Bisacodyl/sodium biphosphate/sodium phosphate Disease Interactions

Alkalinizing agents containing sodium can induce sodium and water retention and result in hypernatremia, hypokalemia, hyperosmolality, edema and aggravation of congestive heart failure. Therapy with sodium- containing alkalinizing agents should not be used in patients with hypernatremia or fluid retention. Clinical monitoring of acid/base balance and electrolytes prior to, during, a following completion of therapy with alkalinizing agents is recommended.

The use of laxatives is contraindicated in patients with inflammatory bowel disease. Patients with inflammatory bowel disease may experience colonic perforation with use of stimulant laxatives.

The use of laxatives is contraindicated in patients with intestinal obstruction disorders. Patients with intestinal obstruction disorders may need their underlying condition treated to correct the constipation. Some laxatives require reduction in the colon to their active form to be effective which may be a problem in patients with intestinal obstruction.

The use of phosphates is in general contraindicated in conditions where high potassium, high phosphate, or low calcium may be encountered such as hypoparathyroidism, osteomalacia, acute pancreatitis, or chronic renal disease.

Therapy with phosphates should be administered with extreme caution in patients with hyperphosphatemia (hypoparathyroidism or severe renal impairment). Elevated serum concentrations of phosphate and calcium can exceed the solubility level and result in calcium-phosphate precipitates that deposit in vascular and renal systems as well as other soft tissues of the body. Clinical monitoring of serum calcium and phosphate concentrations is necessary.

The use of sodium phosphates is contraindicated in patients with congenital megacolon, intestinal obstruction, imperforate anus, active inflammatory disease or congestive heart failure. Serious, potentially life-threatening electrolyte imbalance such as hypocalcemia and hyperphosphatemia can result with prolonged or excessive use of phosphate laxatives. Hypernatremia and dehydration can occur due to improper dilution of hypertonic saline laxatives. Therapy with sodium phosphates should be administered cautiously and frequency of administration limited in patients with renal dysfunction, colostomy, cardiac dysfunction, or electrolyte imbalance. Clinical monitoring of electrolyte concentrations is recommended.

The use of stimulant laxatives is contraindicated in patients with or who may have acute surgical abdomen or appendicitis. These patients may be candidates for emergency surgery. Stimulant laxatives should also not be administered to patients with abdominal pain, particularly if the cause has not been determined.

The use of stimulant laxatives is contraindicated in patients with anal or rectal fissures. These preparations may cause irritation, burning sensation, and proctitis.