bisacodyl rectal

Bisacodyl rectal is a laxative medication available over the counter to treat occasional constipation and irregularity in bowel movement, in both adults and children. Bisacodyl is available as a suppository or an enema liquid that is rectally administered. Bowel movement typically occurs in 5 to 20 minutes after administration of bisacodyl enema and 25 minutes to an hour after insertion of a suppository. Bisacodyl enema is also used for bowel cleansing before a rectal examination.

Bisacodyl is a stimulant laxative that works by stimulating contractions of the smooth muscles of the colon, a process known as peristalsis by which intestines propel their contents, resulting in bowel movement. Bisacodyl is converted to its active metabolite bis-(p-hydroxyphenyl)-pyridyl-2-methane (BHPM) by the colonic bacterial enzymes. BHPM stimulates the nerve endings in the colon, which increases intestinal secretions and motility. BHPM also prevents the reabsorption of water, increasing the water content in the colon, which softens the stools for easy elimination.

• Do not use bisacodyl in patients with the following conditions:
  • Hypersensitivity to any component of bisacodyl rectal
  • Temporary paralysis of intestinal muscles (ileus)
  • Intestinal obstruction
  • Symptoms of appendicitis or any other abdominal condition that requires immediate surgical intervention (acute surgical abdomen)
  • Acute inflammatory bowel disease
  • Severe abdominal pain associated with nausea and vomiting
  • Severe dehydration
• Laxatives including bisacodyl rectal, should not be used for extended periods without investigating the cause of the constipation.
• Prolonged use of laxatives can cause loss of fluids and lead to dehydration and electrolyte imbalance. Advise patients to hydrate adequately.
• Do not administer OTC bisacodyl rectal to children without medical advice and supervision.
• Use of bisacodyl rectal suppositories can cause pain and local irritation, especially in patients with anal fissures and ulcerative proctitis. Avoid use if you have these conditions, unless directed by your physician.

Common side effects of bisacodyl rectal include:

• Rectal burning
• Abdominal cramps
• Abdominal discomfort
• Gas (flatulence)
• Excessive diarrhea
• Dehydration
• Electrolyte imbalance
• Vomiting
• Headache
• Vertigo
• Faintness

Call your doctor immediately if you experience any of the following symptoms or serious side effects while using this drug:

• Serious heart symptoms include fast or pounding heartbeats, fluttering in your chest, shortness of breath, and sudden dizziness;
• Severe headache, confusion, slurred speech, severe weakness, vomiting, loss of coordination, feeling unsteady;
• Severe nervous system reaction with very stiff muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors, and feeling like you might pass out; or
• Serious eye symptoms include blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights.

This is not a complete list of all side effects or adverse reactions that may occur from the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may also report side effects or health problems to the FDA at 1-800-FDA-1088.

Enema

• 10 mg/30 mL

Suppository

• 10 mg

Adult:

Constipation

• Enema: Contents of 1 bottle (i.e., 37 mL) rectally as a single dose
• Suppository: Remove outer wrap and insert 1 suppository into rectum

Enema Administration

• Patient should lie on left side with right knee bent
• Gently insert enema tip into rectum using slight side-to-side movement; point enema tip toward navel (ease insertion by having patient bear down, as if having a bowel movement, to relax anal muscles)
• Do not force enema tip into rectum
• Squeeze bottle to deliver appropriate dose
• Remove enema tip from rectum
• Retain enema in accordance with doctor's instructions

Pediatric:

Constipation

Enema

• Children above 12 years: As adults; contents of 1 bottle (i.e., 37 mL) rectally as a single dose

Suppository

• Children 6-12 years: Remove outer wrap and insert one-half suppository into rectum
• Children above 12 years: As adults; remove outer wrap and insert 1 suppository into rectum

Overdose

Excessive use of bisacodyl rectal can cause diarrhea and lead to dehydration and electrolyte imbalance. Bisacodyl overdose may be treated with discontinuation of bisacodyl, and supportive measures such as adequate fluid intake and correction of electrolytes as required.

Inform your doctor of all medications you are currently taking, who can advise you on any possible drug interactions. Never begin taking, suddenly discontinue, or change the dosage of any medication without your doctor’s recommendation.

• Bisacodyl rectal has no listed severe interactions with other drugs.
• Serious interactions of bisacodyl rectal include:
  • sodium sulfate/magnesium sulfate/potassium chloride
  • sodium sulfate/potassium sulfate/magnesium sulfate
• Moderate interactions of bisacodyl rectal include:
  • deflazacort
• Mild interactions of bisacodyl rectal include:
  • potassium acid phosphate
  • potassium chloride

The drug interactions listed above are not all of the possible interactions or adverse effects. For more information on drug interactions, visit the RxList Drug Interaction Checker.

It is important to always tell your doctor, pharmacist, or health care provider of all prescription and over-the-counter medications you use, as well as the dosage for each, and keep a list of the information. Check with your doctor or health care provider if you have any questions about the medication.

• Constipation during pregnancy is best managed with dietary intake of fluid and fiber, and moderate exercise.
• There are no adequate and well-controlled studies in the use of bisacodyl rectal in pregnant women. Systemic absorption with rectal administration is limited, however, bisacodyl rectal should be used with caution during pregnancy, with medical advice from the physician, because of the risk for excessive diarrhea and electrolyte imbalance.
• Systemic absorption from rectal bisacodyl is limited and the drug and clinical data do not show evidence of the presence of the drug or its metabolites in breastmilk, and likely safe for use during breastfeeding.

• Bisacodyl rectal is for rectal use only. Use exactly as per directions.
• Prolonged or excessive use of laxatives can lead to dehydration and electrolyte imbalance.
• Chronic use of laxatives can lead to laxative dependence for bowel movements.
• Do not use bisacodyl rectal:
  • More than once per day
  • For a period of longer than one week unless directed by a doctor
  • If you have abdominal pain, fever, nausea, or vomiting, unless directed by a doctor
• Discontinue bisacodyl rectal and check with a doctor if you have:
  • No bowel movement after use
  • Rectal bleeding
• Check with your physician before using bisacodyl rectal if you notice changes in bowel habits that persist for longer than 2 weeks.
• Store bisacodyl rectal safely out of reach of children.
• In case of overdose, seek medical help or contact Poison Control.