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Drug Interactions between bisacodyl / polyethylene glycol 3350 / potassium chloride / sodium bicarbonate / sodium chloride and Depo-Cobolin

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Moderate

sodium bicarbonate bisacodyl

Applies to: bisacodyl / polyethylene glycol 3350 / potassium chloride / sodium bicarbonate / sodium chloride and bisacodyl / polyethylene glycol 3350 / potassium chloride / sodium bicarbonate / sodium chloride

ADJUST DOSING INTERVAL: By increasing gastric pH, antacids may reduce the resistance of the enteric coating of bisacodyl tablets, resulting in earlier release of bisacodyl and gastric irritation and dyspepsia.

MANAGEMENT: The administration of antacids and bisacodyl should be separated by at least one hour.

References

  1. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0

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Moderate

bisacodyl polyethylene glycol 3350

Applies to: bisacodyl / polyethylene glycol 3350 / potassium chloride / sodium bicarbonate / sodium chloride and bisacodyl / polyethylene glycol 3350 / potassium chloride / sodium bicarbonate / sodium chloride

GENERALLY AVOID: Concomitant use of stimulant laxatives (e.g., bisacodyl, sodium picosulfate) may increase the risk of serious gastrointestinal adverse effects associated with certain osmotic laxatives (e.g., polyethylene glycol (PEG), oral sulfate solution), such as colonic mucosal ulcerations or ischemic colitis. There have been isolated case reports of ischemic colitis occurring with the use of PEG-based bowel cleansing products in combination with higher dosages of bisacodyl (usually greater than 10 mg). Bisacodyl can cause colonic ischemia due to transient reduction in splanchnic blood flow. When administered in conjunction with an osmotic laxative such as PEG, increased intramural pressure secondary to increased peristalsis may lead to ischemic colitis and perforation.

MANAGEMENT: The manufacturers for some osmotic bowel cleansing products recommend avoiding the concurrent use of stimulant laxatives. However, stimulant laxatives, in particular bisacodyl and sodium picosulfate, are sometimes used with PEG in certain bowel cleansing regimens to help reduce dose volume and improve patient tolerability and acceptance. Please consult individual product labeling for specific recommendations and guidance. Patients using osmotic bowel cleansing products and stimulant laxatives who present with sudden abdominal pain, rectal bleeding, or other symptoms of ischemic colitis should be evaluated promptly.

References

  1. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
  2. Cerner Multum, Inc. "Australian Product Information." O 0
  3. Baudet JS, Castro V, Redondo I "Recurrent ischemic colitis induced by colonoscopy bowel lavage." Am J Gastroenterol 105 (2010): 700-1
  4. "Product Information. Suprep Bowel Prep Kit (magnesium/potassium/sodium sulfates)." Braintree Laboratories (2010):
  5. Ajani S, Hurt RT, Teeters DA, Bellmore LR "Ischaemic colitis associated with oral contraceptive and bisacodyl use." BMJ Case Rep 2012 (2012):
  6. "Product Information. MoviPrep (polyethylene glycol 3350 with electrolytes)." Physicians Total Care (2016):
  7. "Product Information. Plenvu (polyethylene glycol 3350 with electrolytes)." Bausch Health US (formerly Valeant Pharmaceuticals) (2020):
  8. "Product Information. GaviLyte-H and Bisacodyl with Flavor Packs (bisacodyl-PEG 3350 with electrolytes)." Gavis Pharmaceuticals (2022):
  9. "Product Information. Bi-Peglyte (bisacodyl-PEG 3350 with electrolytes)." Pendopharm PROD
  10. Vaizman K, Li J, Iswara K, Tenner S "Ischemic colitis induced by the combination of Bisacodyl and polyethylene glycol in preparation for colonoscopy." Am J Gastroenterol 102 (2007): S267
  11. Belsey J, Epstein O, heresbach D "Systematic review: adverse event reports for oral sodium phosphate and polyethylene glycol." Aliment Pharmacol Ther 29 (2009): 15-28
  12. Hung SY, Chen HC, Chen WT "A randomized trial comparing the bowel cleansing efficacy of sodium picosulfate/magnesium citrate and polyethylene glycol/Bisacodyl (The Bowklean Study)" Sci Rep 10 (2020): 5604
  13. Adamcewicz M, Bearelly D, Porat G, Friedenberg FK "Mechanism of action and toxicities of purgatives used for colonoscopy preparation." Expert Opin Drug Metab Toxicol 7 (2011): 89-101
  14. Anastassopoulos K, Farraye FA, Knight T, Colman S, Cleveland MvB, Pelham RW "A comparative study of treatment-emergent adverse events following use of common bowel preparations among a colonoscopy screening population: results from a post-marketing observational study." Dig Dis Sci 61 (2016): 2993-3006
  15. Barbeau P, Wolfe D, Yazdi F, et al. "Comparative safety of bowel cleansers: protocol for a systematic review and network meta-analysis." BMJ Open 8 (2018): e021892
View all 15 references

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Minor

potassium chloride cyanocobalamin

Applies to: bisacodyl / polyethylene glycol 3350 / potassium chloride / sodium bicarbonate / sodium chloride and Depo-Cobolin (cyanocobalamin)

Limited data suggest that orally administered potassium chloride may decrease the gastrointestinal absorption of vitamin B12. The mechanism is believed to be a reduction in ileal pH by potassium chloride, which significantly decreases the activity of intrinsic factor that is necessary for vitamin B12 absorption. However, the interaction should rarely lead to clinically significant deficiency because the body (primarily the liver) usually has a copious supply of vitamin B12 that can sustain a person for several years in the absence of adequate intake. As for the treatment of B12 deficiency-related anemia, non-oral routes of administration (e.g., parenteral, intranasal, sublingual) are generally preferred, which would bypass the potential interaction.

References

  1. Palva IP, Salokannel SJ, Timonen T, Palva HL "Drug-induced malabsorption of vitamin B 12 . IV. Malabsorption and deficiency of B 12 during treatment with slow-release potassium chloride." Acta Med Scand 191 (1972): 355-7

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Drug and food interactions

No alcohol/food interactions were found. However, this does not necessarily mean no interactions exist. Always consult your healthcare provider.

Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

See also

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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