Last reviewed by Editorial Team on August 28th, 2018.
What is Bisacodyl Suppository?
Bisacodyl is an organic compound (Compound that contains mainly carbon) that is used to stimulate intestine action and loosens the stool. This class of drug is used only on a short-term basis to treat constipation and also to empty the bowel before any surgery.
In general, there are various ways through which drug enter into your body and start its action. It may be in a pill form, syrup form (liquid) or even through injection (intravenous) mode. The suppository is a small, spherical or conical shaped object which is generally inserted into your bottom.
It will dissolve and releases its drug effect. The suppository is not a comfortable way of in taking the drug. But it will be a better option when you cannot swallow the specific drug or your body (intestine) wouldn’t absorb well or the drug tastes too bad to take by mouth.
Suppository may be rectal, vaginal, urethral type. Here Bisacodyl suppository is a rectal injection which is generally treated for constipation, allergies, asthma, anxiety etc.
Bisacodyl Suppository molecular formula and weight
Molecular formula: C2H19NO4
This compound belongs to the class of chemical entities known as diphenylmethanes. These are compounds containing a diphenylmethane moiety, which consists of a methane wherein two hydrogen atoms are replaced by two phenyl groups.
Molecular weight: 361.391 g/mol.
Bisacodyl suppository drug class
Bisacodyl suppository is a contact or Stimulant laxative drug. A laxative is one which can increase the bowel movements. It is first used as a laxative in 1953. It is specifically termed as diphenylmethane laxative, contains chemical members of phenolphthalein and Bisacodyl. This drug came into action for constipation because of constipation. Constipation caused by:
- fibre deficiency in western countries
- Psyllium (It is getting fermented in the colon)
- Methylcellulose, it accumulates faecal mass and delays colonic transit time.
- Calcium polycarbophil, cause bloating.
How does Bisacodyl suppository work in the body?
Stimulant laxative mechanism: It generally works by stimulating myenteric nerve plexus of the gut. It increases gut motility, water level, and electrolyte transfer. Bisacodyl belongs to the diphenylmethane laxative and it has a different mode of action compared to the laxative drug.
These can be hydrolyzed by intestinal enzymes so it can act on both small and large intestines. This group of drugs can produce an effect only for a short time and research reveals it doesn’t show adverse effect with long term use.
Bisacodyl Suppository brand names
Recent research shows there are 21 brands of generic bisacodyl suppository listed.
- Baxative Elder
- Conlax (5mg) Bliss chemicals
- Conlax (10mg) Bliss chemicals
- Dulcolax (5mg) German Remedies
- Dulcolax (10mg) German Remedies
- Junifree-RDS Elder
These are the brands which show only suppository type. There are many other brand names showing tablet form (Oral) for the mode of administration.
What is Bisacodyl suppository used for?
This medicine is prescribed in rectal suppository form for treating constipation, irritability, cleaning the stomach before surgery (Colonoscopy). The suppository should be opened and inserted into the bottom opening. Keep the legs closed for few seconds and the medication works.
Bisacodyl Suppository Dosage form and strengths
These dosage form and strengths are given by pharmaceutical companies and without health advisor advice one should not use this drug in more quantity.
- Baxative – 5mg/1 suppository
- Conlax – 5mg/ 1 suppository
- Conlax – 10mg/ 1 suppository
- Dulcolax – 10mg/ 1 suppository
- Dulcolax – 10mg/ 1 suppository
- Junifree –RDS – 5mg/ 1 suppository
Bisacodyl Suppository Dosage for different indications
To treat constipation:
Even if it is chronic constipation, it is not advisable to use more than one suppository per day. Generally, 10mg tablet is considered to be maximum dose.
Doctor prefers using half suppository sometimes. If that is the case, then cut the suppository along lengthwise and insert it in the bottom. Prefer taking another half in the next dose.
To empty the stomach (surgery purpose):
If surgery is on next day then the doctor will say you to take Bisacodyl tablet that night following morning you will be advised to take suppository as per rules.
It should not be used continuously for more than 4 days. If using more dosage, it may affect bowel function and it will lead to long-term constipation.
Bisacodyl suppository highest dose
Adult dosage for constipation:
- Oral mode of administration: 5 to 15 mg i.e. 1 to 3 tablets can be taken per day.
- Suppository mode of administration: 1 suppository (10mg) can be taken per day as per procedure.
