BISACODYL oral

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Prevention of constipation in patients taking opioid analgesics (codeine, morphine, etc.)
Short-term, symptomatic treatment of constipation

Prevention of constipation in patients taking opioids: start bisacodyl when analgesic treatment continues more than 48 hours. Tablets must be taken daily, at night (onset of effect within 6 to 12 hours after administration), until the end of the opioid treatment. Regular follow up (frequency/consistency of stools) is essential in order to adjust dosage correctly.
Treatment of constipation: until the patient passes stools, maximum 7 days.

Do not administer to patients with Crohn's disease, ulcerative colitis, intestinal obstruction, undiagnosed abdominal pain and dehydration.
May cause: diarrhoea, abdominal cramps, hypokalaemia.
In the event of diarrhoea: exclude a faecal impaction or intestinal obstruction, stop treatment for 24 hours and then start again with a half dose.
In the event of abdominal cramps: reduce or divide the daily dose. Stop treatment if pain continues.
Do not combine with drugs that induce torsades de pointe (halofantrine, erythromycin IV, pentamidine, etc.).
Closely monitor patients taking drugs that induce hypokalaemia (furosemide, amphotericin B, corticosteroids, etc.) or cardiac glycosides.
Pregnancy and breast-feeding: avoid; for routine prevention of constipation due to opioids, use lactulose.

To prevent constipation in patients taking opioids, use lactulose if the patient’s stools are solid; use bisacodyl if the patient’s stools are soft.
In children from 6 months to 3 years, do not use the oral route. Use only 5 mg paediatric suppositories (one suppository daily).
Swallow tablets whole; do not crush or chew.
Bisacodyl is equivalent to senna, the representative example of laxative stimulants in the WHO list of essential medicines.
The treatment must be accompanied by dietary measures (plenty of fluids and fibre).

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