Bisacodyl Oral: Dosing, Duration, and Precautions

Therapeutic action

Stimulant laxative.

Indications

• Prevention of constipation in patients taking opioid analgesics such as codeine or morphine.
• Short-term, symptomatic treatment of constipation.

Forms and strengths

• 5 mg enteric-coated tablet.

Dose

• 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, until the end of the opioid treatment. Regular follow up of stool frequency and consistency is essential 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, or dehydration.
• May cause diarrhoea, abdominal cramps, and hypokalaemia.
• In the event of diarrhoea, exclude a faecal impaction or intestinal obstruction, stop treatment for 24 hours, 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 such as halofantrine, erythromycin IV, or pentamidine.
• Closely monitor patients taking drugs that induce hypokalaemia or cardiac glycosides.
• Pregnancy and breast-feeding: avoid. For routine prevention of constipation due to opioids, use lactulose.