Bisacodyl


Bisacodyl
Bisacodyl
Systematic (IUPAC) name
(pyridin-2-ylmethanediyl)dibenzene-4,1-diyl diacetate
OR
4,4'-(pyridin-2-ylmethylene)bis(4,1-phenylene) diacetate
Clinical data
AHFS/Drugs.com monograph
MedlinePlus a601027
Pregnancy cat. C
Legal status OTC
Routes Oral, rectal
Pharmacokinetic data
Bioavailability 15%
Metabolism Hepatic (CYP450-mediated)
Half-life 16 Hours
Excretion primarily in the feces, systemically absorbed drug is excreted in the urine
Identifiers
CAS number 603-50-9 YesY
ATC code A06AB02
PubChem CID 2391
ChemSpider 2299 YesY
UNII 10X0709Y6I YesY
KEGG D00245 YesY
ChEMBL CHEMBL942 YesY
Chemical data
Formula C22H19NO4 
Mol. mass 361.391 g/mol
SMILES eMolecules & PubChem
 YesY(what is this?)  (verify)

Bisacodyl (INN) is a stimulant laxative drug that works directly on the large colon to produce a bowel movement. It is typically prescribed for relief of constipation and for the management of neurogenic bowel dysfunction as well as part of bowel preparation before medical examinations, such as for a colonoscopy.[1] Bisacodyl is a diphenylmethane (in fact, a modified triphenylmethane) derivative and was first used as a laxative in 1953 due to its similarity to phenolphthalein.[2]

Contents

Available forms

Bisacodyl is sold under the trade names Dulcolax/Durolax, Fleet, Alophen, Correctol, and Carter's Little Pills (formerly Carter's Little Liver Pills[3]) as well 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 fluid ounce prepackaged enema containing a 10 mg delivered dose of liquid bisacodyl.

Administration

When bisacodyl is administered orally, it is usually taken at bedtime. Oral administration is known to produce no action for more than eight hours and then to work suddenly and without much warning. This is especially true if more than 10 milligrams is taken at one time. Normally the dosage is 5 or 10 milligrams, but up to 30 milligrams can be taken for complete cleansing of the bowel before a procedure. If taken in the afternoon or early evening, the action of this drug will start during sleep with undesirable results. If taken at the maximum dosage, there will likely be a sudden, extremely powerful, uncontrollable bowel movement and so precautions should be taken.

When administered rectally in suppository form, it is usually effective in 15 to 60 minutes. Two suppositories can be taken at once if a very strong, purgative, enema-like result is needed. A few hours after the initial evacuation, there can be a secondary action which will continue as long as there is unexpelled bisacodyl.

As a small commercially prepared enema, it is usually effective in 5 to 20 minutes.

Mechanism of action

Bisacodyl works by stimulating enteric nerves to cause colonic mass movements. It is also a contact laxative; it increases fluid and NaCl secretion. Action of bisacodyl on small intestine is negligible; stimulant laxatives mainly promote evacuation of the colon.

References

  1. ^ Wexner, SD; Beck, DE; Baron, TH; Fanelli, RD; Hyman, N; Shen, B; Wasco, KE; American Society of Colon and Rectal Surgeons; American Society for Gastrointestinal Endoscopy; Society of American Gastrointestinal and Endoscopic Surgeons (June 2006). "A consensus document on bowel preparation before colonoscopy: prepared by a task force from the American Society of Colon and Rectal Surgeons (ASCRS), the American Society for Gastrointestinal Endoscopy (ASGE), and the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES)". Gastrointest Endosc. 63 (7): 894–909. doi:10.1016/j.gie.2006.03.918. ISSN 0016-5107. PMID 16733101. 
  2. ^ http://www.medexus.ca/clinicalstudies/Magic%20Bullet%20Study%20paper(1).pdf
  3. ^ "Medicine: Cut Out the Liver". Time. 1951-04-16. http://www.time.com/time/magazine/article/0,9171,814704,00.html. Retrieved 2010-04-26. 

External links


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