Alophen oral and rectal

Bisacodyl is a laxative that stimulates bowel movements.

Bisacodyl is used to treat constipation or to empty the bowels before surgery, colonoscopy, x-rays, or other intestinal medical procedure.

Bisacodyl may also be used for purposes not listed in this medication guide.

You should not use bisacodyl if you are allergic to it, or if you have:

• stomach pain, nausea, or vomiting.

Ask a doctor or pharmacist if it is safe for you to use this medicine if you have other medical conditions, especially:

• a sudden change in bowel habits lasting 2 weeks or longer;

• hemorrhoids or anal fissures (small tears in the skin tissues around your rectum);

• ulcerative colitis, inflammatory bowel disease, or other intestinal disorder;

• a history of perforation (a hole or tear) of your intestines;

• an eating disorder (anorexia or bulimia); or

• (for bisacodyl tablets) if you cannot swallow without chewing.

Older adults should not use rectal bisacodyl without a doctor's advice.

It is not known whether bisacodyl will harm an unborn baby. Do not use this medicine without a doctor's advice if you are pregnant.

It is not known whether bisacodyl passes into breast milk or if it could harm a nursing baby. Do not use this medicine without a doctor's advice if you are breast-feeding a baby.

Do not give this medicine to a child younger than 2 years old without the advice of a doctor.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222, especially if anyone has accidentally swallowed a rectal suppository.

Avoid using other medications within 2 hours before or 2 hours after using bisacodyl.

Avoid drinking milk or taking an antacid within 1 hour before you take bisacodyl by mouth.

Other drugs may interact with bisacodyl, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.

5 to 15 mg (1 to 3 tablets) orally once a day as needed or
10 mg (1 suppository) rectally once a day as needed or
10 mg rectal liquid once a day as needed.

No adjustment recommended

Summary of Use during Lactation

Bisacodyl is not absorbed from the gastrointestinal tract, and its active metabolite, which is absorbed, is not detectable in breastmilk. Bisacodyl can be taken during breastfeeding and no special precautions are required.

Drug Levels

Maternal Levels. Sixteen postpartum women who were not breastfeeding, but were producing at least 200 mL of milk daily by breast pump were given either oral enteric-coated bisacodyl tablets (Dulcolax) 10 mg daily or oral liquid sodium picosulfate (Laxoberal) 10 mg daily for 7 days. Both drugs are prodrugs metabolized to the active drug, bis-(p-hydroxyphenyl)-2-pyridyl-2-methane (BHPM). All breastmilk was collected daily from the day before drug administration to 2 days after the last dose. Free and conjugated BHPM were undetectable (<1 mcg/L) in all milk samples.[1]

Infant Levels. Relevant published information was not found as of the revision date.

Effects in Breastfed Infants

Relevant published information was not found as of the revision date.

Effects on Lactation and Breastmilk

Relevant published information was not found as of the revision date.

Alternate Drugs to Consider

Docusate, Magnesium Hydroxide, Psyllium, Senna

References

1. Friedrich C, Richter E, Trommeshauser D et al. Lack of excretion of the active moiety of bisacodyl and sodium picosulfate into human breast milk: an open-label, parallel group, multiple dose study in healthy lactating women. Drug Metab Pharmacokinet. 2011;26:458-64. PMID: 21697613