bisakodyl

Bisacodyl is a stimulant laxative used to treat constipation and to cleanse the bowels before certain medical procedures. It works by stimulating nerve endings in the colon to increase peristaltic activity and bowel movements; the action is local to the large intestine.

Forms and onset: It is available as oral enteric-coated tablets and as rectal suppositories. Oral tablets generally take 6 to 12 hours to produce a bowel movement; rectal suppositories usually act within 15 minutes to 60 minutes.

Indications: Short-term treatment of constipation; bowel preparation for colonoscopy or other procedures, sometimes as part of a regimen with a polyethylene glycol solution.

Administration and precautions: Swallow the tablets whole with a full glass of water; do not chew or crush the tablets because the enteric coating is designed to resist stomach acid. Do not take with milk or antacids within about one hour of the dose, as these can affect the coating. For suppositories, insert into the rectum as directed and retain for at least 15 to 60 minutes if possible. Use for the shortest duration possible; chronic use can lead to dependence and electrolyte disturbances.

Contraindications: Intestinal obstruction, acute abdominal pain of unknown origin, appendicitis, inflammatory bowel disease, or severe dehydration; known hypersensitivity to bisacodyl.

Adverse effects and safety: Common side effects include abdominal cramps, nausea, and diarrhea. Prolonged use may cause electrolyte imbalances, dehydration, or melanosis coli. Caution in elderly patients and those with heart or kidney disease; consult a clinician if pregnant or breastfeeding.