The side effects of Bisacodyl

Bisacodyl is a stimulant laxative. It works directly on the bowel muscles and the nerves to induce a bowel movement. It is available both as a single active ingredient laxative or as part of medications containing multiple active ingredients. These drugs are available over the counter and are intended for short-term use only.

Bisacodyl's brand names

Bisacodyl is available as a generic drug under its own name. It is also marketed under the following brand names when sold as a drug in which it is the only active ingredient [1]:

• Correctol;
• Bisac-Evac;
• Dulcolax;
• Dulcolax Laxative;

The only multi-ingredient bisacodyl/polyethylene glycol 3350/potassium chloride/sodium bicarbonate/sodium chloride systemic drug is the branded medication named HalfLytely and Bisacodyl.

Multi-ingredient bisacodyl/magnesium citrate systemic medications include these brands:

• LoSo Prep Bowel Cleansing System;
• Royvac Bowel Evacuant;
• Tridate;
• Evac-Q-Kwik;

Three variant formulations of multi-ingredient bisacodyl/sodium biphosphate/sodium phosphate systemic drugs are:

• Fleet Prep Kit 1;
• Fleet Prep Kit 2;
• Fleet Prep Kit 3;

Bisacodyl side effects

Specific side effects caused by bisacodyl include stomach discomfort, nausea, cramping, faintness, diarrhea, fluid depletion, electrolyte depletion and gastrointestinal irritation. Some patients may experience an allergic reaction to the drug. Allergies to bisacodyl manifest themselves as hives, rashes, itching, tightness in the chest, difficulty breathing and swelling of the lips, tongue, mouth or face [2].

Patients using bisacodyl or bisacodyl-containing medications in pill or tablet form might experience vomiting and gastric irritation if the coating of the tablet or pill gets damaged.

Suppositories or suspensions administered rectally can cause a burning sensation or irritation of the rectal area in some users. Enema kits that include bisacodyl in combination with monobasic or dibasic sodium phosphate may cause metabolic problems such as hypernatremia, hypophosphatemia, and hypocalcemia in patients with impaired renal functioning.

Drugs containing bisacodyl tannex can cause liver damage after prolonged use because of the tannic acid in this particular formulation.

Use of Bisacodyl

Like most other laxatives, bisacodyl is intended for short-term use. Patients who use Bisacodyl for longer than recommended may experience a partial or total loss of normal bowel functions. This occurs because the body becomes dependent on bisacodyl to perform bowel movements and becomes unable to move matter through the bowels without the drug. Use of bisacodyl and other stimulant laxatives can be habit-forming. As the body becomes less able to move the bowels on its own, the patient starts taking laxatives more often to get temporary relief, which leads to more long-term damage.

Anything over 5 to 7 days of bisacodyl use is considered long-term. Unfortunately, many people experience constipation lasting longer than a week. Stopping after that point is essential, though. Continuing to use bisacodyl in an attempt to treat long-lasting constipation may damage your intestines' ability to have normal bowel movements [3]

Age and health considerations

Researchers have not completed formal studies of bisacodyl use during pregnancy. Bisacodyl should only be used by pregnant women under the advisement of a doctor. Bisacodyl's safety for breastfeeding mothers also remains unknown at this time. There has been no research on whether bisacodyl is present in the milk of nursing mothers taking the drug, but the risk to babies could be high if the medication gets ingested during nursing.

No studies have been done on the safety of bisacodyl in children, either, and the drug is not recommended at all for patients under the age of six.

Seniors without other health problems seem to tolerate bisacodyl about as well as other healthy adults, although they are still susceptible to all of the standard side effects. Clinical trials in which 8 percent of the participants were seniors age 75 and older and 73 percent of the participants were age 65 or older found that geriatric patients experienced no differences in the safety or effectiveness of the drug compared to younger users. However, many older patients have other conditions that could contraindicate the use of bisacodyl or increase the likelihood of complications from this drug.

Expected time of action

How long it takes for bisacodyl to take effect depends on the specific form you use. Patients with an active lifestyle should plan to have access to a bathroom once the drug starts to take effect or the consequences could be both uncomfortable and embarrassing.

When used as a suppository, bisacodyl and medicines containing bisacodyl typically cause a bowel movement within about 30 minutes in most people. However, in some individuals a bisacodyl suppository could take effect within 10 minutes, while in others it could take as long as 60 minutes to take effect. Essentially, you are limited to your bathroom and nearby rooms during the hour after a bisacodyl suppository.

In extended-release tablet form, the effects of bisacodyl occur within 10 to 12 hours. Patients are advised to ingest extended-release tablets before bedtime to achieve relief from constipation the next day. Patients who use extended-release bisacodyl early in the evening may experience a sudden need to use the bathroom midway through the night. Taking this medication late at night can leave you stranded at home waiting to complete a bowel movement.  Proper timing is essential to avoid problems, but it's hard to arrange the rest of your schedule around your bathroom needs.

Because bisacodyl works directly upon the muscles of the bowels, it is suitable for use in suppository form in individuals with spinal cord injury and injuries. However, the use of laxative suppositories, including bisacodyl, is typically not a first resort method of relieving constipation in these patients. Bisacodyl is considered suitable as an option when more conservative methods for bowel management have failed and is typically tried just before resorting to surgery. Using it as the standard method of care can make problems worse [4].

In general, stimulant laxatives aren't a good idea for anyone with other problems that affect the abdomen or gastrointestinal tract. This includes irritable bowel syndrome, diverticulitis and ischemic colitis. Frequent constipation can be a sign of underlying colorectal problems. Patients with frequent constipation should not use bisacodyl or other stimulant laxatives.

Patients with the following conditions should not use bisacodyl [5]:

• Known allergies to bisacodyl or other ingredients in a multi-ingredient preparation;
• Difficulties swallowing without chewing;
• Appendicitis;
• Severe stomach pain;
• Gastrointestinal obstruction, including fecal obstruction;
• Bowel perforation;
• Toxic colitis or toxic megacolon;
• Severe constipation or fecal impaction;
• Bleeding from the rectum, stomach or intestines;
• Severe dehydration;
• Acute hemorrhoids;
• Electrolyte abnormalities;
• Irritable Bowel Syndrome (IBS).

Individuals who are taking other medications should consult with a doctor before taking bisacodyl. While no specific interactions are currently known, bisacodyl may interact with other drugs.

Taking any other medication within an hour after taking bisacodyl may cause the first medication to be flushed from the body and rendered ineffective. Patients also should avoid taking bisacodyl shortly after taking antacids. Natural supplements, herbs and vitamins could also have unwanted interactions with bisacodyl. Even certain foods can interact with bisacodyl. You shouldn't drink milk or eat dairy products at least an hour before taking this laxative drug. Because of all of the different potential interactions, managing the use of bisacodyl along with other medicines may get complicated [6].

References