Bisacodyl
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| Routes of administration | Oral, rectal |
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| Pharmacokinetic data | |
| Bioavailability | 15% |
| Metabolism | Hepatic (CYP450-mediated) |
| Elimination half-life | 16 Hours |
| Excretion | primarily in the feces, systemically absorbed drug is excreted in the urine |
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| ECHA InfoCard | 100.009.132 |
| Chemical and physical data | |
| Formula | C22H19NO4 |
| Molar mass | 361.391 g/mol g·mol−1 |
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Bisacodyl (INN) is a stimulant laxative drug. 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.[2] Bisacodyl is a diphenylmethane derivative and was first used as a laxative in 1953 due to its similarity to phenolphthalein.[3]
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[4]) as well as 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. This is due to the relatively long onset of the drug when taken orally (around 6–10 hours). When administered rectally in suppository form, it is usually effective in 15 to 60 minutes. As an enema, a bowel movement usually occurs 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.
Cultural references
Carter's Little Liver Pills predated the other available forms of bisacodyl and was a very popular and heavily advertised patent medicine up into the 1960s, spawning a common saying (with variants) in the first half of the 20th Century: "He/She has more _________ than Carter has Little Liver Pills".
The senator Robert Byrd, after winning re-election in 2000, is quoted as saying, "West Virginia has always had four friends, God Almighty, Sears Roebuck, Carter's Liver Pills and Robert C. Byrd." [5]
References
- ^ "FDA-sourced list of all drugs with black box warnings (Use Download Full Results and View Query links.)". nctr-crs.fda.gov. FDA. Retrieved 22 Oct 2023.
- ^ Wexner, SD (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.
{{cite journal}}:|access-date=requires|url=(help); Unknown parameter|coauthors=ignored (|author=suggested) (help); Unknown parameter|month=ignored (help) - ^ [1]
- ^ "Medicine: Cut Out the Liver". Time. 1951-04-16. Retrieved 2010-04-26.
- ^ "Robert Byrd, Longest-Serving US Senator, Dies at 92". Wall Street Journal. 2010-06-28. Retrieved 2010-06-28. [dead link]