Bisacodyl (
INN
Inns are generally establishments or buildings where travelers can seek lodging, and usually, food and drink. Inns are typically located in the country or along a highway; before the advent of motorized transportation they also provided accommo ...
) is an
organic compound
In chemistry, organic compounds are generally any chemical compounds that contain carbon-hydrogen or carbon-carbon bonds. Due to carbon's ability to catenate (form chains with other carbon atoms), millions of organic compounds are known. T ...
that is used as a stimulant
laxative
Laxatives, purgatives, or aperients are substances that loosen stools and increase bowel movements. They are used to treat and prevent constipation.
Laxatives vary as to how they work and the side effects they may have. Certain stimulant, lubri ...
drug. It works directly on the
colon to produce a bowel movement. It is typically prescribed for relief of episodic and chronic
constipation
Constipation is a bowel dysfunction that makes bowel movements infrequent or hard to pass. The stool is often hard and dry. Other symptoms may include abdominal pain, bloating, and feeling as if one has not completely passed the bowel movement ...
and for the management of
neurogenic bowel dysfunction, as well as part of bowel preparation before medical examinations, such as for a
colonoscopy.
Bisacodyl is a derivative of
triphenylmethane
Triphenylmethane, or triphenyl methane, is the hydrocarbon with the formula (C6H5)3CH. This colorless solid is soluble in nonpolar organic solvents and not in water. Triphenylmethane is the basic skeleton of many synthetic dyes called triarylmeth ...
. It was first used as a laxative in 1953 because of its structural similarity to
phenolphthalein
Phenolphthalein ( ) is a chemical compound with the formula C20 H14 O4 and is often written as "HIn", "HPh", "phph" or simply "Ph" in shorthand notation. Phenolphthalein is often used as an indicator in acid–base titrations. For this applica ...
.
It is on the
World Health Organization's List of Essential Medicines
The WHO Model List of Essential Medicines (aka Essential Medicines List or EML), published by the World Health Organization (WHO), contains the medications considered to be most effective and safe to meet the most important needs in a health s ...
.
Available forms
Bisacodyl is marketed under the trade names Dulcolax/Durolax, Muxol, Fleet, Nourilax, Alophen, Correctol, and Carter's Little Pills (formerly
Carter's Little Liver Pills),
as well as 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 pre-packaged
enema
An enema, also known as a clyster, is an injection of fluid into the lower bowel by way of the rectum.Cullingworth, ''A Manual of Nursing, Medical and Surgical'':155 The word enema can also refer to the liquid injected, as well as to a device ...
containing a 10 mg delivered dose of liquid bisacodyl.
Administration
When bisacodyl is administered orally, it is usually taken at breakfast. Oral administration is known to produce no action for more than eight hours and then to work suddenly and relatively quickly. This is especially true if more than 10 mg is taken at one time. Normally, the dosage is 5 or 10 mg, but up to 30 mg can be taken for complete cleansing of the bowel before a procedure.
When administered rectally in suppository form, it is usually effective in 15 to 60 minutes. For optimal use, if used as a suppository, it is recommended that bisacodyl be given after breakfast to synchronize with the
gastrocolic reflex
The gastrocolic reflex or gastrocolic response is a physiological reflex that controls the motility, or peristalsis, of the gastrointestinal tract following a meal. It involves an increase in motility of the colon consisting primarily of giant mi ...
.
Two suppositories can be inserted 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 present in the rectum.
As a commercially prepared
micro-enema, it is usually effective in 5 to 20 minutes.
[
]
Mechanism of action
Bisacodyl works by stimulating enteric neurons to cause peristalsis
Peristalsis ( , ) is a radially symmetrical contraction and relaxation of muscles that propagate in a wave down a tube, in an anterograde direction. Peristalsis is progression of coordinated contraction of involuntary circular muscles, whic ...
, i.e., colonic contractions. It is also a contact laxative; it increases fluid and salt secretion. The action of bisacodyl on the small intestine is negligible; stimulant laxatives mainly promote evacuation of the colon.[
]
See also
* Diphenyl-2-pyridylmethane
* Cyclofenil
References
External links
, Bisacodyl,00.html Bisacodyl at Drugdigest.orgDulcolax LaxativeDulcoflex Tablet Uses in Hindi
{{Laxatives
Acetate esters
Laxatives
2-Pyridyl compounds
Bis(4-hydroxyphenyl)methanes