Same dosage level is followed for bowel preparation.
Bisacodyl Suppository side effects
The side effects may be major or minor based on your body acceptance to that medicine and even on overdosage. Common side effects till date revealed by studies are:
- Abdominal pain
- Inflammation of the bowel
- Irritation in the anus or rectum
- Allergic reactions in some individual
- Rectal bleeding
- Hypokalaemia ( potassium levels gets decreased in blood)
- Electrolyte imbalance may occur.
These are the sure symptoms one will experience taking laxative drugs. It even causes rare symptom like the continuous use of the laxative drug may lead to worsening your constipation.
How to take bisacodyl suppository?
- Before taking laxatives, check the label on the drug for exact instructions.
- Before unwrapping it, just dip it in hot water to make it hard (stiff)
- Remove the wrapper, insert it up into the rectum (end of the digestive system) as directed in the pack.
- Hold it for 15 to 20 minutes for its better action.
- Coating the tip of the suppository with petroleum jelly will make it soft so it can even be used now by haemorrhoids.
- It is to be used regularly. If you missed a dose, do not rush with 2 suppositories. Just wait and go with your regular schedule.
Is bisacodyl suppository addictive?
Some people are health conscious and obsessed with body shapes. They achieve this easily by laxative like senna (tablet).
Some may have the wrong perception that they must have bowel movement and cleaning process every day. In this way, it is addicted.
In older days, Bermuda grass juice (arugampul) was taken on empty stomach and it stimulates a bowel movement. Nowadays, due to modern lifestyle people using easily available laxatives to clear all faeces and it is following daily. After several weeks of this practice, Patients will be addicted to it.
Can I abrupt Bisacodyl suppository therapy suddenly?
Sudden abruption of this therapy will lead to severe effects like kidney failure, dehydration, bowel damage etc.
Bisacodyl Suppository withdrawal effects
Bisacodyl suppository is a general laxative class of drug. It is not showing any withdrawal symptoms after medication. For safer side, consult a doctor regarding your health effects.
Precautions and warnings for using Bisacodyl Suppository
- If you are allergic to any reactive compound in bisacodyl suppository try avoiding it.
- If you are recently undergone any bowel surgery and appendicitis
- If you are pregnant or planning to become pregnant consult your health care advisor before using it.
- Since it causes Hypokalaemia, low levels of potassium in your body. It is to be safe with persons who are taking medication for this already.
- Using any herbal medicine or dietary supplement tries avoiding this.
- Medication should not be carried for more than one week. It may lead to bowel failure.
- Any problems regarding bowel last for more than 1 week stop avoiding this suppository and immediately consult a doctor.
- Should not use any additional laxatives or stool softeners along with this medication.
- Pregnancy and breastfeeding women should meet the doctor and discuss its good and risk factors. There are no studies on laxatives may pass through the tube to the child.
- It is not advisable to give to children below 6 years.
- It causes adverse effects on elderly persons.
- People with Crohn’s disease taking medication may be fatal.
- People who are more dehydrated should avoid this drug.
- People using multiple drugs like corticosteroids, drug related with heart.
Bisacodyl suppository during pregnancy
It is estimated 40% of pregnant women are experiencing difficult evacuation and improper bowel movements even after increasing dietary fibre. Here stimulant laxatives come into play. Since bisacodyl suppository has minimum systemic absorption (from studies) it is not showing any risk to pregnant women. It is declared under category B i.e.
Animal studies failed to demonstrate risk and there are no adequate human studies. Using it for long period may lead to dehydration and imbalances in fluid level in pregnant women. Pregnant women will be in need of other vitamin supplements during pregnancy so it is better to take health advice before using a laxative.
Bisacodyl has been assigned to pregnancy category B by the FDA. Animal studies have failed to reveal evidence of teratogenicity or fetotoxicity. At doses 70 times the maximum recommended human dose, there is evidence of decreased litter survival at weaning. No data are available from controlled human pregnancy studies. Bisacodyl should only be given during pregnancy when need has been clearly established.
Bisacodyl suppository during breastfeeding
From research, it is revealed that bisacodyl suppository causing only less effect on breast feeding mothers. Only overdosage might lead to danger. Some medicines may pass into your breast milk. When baby nurses, he/ she might intake a small amount of bisacodyl so it is better to consult the doctor regarding your situation.
