BISACODYL oral


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