Skip to Content

Bisacodyl

Medically reviewed by Drugs.com. Last updated on Sep 12, 2020.

Pronunciation

(bis a KOE dil)

Index Terms

  • Doxidan

Dosage Forms

Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product

Enema, Rectal:

Fleet Bisacodyl: 10 mg/30 mL (37 mL)

Suppository, Rectal:

Bisac-Evac: 10 mg (1 ea [DSC], 8 ea [DSC], 12 ea [DSC], 50 ea [DSC], 100 ea [DSC], 500 ea [DSC], 1000 ea [DSC])

Biscolax: 10 mg (12 ea [DSC], 100 ea)

Dulcolax: 10 mg (4 ea, 8 ea, 16 ea, 28 ea, 50 ea)

Gentle Laxative: 10 mg (50 ea)

The Magic Bullet: 10 mg (10 ea, 100 ea)

Generic: 10 mg (12 ea, 50 ea, 100 ea)

Tablet Delayed Release, Oral:

Bisacodyl EC: 5 mg

Bisacodyl EC: 5 mg [contains corn starch, fd&c yellow #10 aluminum lake, fd&c yellow #6 aluminum lake]

Bisacodyl EC: 5 mg [contains corn starch, fd&c yellow #10 aluminum lake, fd&c yellow #6 aluminum lake, methylparaben, propylparaben]

Bisacodyl EC: 5 mg [contains corn starch, fd&c yellow #10 aluminum lake, fd&c yellow #6 aluminum lake, methylparaben, propylparaben, sodium benzoate]

Bisacodyl EC: 5 mg [contains fd&c yellow #10 aluminum lake, fd&c yellow #6 aluminum lake]

Bisacodyl EC: 5 mg [contains fd&c yellow #10 aluminum lake, fd&c yellow #6 aluminum lake, methylparaben, propylparaben, sodium benzoate]

Correct: 5 mg

Ducodyl: 5 mg

Dulcolax: 5 mg [contains fd&c yellow #10 (quinoline yellow), methylparaben, propylparaben, sodium benzoate]

Ex-Lax Ultra: 5 mg [contains fd&c yellow #6 (sunset yellow), methylparaben]

Fleet Laxative: 5 mg [DSC]

GoodSense Bisacodyl EC: 5 mg [contains corn starch, fd&c yellow #10 aluminum lake, fd&c yellow #6 aluminum lake]

GoodSense Womens Laxative: 5 mg [gluten free; contains corn starch]

Womens Laxative: 5 mg [contains fd&c blue #1 aluminum lake, sodium benzoate, tartrazine (fd&c yellow #5)]

Brand Names: U.S.

  • Bisac-Evac [OTC] [DSC]
  • Bisacodyl EC [OTC]
  • Biscolax [OTC]
  • Correct [OTC]
  • Ducodyl [OTC]
  • Dulcolax [OTC]
  • Ex-Lax Ultra [OTC]
  • Fleet Bisacodyl [OTC]
  • Fleet Laxative [OTC] [DSC]
  • Gentle Laxative [OTC]
  • GoodSense Bisacodyl EC [OTC]
  • GoodSense Womens Laxative [OTC]
  • The Magic Bullet [OTC]
  • Womens Laxative [OTC]

Pharmacologic Category

  • Laxative, Stimulant

Pharmacology

Stimulates peristalsis by directly irritating the smooth muscle of the intestine, possibly the colonic intramural plexus; alters water and electrolyte secretion producing net intestinal fluid accumulation and laxation

Absorption

Oral, rectal: Systemic, <5% (Wald 2003)

Distribution

Vd: BHPM: 289 L (after multiple doses) (Friedrich 2011)

Metabolism

Bisacodyl is metabolized to an active metabolite (BHPM) in the colon; BHPM is then converted in the liver to a glucuronide salt (Friedrich 2011)

Excretion

BHPM: Urine, bile (Friedrich 2011)

Onset of Action

Oral: 6 to 12 hours; Rectal: 0.25 to 1 hour (suppository), 5 to 20 minutes (enema)

Half-Life Elimination

BHPM: ~8 hours (Friedrich 2011)

Use: Labeled Indications

Bowel cleansing (enema only): Bowel cleansing prior to rectal examination.

Constipation: Temporary relief of occasional constipation and irregularity.

Dosing: Adult

Bowel cleansing (enema only): Rectal: 10 mg (1 enema) as single dose

Constipation:

Oral: 5 to 15 mg once daily

Rectal: Enema, suppository: 10 mg (1 enema or suppository) once daily

Dosing: Geriatric

Refer to adult dosing.

Dosing: Pediatric

Constipation:

Oral: Limited data available in patients <6 years:

Children ≥3 years to <10 years: 5 mg once daily (NASPGHAN/ESPGHAN [Tabbers 2014]).

Children 10 to <12 years: 5 to 10 mg once daily (NASPGHAN/ESPGHAN [Tabbers 2014]).

Children ≥12 years and Adolescents: 5 to 15 mg once daily (NASPGHAN/ESPGHAN [Tabbers 2014]; manufacturer's labeling).

Rectal:

Suppository: Limited data available in children <6 years:

Children 2 to ≤10 years: 5 mg (1/2 suppository) once daily (NASPGHAN/ESPGHAN [Tabbers 2014]).