Bisacodyl suppository over the counter
Over the Counter (OTC) drugs were popularly known as “non-prescription” drugs. They are sold in black (without permission) from supermarket and pharmacies in other countries. Laxatives such as bisacodyl were used by youths as weight loss drug.
US government passed the order to abuse Over the Counter drugs because some laxative may be safe and some cause dreadful disease. It is reported fibre laxatives may increase the risk of colorectal cancer and non-fibre laxative cause higher risks.
Bisacodyl suppository for infants
Suppository should not be used by children under 10 years without medical advice. Bisacodyl suppository dosage (minimum 5mg) is heavy for infants to insert. So glycerine suppository is used as an alternative for rectal insertion. They are available in 1g, 2g, and 4 g. The dosage levels are decided by the doctor.
While taking glycerine suppository, one should increase the high-fibre food levels and encourage infants to drink plenty of water. It will relieve them from imbalances in fluid and other side effects. If the baby still does not empty the bowel should not insert another suppository without doctor consultation.
- < 6 years- not recommended
- 6-11 years – half (1/2) rectal suppository per day.
Can I take bisacodyl suppository before surgery?
Bisacodyl suppository is taken generally before some surgery or medical examinations to clean the bowel. Colonoscopy (removing lesions) procedure involves the use of bisacodyl suppository (laxative) along with Polyethylene glycol (PEG) to clear the large intestine before surgery.
Colonoscopy involves putting the camera into you and searching for lesions. One should not take a laxative on his own prior to surgery. If the lesions are not clear, then the doctor will prescribe some suppository to take in the early morning before few hours of surgery.
Bisacodyl suppository for constipation
It is one of the prescribed medicines for treating constipation and irregularity. Suppository works by loosening the bowel muscles and make you poo (defecation). It reflects the proverb, “Anything beyond the limit is dangerous”. Thus long term usage leads to bowel disorders.
Bisacodyl suppository and renal failure
Taking bisacodyl suppository will develop rare renal failure. It was estimated in 2004 and it is reported to FDA by the patients who used a laxative for chronic constipation. Still, studies are going on to estimate the real cause of this drug for kidney failure.
Bisacodyl suppository v/s glycerine suppository
Bisacodyl and glycerine suppository are different from each other. But both belong to a same class stimulant laxative. From the clinical studies, bisacodyl suppository is known to be 75% effective in patients with constipation. Glycerine is known to be only 40% effective.
People find easy insertion into the rectum in the case of glycerine because of its jelly-like (Lubricant) behaviour. They suggest using glycerine for baby below 3 years since it is available in small doses. Bisacodyl suppository should be coated with petroleum jelly before insertion into the rectum.
But it shows a good effect in a single dose even for severe constipation. Always store a pack of bisacodyl suppository in your cupboard for constipation and evacuation. Don’t get “addicted”.
Bisacodyl suppository overdose
Seek medical advice immediately if you took more than recommended or prescribed level. Advice can be taken from the nearby pharmacy, poison centre or health advisor. Overdose leads to:
- Imbalance in salts ( sodium and potassium)
- Electrolytes loss (fluid)
- Hyperaldosteronism ( increased production of aldosteronism leading to low level of potassium )
- Alkalosis (increased hydrogen ion excretion)
- Decreasing normal function of bowels.
Bisacodyl suppository mechanism of action
Bisacodyl is the active ingredient in this drug. The active ingredient is one, which when removed the drug will lose its function. It works by contracting colon and increase salt and fluid elimination. In Small intestine its action is minimum, and its action is visible more in the large intestine.
Bisacodyl suppository absorption and elimination
After the administration of this drug both by orally as bisacodyl tablet and rectally as a suppository, they get hydrolyzed by bacterial enzymes to deacetylated form (active metabolite). This metabolite is responsible for the laxative action.
Generally, laxatives will not show much absorption capacity as another drug. So it is considered to be safe drug during pregnancy and breastfeeding. This minimal absorption will take place at gastrointestinal tract.
Any drug which is reaching general circulatory system is considered to be a good drug. From the previous studies, it is concluded that only 16% of the drug which is orally administered is absorbed. So people use a suppository for better results. It shows 60% absorption. The laxative effect starts 8 hours after intake.
Bioavailability: The amount of drug which is present in the general circulatory system (GCS). Oral uptake shows a low amount of drug entering into the body. Intravenous (injection), suppository shows the immediate effect and large amount enters into the body.
