|Trade names||Fleet, Dulcolax, Brooklax, others|
|Drug class||Stimulant laxative|
|By mouth, rectal|
|Onset of action||6 to 12 hr (by mouth), <1 hr (rectal)|
|Elimination half-life||16 Hours|
|Excretion||Primarily in the feces, systemically absorbed drug is excreted in the urine|
|Chemical and physical data|
|Molar mass||361.397 g·mol−1|
|3D model (JSmol)|
|(what is this?)|
Bisacodyl is a medication use for constipation and to clear the bowels before colonoscopy. It may be taken by mouth or used rectally. Generally by mouth effects occur in 6 to 12 hours while rectally effects are within an hour. Long term use appears to be safe.
Common side effect include abdominal cramps and nausea. Other side effects may include dehydration, electrolyte problems, and angioedema. Use in pregnancy appears to be generally safe. It is a type of stimulant laxative. It is believed to work by altering water and electrolyte absorption and increasing the contraction of the large intestines.
Bisacodyl was patented in 1952 and came into medical use in 1953. It is avaliable as a generic medication, over the counter, and is inexpensive. It is sold under a number of brand names including Dulcolax and Fleet.
When bisacodyl is administered orally, it is usually taken at bedtime. Oral administration is known to produce no action for more than eight hours and then to work suddenly and relatively quickly. This is especially true if more than 10 mg is taken at one time. Normally, the dosage is 5 or 10 mg, but up to 30 mg can be taken for complete cleansing of the bowel before a procedure.
When administered rectally in suppository form, it is usually effective in 15 to 60 minutes. For optimal use, if used as a suppository, it is recommended that bisacodyl be given after breakfast to synchronize with the gastrocolic reflex. Two suppositories can be inserted at once if a very strong, purgative, enema-like result is needed. A few hours after the initial evacuation, there can be a secondary action which will continue as long as there is unexpelled bisacodyl present in the rectum.
Mechanism of action
Bisacodyl works by stimulating enteric nerves to cause peristalsis, i.e., colonic contractions. It is also a contact laxative; it increases fluid and salt secretion. The action of bisacodyl on the small intestine is negligible; stimulant laxatives mainly promote evacuation of the colon.
It is usually sold as 5 mg tablets, 10 mg suppositories, or 5 mg pediatric suppositories. It is also available as a 1.25 US fluid ounces (37 ml) pre-packaged enema containing a 10 mg delivered dose of liquid bisacodyl.
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