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Treatment Name: Bisacodyl (Dulcolax®)

Bisacodyl (Dulcolax®) is a Supportive Care Therapy to treat Constipation

How does bisacodyl (Dulcolax®) work?
Bisacodyl is a laxative designed to directly stimulate the movement of the intestines, which produces a bowel movement. It also causes the body to move water into the intestines, which softens the stool and the excess water can also stimulate the intestines and produce a bowel movement.

Goals of therapy:
Bisacodyl (Dulcolax®) is taken to relieve occasional constipation. It is commonly taken on an as needed basis with the goal of treating constipation.

Bisacodyl (Dulcolax®) is available as an over-the-counter medication.

Schedule

Bisacodyl is commonly taken at home on an as needed basis to treat constipation and maintain normal, regular bowel movements daily or every other day.

Onset of action:
When dosed adequately, bisacodyl tablets generally induce a bowel movement in approximately 6 to 12 hours when taken by mouth. If suppositories are used, the effect is often quicker and a bowel movement may occur in as little as 15 minutes to 1 hour.

Dosing:
Bisacodyl (Dulcolax®) tablets:

  • Bisacodyl 5-15 mg (one to three tablets) by mouth once daily with a glass of water
  • Do not take bisacodyl tablets within one hour after taking antacids or eating and drinking milk or dairy products
  • Unless directed by a doctor, bisacodyl should not be used for longer than one week at a time

Bisacodyl (Dulcolax®) suppositories:

  • Bisacodyl 10 mg suppository inserted into the rectum once daily. Retain in rectum for 15 to 20 minutes. Do not use more than one bisacodyl suppository per day
  • If you are receiving chemotherapy, do NOT attempt to use a suppository unless you have discussed this with your doctor. Use of suppositories could cause a tear in the rectum and may lead to a serious infection
  • Unless directed by a doctor, bisacodyl should not be used for longer than one week at a time

Bisacodyl is usually taken at home. Typical duration of therapy is until bisacodyl no longer works in relieving constipation, or constipation is resolved and bisacodyl is no longer needed. Do not take bisacodyl for more than seven days without talking to your doctor.

Store bisacodyl tablets at room temperature (68-77°F). Store bisacodyl suppositories at a temperature that is less than 86°F otherwise the suppository may melt.

Side Effects

In the prescribing label information (bisacodyl package insert), the most commonly reported side effects from bisacodyl (Dulcolax®) are shown here:

  • Stomach pain
  • Dizziness
  • Stomach cramps
  • Rectal burning (suppository only)

Bisacodyl should be used in pregnant women only if the potential benefits to the mother outweigh the potential risks to the unborn baby.

Note: The exact percentages of patients that will experience bisacodyl side effects is unknown because it has been used under widely varying patient populations in a variety of clinical trials.

Side effect videos Side Effect Videos
ConstipationConstipationPainPain

Monitoring

How often is monitoring needed?
Labs (blood tests) are usually not necessary to start or continue bisacodyl therapy. If suppositories are used, a complete blood count (CBC) may be ordered to ensure that the white blood cell count is not too low

How often is imaging needed?
Imaging may be checked if there is concern of a small bowel obstruction (SBO) or blockage. Imaging may include: Abdominal X-ray, or CT scan of the abdomen and pelvis.

How might blood test results/imaging affect treatment?
Depending upon the results, your doctor may advise to continue bisacodyl as planned, add additional laxatives, place you on “bowel rest” (nothing by mouth until the obstruction clears), or switch to an alternative therapy for constipation.

To prevent constipation from getting worse, call your doctor if bisacodyl does not produce a bowel movement within the time that they have specified.

ChemoExperts Tips

  • Bisacodyl (Dulcolax®) is an inexpensive, yet effective over-the-counter remedy for constipation
  • Bisacodyl should not be used if you have noticed blood in the stool as this could be a sign of a serious condition
  • To maintain regular bowel movements, bisacodyl may be combined with other over-the-counter medications. Talk to your doctor or pharmacist if you have trouble maintaining normal bowel movements
  • If you are receiving chemotherapy, do NOT attempt to use a suppository or enema unless you have discussed this with your doctor. Suppositories and enemas can cause a tear in the rectum and may lead to a serious infection
  • Walking helps to stimulate the bowels to move stool down the intestinal tract. A diet high in fiber (found in fruits, vegetables, and whole grains) also helps to maintain a healthy colon (large intestine)
  • It is important to have regular bowel movements, usually once daily or every other day. Otherwise, your small bowel (intestine) may become blocked. Call your doctor if you have not had a bowel movement for 3 days or more, especially if you feel bloated. If you feel pain in your abdomen/belly, feel nauseated, or vomit at any point while constipated, call your doctor immediately
  • Do not use suppositories if the foil wrapper is ripped or torn
  • A pharmacist should ALWAYS review your medication list to ensure that drug interactions are prevented or managed appropriately

Patient Assistance & Co-payment Coverage

Patients under the age of 65 years, or those with private insurance plans:
If you have insurance and are looking for patient assistance or copay assistance for Bisacodyl (Dulcolax®), we have provided links that may help.

Visit our Patient Assistance page and click the links to various patient assistance programs for help paying for Bisacodyl (Dulcolax®). Depending upon your income, they may be able to help cover the cost of:

  • Bisacodyl (Dulcolax®)

For Branded medications (may be available for generic medications too), check with the manufacturer to determine if a co-pay card is offered and if it could reduce your monthly copay.

  • If you are uninsured, check with the manufacturer to determine if you are eligible to receive medication at no cost.

Medicare and Medicaid patients (Patients 65 years or older):
The clinic providing treatment will likely pre-authorize medications and immune therapies such as Bisacodyl (Dulcolax®) and are the best source to help you understand drug cost.

  • Ask to speak with a patient assistance technician or financial counselor at the clinic or hospital administering this therapy.

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References

Bisacodyl (Dulcolax®) package insert

Created: January 7, 2018 Updated: January 7, 2018

What is Constipation?

Many treatment options for constipation exist. Watch our video to learn more about constipation and available treatments.

What is a CBC?

A Complete Blood Count (CBC) is a frequently ordered blood test that tells clinicians the status of your: 1) White blood cell count, 2) Hemoglobin, and 3) Platelet count at the time the test was taken.

Common uses:
1) White blood cell count (WBC): is used to determine infection risk, or response to chemotherapy. Certain chemotherapy agents may harm our good infection-fighting cells. Sometimes chemotherapy may need to be delayed to allow these cells to recover.

2) Hemoglobin: is used to determine if someone is anemic. Anytime the hemoglobin is below 12 g/dL, the person is said to be anemic. Red blood cell transfusions, and sometimes iron can be given to restore the hemoglobin level, but anemia treatment should always aim at treating the underlying cause or condition.

3) Platelet count: is used to determine if the risk of bleeding is increased or if a platelet transfusion is required to prevent bleeding. Certain medications that increase bleeding risk, such as: aspirin, certain chemotherapy agents, and blood thinners, may need to be stopped temporarily until the platelet count is within a safe range.