ACTION AND MECHANISM

- [LAXATIVE]. Bisacodyl is a stimulant laxative derived from diphenylmethane. It acts by stimulating colonic peristalsis through direct action on the mucosa or on Auerbach's myenteric plexuses. It produces an accumulation of fluids and electrolytes in the intestinal lumen. The onset of action occurs within 6–10 hours when administered orally, or 15–60 minutes when administered rectally.

SPECIAL WARNINGS

- The cause of constipation should be diagnosed before treatment, ruling out the possibility of gastrointestinal tract obstructions or appendicitis.
- Before starting treatment, the patient must be adequately hydrated and have normal electrolyte levels. Treatment should not be started if these levels are abnormal.
- In elderly or debilitated patients, periodic monitoring of electrolyte levels is recommended.

SENIORS

Peristalsis stimulants may exacerbate weakness, incoordination, and orthostatic hypotension in geriatric patients, resulting from extensive electrolyte loss, when used repeatedly.

PATIENT ADVICE

- This medicine should not be used by patients with intestinal obstructions.
- Continued use may cause habituation.
- If after 1 week of use, constipation does not improve, persists, or worsens, consult your doctor or pharmacist.
- Before starting treatment for constipation, lifestyle changes should be made. It is recommended to drink plenty of water daily (more than two liters), get an adequate intake of fiber, respond to the urge to defecate, and exercise.

CONTRAINDICATIONS

- Hypersensitivity to any component of the medication.- Situations in which gastrointestinal transit is difficult or impeded, such as [INTESTINAL OBSTRUCTION], [ILEUS] or [FECAL IMPACTION]. Due to the laxative effects of bisacodyl, the obstruction could be aggravated.- [ABDOMINAL PAIN] of unknown origin. Treatment with a laxative should not be started in patients suffering from abdominal pain until the cause has been identified, since the laxative could mask the symptoms of a more serious condition.- Pathologies in which increased intestinal peristalsis is dangerous, such as [APPENDICITIS] or [INTESTINAL PERFORATION]. The use of laxatives in these patients could aggravate the condition.- [DIGESTIVE HEMORRHAGE] and inflammatory bowel diseases ([ULCEROUS COLITIS], [CROHN'S DISEASE]). Bisacodyl should not be administered to patients with gastrointestinal bleeding due to its irritating effect on the intestinal mucosa. - Anal disorders such as [HEMORRHOIDS] or [ANAL FISSURE]. Bisacodyl administered rectally may cause local irritation.

PREGNANCY

FDA Category B. Considered safe when used alone.

PHARMACOKINETICS

Oral route: It is a prodrug that is metabolized in the colon by the action of bacterial flora, giving rise to the active metabolite, bis- (para-hydroxyphenyl) -2-pyridylmethane. - Absorption. It is absorbed in very small quantities. Food: Milk can increase the absorption of bisacodyl, so it is recommended to separate the intake of milk and bisacodyl by at least two hours. - Metabolism. The absorbed portion is metabolized in the liver by conjugation reactions. - Excretion. Unabsorbed bisacodyl is excreted in the feces, while the small absorbed fraction is eliminated in urine.

INDICATIONS

- [CONSTIPATION]. Symptomatic treatment of temporary constipation, such as that caused by prolonged bed rest or travel.

INTERACTIONS

- Digoxin. Prolonged use of laxatives can lead to potassium depletion, increasing digoxin toxicity. Monitoring electrolyte levels is recommended in patients receiving digoxin.

LACTATION

Neither the active moiety of bisacodyl (bis-(p-hydroxyphenyl)-pyridyl-2-methane) nor its glucuronides are excreted in breast milk. Acceptable use during lactation.

CHILDREN

As a general rule, laxatives are not recommended for children under 6 years of age, as they are often unable to accurately describe their symptoms. A proper diagnosis should be made before using a laxative, as it could mask more serious symptoms. The labeling approves the use of the tablets for children over 2 years of age.

RULES FOR CORRECT ADMINISTRATION

Suppositories should be administered first thing in the morning.

POSOLOGY

DOSAGE:

PRECAUTIONS

- Symptoms of appendicitis, such as patients complaining of [NAUSEA], [VOMITING], or [ABDOMINAL CRAMPS]. In patients with these symptoms, it is recommended that appendicitis be ruled out, and if diagnosed, a laxative should not be used.
- [Electrolyte IMBALANCE]. The use of laxatives for long periods of time may result in electrolyte imbalance. Patients should be adequately hydrated and have normal electrolyte levels before starting treatment with a laxative.
- Dependence. Continued use of laxatives can lead to dependence, as they may cause electrolyte imbalances that cause intestinal atony.

Dizziness/syncope: Dizziness and/or syncope have been described and appear to be attributable to distension caused by stool or as a vasovagal response to abdominal pain related to the procedure.
constipation and not necessarily to the administration of bisacodyl itself.

ADVERSE REACTIONS

The adverse effects of bisacodyl are generally mild and transient. The most common adverse reactions are:
- Digestive. [ABDOMINAL CRAMPS] and [ABDOMINAL DISTENSION] may occur after continued use. Rectal forms may also cause irritation, pain, and bleeding of the rectal mucosa, and in more severe cases, [PROCTITIS].

Hematochezia (passage of bloody stools) has been observed, which is generally mild and self-limiting.
- Allergic/dermatological: [EXANTHEMATOUS ERUPTIONS] and hypersensitivity reactions including [ANGIOEDEMA] and [ANAPHYLAXIS] are very rare.

- Metabolism and nutrition: [DEHYDRATION].

OVERDOSE

Symptoms: Excessive administration may result in gastrointestinal cramps, mucousy, diarrheal stools, and loss of potassium and other electrolytes. Treatment: The laxative should be discontinued. Supportive care should be initiated, with rehydration with saline solution and mineral salts if necessary. Antispasmodics may be administered to relieve intestinal cramps.

COMPOSITION

BISACODYL: 10 MILLIGRAMS