International generic name

Bisacodyl

Drug form and composition

Suppositories. One suppository (for children) contains 5 mg Bisacodyl (as 100%). One suppository (for adult patients) contains 10 mg Bisacodyl (as 100%).

Indications

Chronic constipation in different diseases; for patient preparation before X-ray, endoscopy and ultrasonography examinations, as well as in preoperative period; constipation during pregnancy and before surgery.

Dosage and administration

For adult patients as a purgative - 10 mg (1 suppository) daily, rectally. For children older than 6 years - 5 mg (one pediatric suppository), rectally.

Contraindications

Hypersensitivity to the medicine; ileus; acute inflammations of the abdominal organs; gastrointestinal and vaginal bleeding; acute enterocolitis; dehydration; rectal bleeding (fissure, laceration, hemorrhoids).

Special warnings and precautions

Bisacodyl should be used with care in elderly patients, in patients with cardiovascular diseases (hypotension, chronic heart failure); in exhausted and febrile patients. Bisacidyl should be used with care in cases with abdominal pain of unclear cause, nausea and vomiting. In case of gastrointestinal discomfort with more than two weeks persistence it is necessary to consult a physician before the treatment. Higher doses of the preparation may provoke an abdominal pain, enhanced mucus secretion and loss of significant quantities of water. It is advisable to start the treatment with lower doses, which may be enhanced gradually if necessary. Long term administration and graundless treatment should be avoided. Administration of Bisacidyl in children younger than 6 years is not advisable. In pregnant women it should be used with care, as the preparation enhances the rectal tone and leads to intensification of the blood congestion in the pelvis.

Drug interactions

Concomitant administration of Bisacidyl and several other drugs (particularly oral anticoagulants) may lead to a shortening of their active absorbtion time, which may require correction of the dose. Bisacidyl is a local laxative preparation, so local anesthetics and narcotic agents reduce its activity. Cholinomimetic agents (acetilcholine, pilocarpine, etc.), as well as adrenolytic agents (yohimbin, vasolat), stimulate cholinergic innervation of the bowels and may potentiate the preparation activity. In controversy, adrenomimetic and cholinolytic preparations may depress its activity. Bisacidyl may raise the potassium loss if given together with thiazide and loop diuretics, and glucocorticoids.

Adverse reactions

Nausea, abdomonal discomfort and meteorism; gripping abdominal pain; anal and rectal inflammation; proctitis. In long-term treatment the preparation may cause diarrhea, fluid and electrolyte loss. Tolerance to the preparation may develop also.

Pharmacological mechanisms

Bisacidyl is a diphenylmethane derivative. It intensifies the bowels peristalsis, by stimulation of the sensor nerve ends in the bowels mucous membrane. Bisacidyl stimulates water and electrolytes secretion in the bowel lumen; stimulates intestinal passage and causes diarrhea due to activation of the nitric oxide synthesis. Its mechanism of action makes Bisacidyl eligible for the treatment of constipation, due to ganglion blocking or different spinal cord diseases (inflammation, intoxication, mechanical damage). This preparation does not stimulate the uterus and does not cause contractions. In rectal administration the effect is expected 15-30 minutes after application.

Supplied

6 suppositories of 5 mg and 10 mg.

Expiry

3 years.