Description
Therapeutic action
– Stimulant laxative
Indications
– Prevention of constipation in patients taking opioid analgesics (codeine, morphine, etc.)
– Short-term, symptomatic treatment of constipation
Presentation
– 5 mg enteric-coated tablet
Dosage
– Child over 3 years: 5 to 10 mg once daily
– Adult: 10 to 15 mg once daily
Duration
– Prevention of constipation in patients taking opioids : start bisacodyl when analgesic treatment continues
more than 48 hours. Tablets must be taken daily, at night (bisacodyl is effective 6 to 12 hours after
administration), until the end of the opioid treatment. Regular follow up (frequency/consistency of
stools) is essential in order to adjust dosage correctly.
–
Treatment of constipation: until the patient passes stools, maximum 7 days.
Contra-indications, adverse effects, precautions
– Do not administer to patients with Crohn’s disease, ulcerative colitis, intestinal obstruction, undiagnosed
abdominal pain and dehydration.
– May cause: diarrhoea, abdominal cramps, hypokalaemia.
– In the event of diarrhoea: exclude a faecal impaction or intestinal obstruction, stop treatment for
24 hours and then start again with a half dose.
– In the event of abdominal cramps: reduce or divide the daily dose. Stop treatment if pain continues.
– Do not combine with drugs that induce torsades de pointe (halofantrine, erythromycin IV, pentamidine,
etc.).
– Closely monitor patients taking drugs that induce hypokalaemia (furosemide, amphotericin B,
corticosteroids, etc.) or cardiac glycosides.
– Pregnancy and breast-feeding: avoid; for routine prevention of constipation due to opioids, use lactulose.
Remarks
– To prevent constipation in patients taking opioids, use lactulose if the patient’s stools are solid; use
bisacodyl if the patient’s stools are soft.
– In children from 6 months to 3 years, do not use the oral route. Use only 5 mg paediatric suppositories
(one suppository/day).
– Swallow tablets whole; do not crush or chew.
– Bisacodyl is equivalent to senna, the representative example of laxative stimulants in the W O list of
essential medicines.
– The treatment must be accompanied by dietary measures (plenty of fluids and fibr
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