bisacodyl, Bisac-Evac, Bisacolax, Biscolax, Carter’s Little Pills, Codulax, Correctol, Dacodyl, Doxidan, Dulcolax, Ex- Lax Ultra, Femilax, Fleet Laxative, Soflax-Ex

 Indications

Treatment of constipation. Evacuation of the bowel before

radiologic studies or surgery. Part of a bowel regimen

in spinal cord injury patients.

Action

Stimulates peristalsis. Alters fluid and electrolyte transport,

producing fluid accumulation in the colon. Therapeutic

Effects: Evacuation of the colon.

Pharmacokinetics

Absorption: Variable absorption follows oral administration;

rectal absorption is minimal; action is local in

the colon.

Distribution: Small amounts of metabolites excreted

in breast milk.

Metabolism and Excretion: Small amounts absorbed

are metabolized by the liver.

Half-life: Unknown.

TIME/ACTION PROFILE (evacuation of bowel)

ROUTE ONSET PEAK DURATION

PO 6–12 hr unknown unknown

Rectal 15–60 min unknown unknown

Contraindications/Precautions

Contraindicated in: Hypersensitivity; Abdominal

pain; Obstruction; Nausea or vomiting (especially with

fever or other signs of an acute abdomen).

Use Cautiously in: Severe cardiovascular disease;

Anal or rectal fissures; Excess or prolonged use (may

result in dependence); OB, Lactation: May be used during

pregnancy and lactation.

Adverse Reactions/Side Effects

GI: abdominal cramps, nausea, diarrhea, rectal burning.

F and E: hypokalemia (with chronic use). MS:

muscle weakness (with chronic use). Misc: proteinlosing

enteropathy, tetany (with chronic use).

Interactions

Drug-Drug: Antacids, histamine H2-receptor antagonists,

and gastric acid–pump inhibitors may

remove enteric coating of tablets resulting in gastric irritation/

dyspepsia. Maypthe absorption of other

orally administered drugs because ofqmotility and

ptransit time.

Drug-Food: Milk may remove enteric coating of tablets,

resulting in gastric irritation/dyspepsia.

Route/Dosage

PO (Adults and Children 12 yr): 5–15 mg/day

(up to 30 mg/day) as a single dose.

PO (Children 3–11 yr): 5–10 mg/day (0.3 mg/kg)

as a single dose.

Rect (Adults and Children 12 yr): 10 mg/day single

dose.

Rect (Children 2–11 yr): 5–10 mg/day single dose.

Rect (Children 2 yr): 5 mg/day single dose.

Availability (generic available)

Enteric-coated tablets: 5 mgOTC. Enteric coated

and delayed release: 5 mgOTC. Suppositories: 10

mgOTC. Rectal solution: 10 mg/30 mLOTC. In combination

with: In Bowel Preparation kits with Magnesium

citrate (Evac-Q-KwikOTC, EZ-EM Prep KitOTC,

LiquiPrep Bowel EvacuantOTC, Tridate Bowel Cleansing

KitOTC), Phosphate/biphosphate (Fleet Prep Kit. No.

1OTC, Fleet Prep Kit No. 2OTC, Fleet Prep Kit No. 3OTC),

sennosides (X-Prep Bowel Evacuant Kit #1OTC), sennosides,

magnesium citrate, magnesium sulfate (X-Prep

Bowel Evacuant Kit #2OTC). See Appendix B.