Bisacodyl

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Bisacodyl
File:Bisacodyl skeletal.svg
File:Bisacodyl-from-xtal-3D-bs-17.png
Clinical data
Trade namesFleet, Dulcolax, Brooklax, others
AHFS/Drugs.comMonograph
MedlinePlusa601027
License data
Routes of
administration
By mouth, rectal
ATC code
Legal status
Legal status
Pharmacokinetic data
Bioavailability15%[citation needed]
MetabolismLiver (CYP450-mediated)
Elimination half-life16 hours[citation needed]
ExcretionPrimarily in the feces, systemically absorbed drug is excreted in the urine[citation needed]
Identifiers
  • (pyridin-2-ylmethanediyl)dibenzene-4,1-diyl diacetate
    OR
    4,4'-(pyridin-2-ylmethylene)bis(4,1-phenylene) diacetate
CAS Number
PubChem CID
DrugBank
ChemSpider
UNII
KEGG
ChEMBL
E number{{#property:P628}}
CompTox Dashboard (EPA)
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Chemical and physical data
FormulaC22H19NO4
Molar mass361.397 g·mol−1
3D model (JSmol)
  • O=C(Oc1ccc(cc1)C(c2ccc(OC(=O)C)cc2)c3ncccc3)C
  • InChI=1S/C22H19NO4/c1-15(24)26-19-10-6-17(7-11-19)22(21-5-3-4-14-23-21)18-8-12-20(13-9-18)27-16(2)25/h3-14,22H,1-2H3 checkY
  • Key:KHOITXIGCFIULA-UHFFFAOYSA-N checkY
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Bisacodyl is an organic compound that is used as a stimulant laxative drug. It works directly on the colon to produce a bowel movement. It is typically prescribed for relief of episodic and chronic constipation and for the management of neurogenic bowel dysfunction, as well as part of bowel preparation before medical examinations, such as for a colonoscopy.[2][3]

Bisacodyl is a derivative of triphenylmethane. It was first used as a laxative in 1953 because of its structural similarity to phenolphthalein.[4][5]

It is on the World Health Organization's List of Essential Medicines.[6] In 2023, it was the 293rd most commonly prescribed medication in the United States, with more than 400,000 prescriptions.[7][8]

Medical uses

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Bisacodyl is used to treat both episodic and chronic constipation, manage symptoms of neurogenic bowel dysfunction, as well as for bowel preparation for a colonoscopy.[2][3]

Available forms

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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),[9] 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 1.25 US fluid ounces (37 ml) pre-packaged enema containing a 10 mg delivered dose of liquid bisacodyl.[10]

Administration

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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.[3]

As a commercially prepared micro-enema, it is usually effective in 5 to 20 minutes.[10]

Mechanism of action

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Bisacodyl works by stimulating enteric neurons to cause peristalsis (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.[10]

References

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