Bisacodyl

Stimulant Laxative·Gastrointestinal - Laxatives

Bowel preparation for colonoscopy/surgery, acute severe constipation

STIMULANTDulcolax, Bisalax5 mg EC tabletUNSCHEDULEDTGA

Max Dose

10 mg/day

Onset

6-12 h (PO)

Cramping

COMMON

Hypokalemia

RISK

Rapid Summary

Overview

Potent diphenylmethane stimulant laxative. Directly stimulates enteric nerves to cause colonic mass movements. Often used for bowel prep or severe opioid-induced constipation.

Maximum Dose

Max 10 mg/day (oral) or 10 mg (rectal).

Clinical Focus

Do not crush

Tablets are enteric-coated to prevent severe gastric irritation. Do not crush, and do not take with antacids or PPIs.

Bottom Line

Bisacodyl is a potent stimulant laxative available in oral and rectal forms for acute constipation, but causes abdominal cramps and is not suitable for long-term use.

Formulation & Access

Brand Names

Dulcolax, Bisalax

Oral Routes

Enteric-coated tablets (5 mg).

Parenteral

Suppositories (10 mg) for PR administration.

Prescribing & PBS

Over The Counter (OTC).

Indications & Use

Primary

TGA

Bowel preparation for colonoscopy/surgery, acute severe constipation.

Clinical Place

Highly effective 'push' laxative. Usually reserved for when Senna is ineffective or rapid PR action is needed.

Quick reference

Class & Role

Stimulant Laxative — Potent diphenylmethane stimulant laxative.

Route / Formulation

Enteric-coated tablets (5 mg). (Dulcolax, Bisalax)

Usual Dose & Max

PO 5-10 mg NOCTE. OR PR 10 mg suppository STAT. Max 10 mg/day (oral) or 10 mg (rectal).

Key Indication Doses

Severe Constipation: PO 5-10 mg NOCTE. OR PR 10 mg suppository STAT. Bowel Preparation: PO 10 mg OD for 2 days prior to procedure, often combined with osmotic agents.

Best Uses

Bisacodyl is a potent stimulant laxative available in oral and rectal forms for acute constipation, but causes abdominal cramps and is not suitable for long-term use.

Avoid / Cautions

Ileus, intestinal obstruction, acute surgical abdomen (e.g., appendicitis). Pregnancy Category A, but strong stimulants are generally avoided due to theoretical uterine stimulation risk.

Key Risks

Gastrointestinal: Severe abdominal cramping, griping pain, nausea. Enteric coating degradation causes severe gastric pain. Metabolic: Dehydration and hypokalemia (with chronic abuse or high bowel-prep doses).

Key Interactions

Antacids, Milk, and PPIs (Pantoprazole). These raise gastric pH, causing the enteric coating of Bisacodyl to dissolve in the stomach instead of the colon, leading to severe vomiting and gastric cramps. Separate by 2 hours.

Monitoring

Monitor bowel chart. Cease immediately once bowels have opened to avoid griping and diarrhea.

Clinical Pearl

Oral bisacodyl takes all night to work. A bisacodyl suppository (PR) works in 20 minutes. Use the suppository if the ward needs an immediate result.

Access

Dulcolax, Bisalax5 mg EC tablet

Brand: Dulcolax, Bisalax
Formulation: Enteric-coated tablets (5 mg)

Bisacodyl

Stimulant Laxative·Gastrointestinal - Laxatives

Bowel preparation for colonoscopy/surgery, acute severe constipation

STIMULANTDulcolax, Bisalax5 mg EC tabletUNSCHEDULEDTGA

Max Dose

10 mg/day

Onset

6-12 h (PO)

Cramping

COMMON

Hypokalemia

RISK

Rapid Summary

Overview

Potent diphenylmethane stimulant laxative. Directly stimulates enteric nerves to cause colonic mass movements. Often used for bowel prep or severe opioid-induced constipation.

Maximum Dose

Max 10 mg/day (oral) or 10 mg (rectal).

Clinical Focus

Do not crush

Tablets are enteric-coated to prevent severe gastric irritation. Do not crush, and do not take with antacids or PPIs.

Bottom Line

Bisacodyl is a potent stimulant laxative available in oral and rectal forms for acute constipation, but causes abdominal cramps and is not suitable for long-term use.

Formulation & Access

Brand Names

Dulcolax, Bisalax

Oral Routes

Enteric-coated tablets (5 mg).

Parenteral

Suppositories (10 mg) for PR administration.

Prescribing & PBS

Over The Counter (OTC).

Indications & Use

Primary

TGA

Bowel preparation for colonoscopy/surgery, acute severe constipation.

Clinical Place

Highly effective 'push' laxative. Usually reserved for when Senna is ineffective or rapid PR action is needed.

Quick reference

Class & Role

Stimulant Laxative — Potent diphenylmethane stimulant laxative.

Route / Formulation

Enteric-coated tablets (5 mg). (Dulcolax, Bisalax)

Usual Dose & Max

PO 5-10 mg NOCTE. OR PR 10 mg suppository STAT. Max 10 mg/day (oral) or 10 mg (rectal).

Key Indication Doses

Severe Constipation: PO 5-10 mg NOCTE. OR PR 10 mg suppository STAT. Bowel Preparation: PO 10 mg OD for 2 days prior to procedure, often combined with osmotic agents.

Best Uses

Bisacodyl is a potent stimulant laxative available in oral and rectal forms for acute constipation, but causes abdominal cramps and is not suitable for long-term use.

Avoid / Cautions

Ileus, intestinal obstruction, acute surgical abdomen (e.g., appendicitis). Pregnancy Category A, but strong stimulants are generally avoided due to theoretical uterine stimulation risk.

Key Risks

Key Interactions

Monitoring

Monitor bowel chart. Cease immediately once bowels have opened to avoid griping and diarrhea.

Clinical Pearl

Oral bisacodyl takes all night to work. A bisacodyl suppository (PR) works in 20 minutes. Use the suppository if the ward needs an immediate result.

Access

Dulcolax, Bisalax5 mg EC tablet

Brand: Dulcolax, Bisalax
Formulation: Enteric-coated tablets (5 mg)