BISACODYL oral

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    Therapeutic action

    • Stimulant laxative

    Indications

    • 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

    Dosage

    • Child over 3 years: 5 to 10 mg once daily
    • Adult: 10 to 15 mg once daily

    Duration

    • 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.

    Remarks

    • 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).

    Storage 

    Below 25 °C