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- Stimulant laxative
- Prevention of constipation in patients taking opioid analgesics (codeine, morphine, etc.)
- Short-term, symptomatic treatment of constipation
Forms and strengths
- 5 mg enteric-coated tablet
- Child over 3 years: 5 to 10 mg once daily
- Adult: 10 to 15 mg once daily
- 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.
Contra-indications, adverse effects, precautions
- 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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