| Systematic (IUPAC) name | |
|---|---|
| (pyridin-2-ylmethanediyl)dibenzene-4,1-diyl diacetate OR 4,4'-(pyridin-2-ylmethylene)bis(4,1-phenylene) diacetate |
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| Clinical data | |
| AHFS/Drugs.com | monograph |
| MedlinePlus | a601027 |
| Pregnancy cat. | C |
| Legal status | OTC |
| Routes | Oral, rectal |
| Pharmacokinetic data | |
| Bioavailability | 15% |
| Metabolism | Hepatic (CYP450-mediated) |
| Half-life | 16 Hours |
| Excretion | primarily in the feces, systemically absorbed drug is excreted in the urine |
| Identifiers | |
| CAS number | 603-50-9 |
| ATC code | A06AB02 |
| PubChem | CID 2391 |
| ChemSpider | 2299 |
| UNII | 10X0709Y6I |
| KEGG | D00245 |
| ChEMBL | CHEMBL942 |
| Chemical data | |
| Formula | C22H19NO4 |
| Mol. mass | 361.391 g/mol |
| SMILES | eMolecules & PubChem |
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Bisacodyl (INN) is a stimulant laxative drug that works directly on the large colon to produce a bowel movement. It is typically prescribed for relief of constipation and for the management of neurogenic bowel dysfunction as well as part of bowel preparation before medical examinations, such as for a colonoscopy.[1] Bisacodyl is a diphenylmethane (in fact, a modified triphenylmethane) derivative and was first used as a laxative in 1953 due to its similarity to phenolphthalein.[2]
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Bisacodyl is sold under the trade names Dulcolax/Durolax, Fleet, Alophen, Correctol, and Carter's Little Pills (formerly Carter's Little Liver Pills[3]) as well being available generically. It is usually sold as 5 mg tablets, 10 mg suppositories, or 5 mg pediatric suppositories. It is also available as a 1.25 fluid ounce prepackaged enema containing a 10 mg delivered dose of liquid bisacodyl.
When bisacodyl is administered orally, it is usually taken at bedtime. Oral administration is known to produce no action for more than eight hours and then to work suddenly and without much warning. This is especially true if more than 10 milligrams is taken at one time. Normally the dosage is 5 or 10 milligrams, but up to 30 milligrams can be taken for complete cleansing of the bowel before a procedure. If taken in the afternoon or early evening, the action of this drug will start during sleep with undesirable results. If taken at the maximum dosage, there will likely be a sudden, extremely powerful, uncontrollable bowel movement and so precautions should be taken.
When administered rectally in suppository form, it is usually effective in 15 to 60 minutes. Two suppositories can be taken at once if a very strong, purgative, enema-like result is needed. A few hours after the initial evacuation, there can be a secondary action which will continue as long as there is unexpelled bisacodyl.
As a small commercially prepared enema, it is usually effective in 5 to 20 minutes.
It is not recommended to take biscodyl within one hour of taking an antacid or milk.
Bisacodyl works by stimulating enteric nerves to cause colonic mass movements. It is also a contact laxative; it increases fluid and NaCl secretion. Action of bisacodyl on small intestine is negligible; stimulant laxatives mainly promote evacuation of the colon.
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