Based on the concentration of the drug molecule in the plasma it is considered to be a drug with good bioavailability. High level, considered to be bad drug and vice versa. Bisacodyl oral drug shows a high level. But suppository shows apparently low plasma levels.
Elimination: Small amount absorbed may be excreted through urine as glucuronide (glucuronidation), the process by which animals use to excrete toxic substances or drug. This glucuronide has high water solubility and it gets excreted mainly by the kidneys.
Bisacodyl suppository peanut allergy
Bisacodyl suppository is taken to obtain rectum with soft faeces. There is no evident in suppository leading to peanut allergy. It is evident in another class of laxative namely stool- softening laxative. In this class Arachis oil is prescribed for high impacted stool. Using Arachis oil in excess or without seeing product description may lead to peanut allergy.
Can I take bisacodyl suppository along with Aspirin low strength (aspirin)?
Aspirin is generally used to reduce fever and pain. It is a derivative of salicylic acid. It belongs to the drug classes’ platelet aggregation inhibitors and Salicylates. Salicylates are naturally found in the white willow tree and wintergreen tree.
From the studies, there is no interaction found between aspirin and bisacodyl suppository. Always consult your doctor or pharmacist before using multiple drugs.
Can I take bisacodyl suppository with fish oil (omega-3 polyunsaturated fatty acids)?
Fish oil belongs to the nutraceutical products. It helps as dietary supplements and to treat hypertriglyceridemia (high level of triglycerides)
There are no interactions between bisacodyl and fish oil. Seeking health advice before taking many medications will be is strictly needed.
Can I take bisacodyl suppository with Lasix (furosemide)?
Lasix is a drug which belongs to the class furosemide. It is a water pill which stops the absorption of sodium, chloride, water (salts) from your body (from kidney tubules) and makes it pass in your urine. The excessive production of urine lasts 6-8 hours.
Thus using it along with bisacodyl suppository may increase the risk of dehydration, electrolyte imbalances, irregular heart rate and kidney problems. It is important to tell your doctor if you have a weakness, muscle cramps decreased urination etc. Thus it is not advisable to take two medications at the same time.
Can I take bisacodyl suppository with the milk of magnesia (magnesium hydroxide)?
Milk of magnesia works by two means:
- To treat indigestion by neutralizing excess stomach acid.
- If taken in excess, can act as a saline laxative that moves the excess salt or saline solution to the intestine from the blood.
Milk of magnesia mode of action is opposite to the stimulant laxative (bisacodyl suppository).
When these two drugs are taken together it causes dehydration, electrolyte imbalances, stomach cramp and increased thirst. The time gap between both the drugs should be minimum of 1 hour.
Can I take bisacodyl suppository along with Tylenol (acetaminophen)?
Acetaminophen is used as the pain reliever and in reducing fever. Other than this they can be used for arthritis, muscle aches, toothaches, headache etc. It is different from laxative family. There are no interactions between bisacodyl suppository and acetaminophen. Consult a doctor before taking these drugs.
Can I take bisacodyl suppository along with Zofran (ondansetron)?
Zofran (ondansetron) can block the action of chemicals in the body to prevent vomiting and nausea. Zofran causes irregular heartbeat and it may be life threading in some cases. But taking along with bisacodyl suppository can lead to lowering the levels of magnesium and potassium.
It is achieved by excess usage of bisacodyl which cleanses the bowel for stool excretion. Thus the interaction between Zofran and bisacodyl is not studied. Seeking a doctor’s advice is essential in this case.
Can I take bisacodyl suppository along with vitamin D3 (cholecalciferol)?
Vitamin D3 (cholecalciferol) belongs to the drug class vitamins. It is generally used to treat vitamin D deficiency, prevention of fractures, Vitamin D insufficiency. This drug is nothing to do with laxative bisacodyl. Taking vitamin supplement along with bisacodyl should be recommended by the doctor. Only then an individual should continue with it.
Can I take bisacodyl suppository along with Vitamin C (ascorbic acid)?
Vitamin C (ascorbic acid) belongs to drug class of vitamins. It is used as dietary supplement, to treat scurvy, urinary acidification. There is no interaction between vitamin C and bisacodyl suppository. Studies are still going on for this research and one should consult a doctor before using supplement and laxative together.