Children >10 years and Adolescents: 5 to 10 mg once daily (NASPGHAN/ESPGHAN [Tabbers 2014]).

Enema: Limited data available in children <12 years:

Children ≥2 to 10 years: 5 mg once daily (NASPGHAN/ESPGHAN [Tabbers 2014]).

Children >10 years and Adolescents: 5 to 10 mg once daily (NASPGHAN/ESPGHAN [Tabbers 2014]).

Administration

Oral: Administer with water. Swallow tablet whole; do not break, chew, or crush; do not administer within 1 hour of antacids, milk, or dairy products.

Bariatric surgery: Tablet, delayed release: Some institutions may have specific protocols that conflict with these recommendations; refer to institutional protocols as appropriate. Do not cut or crush in order to avoid gastric irritation.

Rectal:

Enema: Shake well; remove protective shield, insert tip into rectum with slight side to side movement; squeeze the bottle until nearly all liquid expelled (some liquid will remain in unit after use). Gently remove the unit, a small amount of liquid will remain in unit after use.

Suppository: Remove foil, insert into rectum with pointed end first. Retain in rectum for 15 to 20 minutes.

Dietary Considerations

Tablet: Do not administer within 1 hour of milk, dairy products, or an antacid.

Storage

Oral: Store at 20°C to 25°C (68°F to 77°F); protect from humidity.

Rectal: Store at <30°C (86°F).

Drug Interactions

Antacids: May diminish the therapeutic effect of Bisacodyl. Antacids may cause the delayed-release bisacodyl tablets to release drug prior to reaching the large intestine. Gastric irritation and/or cramps may occur. Management: Antacids should not be used within 1 hour before bisacodyl administration. Consider therapy modification

Dichlorphenamide: Laxatives may enhance the hypokalemic effect of Dichlorphenamide. Monitor therapy

Polyethylene Glycol-Electrolyte Solution: Bisacodyl may enhance the adverse/toxic effect of Polyethylene Glycol-Electrolyte Solution. Monitor therapy

Adverse Reactions

The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified.

<1%: Abdominal cramps (mild), electrolyte disturbance (metabolic acidosis or alkalosis, hypocalcemia), nausea, rectal irritation (burning), vertigo, vomiting

Warnings/Precautions

Dosage form specific issues:

• Benzyl alcohol and derivatives: Some dosage forms may contain sodium benzoate/benzoic acid; benzoic acid (benzoate) is a metabolite of benzyl alcohol; large amounts of benzyl alcohol (≥99 mg/kg/day) have been associated with a potentially fatal toxicity (“gasping syndrome”) in neonates; the “gasping syndrome” consists of metabolic acidosis, respiratory distress, gasping respirations, CNS dysfunction (including convulsions, intracranial hemorrhage), hypotension, and cardiovascular collapse (AAP ["Inactive" 1997]; CDC, 1982); some data suggests that benzoate displaces bilirubin from protein binding sites (Ahlfors, 2001); avoid or use dosage forms containing benzyl alcohol derivative with caution in neonates. See manufacturer’s labeling.

Other warnings/precautions:

• Appropriate use: Tablets: Do not chew or crush; do not use if you cannot swallow without chewing. Do not administer within 1 hour after taking an antacid, milk, or any dairy products.

• Appropriate use: Enema/Suppositories: For rectal use only, discontinue use and consult a health care provider if rectal bleeding occurs or if no bowel movement is produced after use.

• Self-medication (OTC use): Consult a health care provider prior to use if stomach pain, nausea, vomiting, or a sudden change in bowel movements lasting >2 weeks occurs, or if you have already used a laxative, including bisacodyl, for >1 week. Use may cause stomach discomfort, faintness, rectal burning, and mild cramps. Discontinue use and consult a health care provider if use >1 week is needed.

Pregnancy Considerations

Systemic exposure following maternal use of bisacodyl is limited. Plasma concentrations of BHPM (the active metabolite of bisacodyl) are low (median: 61 ng/mL; range: 20 to 118 ng/mL) and the pharmacokinetics are highly variable following oral doses of 10 mg/day for 7 days to women immediately postpartum (Friedrich 2011).

Use of bisacodyl should be limited during pregnancy due to an increased risk of adverse events, such as electrolyte abnormalities. When dietary changes and lifestyle modifications are insufficient, agents other than bisacodyl are recommended for the treatment of constipation in pregnant women (Body 2016; Gomes 2018).

Patient Education

What is this drug used for?

• It is used to treat constipation.

• It is used as a laxative to clean out the colon before an exam.

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:

• Abdominal pain

• Abdominal cramps

• Rectal burning

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

• Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.

Note: This is not a comprehensive list of all side effects. Talk to your doctor if you have questions.

Consumer Information Use and Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only the healthcare provider has the knowledge and training to decide which medicines are right for a specific patient. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a limited summary of general information about the medicine's uses from the patient education leaflet and is not intended to be comprehensive. This limited summary does NOT include all information available about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not intended to provide medical advice, diagnosis or treatment and does not replace information you receive from the healthcare provider. For a more detailed summary of information about the risks and benefits of using this medicine, please speak with your healthcare provider and review the entire patient education leaflet.

Further information

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

Frequently Asked Questions