Bisacodyl

Bisacodyl belongs to a subgroup of contact laxatives.

The drug has a powerful laxative effect, which allows to liquefy or soften hardened fecal matter. The principle of development of the laxative effect is associated with an increase in the volume of water penetrating into the intestinal cavity, as well as with a decrease in the intensity of its absorption. In addition, the therapeutic effect of the drug increases the rate of intestinal peristalsis. [ 1 ]

Indications Bisacodyl

It is used for short-term therapy in cases of constipation. In addition, it can be prescribed for clinical needs to facilitate defecation processes in the presence of anal fissures and fistulas, as well as hemorrhoids.

Used in preparation for diagnostics or surgery (under medical supervision).

Release form

The medicinal substance is released in tablets - 10 pieces inside a cell plate; inside a pack - 3 such plates. Also sold in 30 pieces inside a blister pack; inside a box - 1 such pack.

Pharmacodynamics

In the development of the therapeutic effect, an important part is the splitting of the medicinal component within the alkaline intestinal environment. In this case, elements are formed that irritate the ends of the mucous membrane. Due to this, intestinal peristalsis is stimulated. [ 2 ]

Pharmacokinetics

Microbial and intestinal enzymes rapidly transform the drug into its active metabolic component. Only 5% of the dose taken orally is absorbed into the systemic circulation, undergoes intrahepatic transformation and is excreted in the urine and bile as inactive metabolites (glucuronides). [ 3 ]

Dosing and administration

To make defecation more effective, Bisacodyl should be taken before bedtime; the medicine is taken orally, without reference to food intake. The tablet is swallowed without chewing and washed down with plain water.

For short-term treatment of constipation or clinical need to facilitate defecation in individuals with anal fissures/fistulas or haemorrhoids.

Children over 10 years of age and adults should take 5-10 mg of the substance once a day (1-2 tablets).

For a child aged 4-10 years – 5 mg of the drug once a day (1 tablet).

In preparation for an operation or diagnosis.

For persons over 10 years of age – 10-20 mg of the medicine once in the evening (2-4 tablets).

Children 4-10 years old – 1 tablet (5 mg).

It is forbidden to use the medicine for more than 8-10 days; it is also not advisable to take it every day.

• Application for children

The medication should not be used by persons under 4 years of age. Use by children aged 4-10 years is permitted only with a doctor's prescription.

Use Bisacodyl during pregnancy

It is prohibited to prescribe Bisacodyl during breastfeeding or pregnancy, since there is no information regarding the safety of taking the drug in these categories of patients.

Contraindications

Main contraindications:

• severe intolerance to bisacodyl or other components of the medication;
• active forms of hemorrhoids or proctitis;
• spastic obstipation;
• intestinal obstruction;
• bleeding inside the gastrointestinal tract and uterus;
• acute abdomen syndrome, which includes appendicitis and other active forms of intestinal inflammation;
• severe abdominal pain, accompanied by vomiting and nausea (these signs may be symptoms of the severe conditions described above);
• severe dehydration.

Side effects Bisacodyl

Side effects include:

• Gastrointestinal disorders: abdominal discomfort (e.g. colic), vomiting, diarrhea, bloating, colitis, hematochezia, nausea, abdominal pain and discomfort in the anorectal area may occur. Long-term use of the drug or an overdose may cause severe loss of fluid and electrolytes, especially potassium (development of hypokalemia). With long-term use of the drug, atony is possible, affecting the colon;
• disorders of nutritional and metabolic processes: dehydration, which causes cramps, muscle weakness and decreased blood pressure;
• problems with the function of the nervous system: fainting and dizziness associated with a vasovagal reaction (for example, to defecation or colic);
• immune damage: there is information about the appearance of allergies after taking the drug - anaphylactic symptoms or Quincke's edema develop.

Overdose

In case of intoxication, abdominal cramps and diarrhea may occur, clinically significant fluid loss and electrolyte imbalance (also with manifestations of atony in the colon and hypokalemia) may develop. Chronic poisoning may provoke chronic diarrhea, hypokalemia, abdominal pain, secondary hyperaldosteronism and nephrolithiasis. There are reports of metabolic alkalosis, renal tubular damage and muscle weakness due to hypokalemia.

It is necessary to stop taking the medicine and consult a doctor. Induction of vomiting or gastric lavage is required. It is recommended to correct the EBV indicators (especially in children and the elderly), and also to use symptomatic drugs. Sometimes antispasmodics may be required.

Interactions with other drugs

Bisacodyl should be combined with caution with substances that lead to the development of hypokalemia: GCS, tetracosactide, diuretics and amphotericin B.

Any laxative medications are prohibited to be combined with diuretics. Bisacodyl can lead to a delay in the secretion of calcium ions.

Use together with foxglove (digitalis glycosides) increases the likelihood of digitalis poisoning and hypokalemia.

The drug should not be used in combination with substances that block H2-endings, antacids and dairy products (within 60 minutes), as this can accelerate the process of dissolution of the outer tablet shell, which leads to irritation of the gastrointestinal mucosa and weakening of the effect of the drug.

The use of the drug in combination with terfenadine, amiodarone, astemizole, as well as with sotalol, erythromycin and quinidine substances is prohibited.

Simultaneously with the administration of Bisacodyl, as well as during the period of 1 hour before and after its use, it is prohibited to use alkaline products.

Storage conditions

Bisacodyl should be stored in a place inaccessible to small children. Temperature indicators - no more than 25 ° C.

Shelf life

Bisacodyl can be used within 24 months from the date of sale of the pharmaceutical product.

Analogues

Analogues of the drug are the substances Senalde, Picoprep and Softovac with Castor oil, and also Agiolax, Senadex, Regulax with Xena, Enterolax and Stalnik tincture.