy
Generally considered low risk for short-term use during pregnancy due to minimal systemic absorption. However, use only if clearly needed and under medical supervision.
Trimester-Specific Risks:
First Trimester:
Low risk, but consult physician.
Second Trimester:
Low risk, but consult physician.
Third Trimester:
Low risk, but consult physician.
Lactation
Considered low risk for nursing infants due to minimal systemic absorption of bisacodyl and its active metabolite. Small amounts may be excreted in breast milk, but adverse effects on the infant are unlikely.
Infant Risk:
Low risk
Pediatric Use
Use with caution and under medical supervision, especially in children under 2 years. Dosing must be age-appropriate (5 mg for 2-10 years, 10 mg for >10 years). Not for prolonged use.
Geriatric Use
Use with caution. Elderly patients may be more susceptible to fluid and electrolyte imbalances, especially with prolonged or excessive use. Encourage adequate hydration.
Clinical Information
Clinical Pearls
- Bisacodyl suppositories are for acute, occasional constipation and should not be used for chronic constipation.
- Onset of action is typically rapid (within 15-60 minutes), making them suitable for immediate relief or bowel preparation.
- Prolonged or excessive use can lead to fluid and electrolyte disturbances, particularly hypokalemia, and may result in laxative dependence.
- Patients should be advised to drink plenty of fluids while using laxatives.
- Rectal irritation or burning can occur with suppository use.
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)
- Glycerin suppositories
Cost & Coverage
Average Cost:
$5 - $15 per 12 suppositories
Generic Available:
Yes
Insurance Coverage:
OTC (Over-the-Counter), generally not covered by prescription plans unless prescribed by a physician and submitted for 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's a good idea to check with your pharmacist for more information. If you have any questions or concerns about this 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 emergency medical attention. When seeking help, be prepared to provide details about the medication taken, the amount, and the time it occurred.