The therapeutic efficacy of Bisacodyl can be decreased when used in combination with Aclidinium.
The risk or severity of adverse effects can be increased when Acetazolamide is combined with Bisacodyl. Hover over products below to view reaction partners 4, 5, 6 A small amount of BHPM is absorbed from the gastrointestinal tract, and is glucuronidated before elimination. 6 Protein bindingīisacodyl is deacetylated to the active bis-(p-hydroxyphenyl)-pyridyl-2-methane (BHPM) by an intestinal deacetylase. However, the volume of distribution of the active metabolite, BHPM, in lactating women is 181 L after a single dose and 289 L at steady state. 6 Volume of distributionĭata regarding the volume of distribution of bisacodyl is not readily available. 6 After multiple doses, the geometric mean AUC decreases to 311 h*ng/mL. In lactating women, 10mg of oral bisacodyl reaches a C max of 20.5-195 ng/mL, with a T max of 3-4 hours, and a geometric mean AUC after a single dose of 471 h*ng/mL. 10 A 10 mg suppository reaches a C max of 0-64 ng/mL. 2, 3 A 10 mg enteric coated oral tablet reaches a C max of 26 ng/mL with a T max of 8 hours, while a 10 mg oral solution reaches a C max of 237 ng/mL with a T max of 1.7 hours. Oral formulations of bisacodyl are only 16% bioavailable. 7īisacodyl directly stimulates parasympathetic nerves in the colon, stimulating contraction of longitudinal smooth muscle but not circular smooth muscle. 7 Bisacodyl decreases expression of aquaporin 3, preventing water from moving into the vasculature, which may contribute to increased water in the colon. Water is also be transported from the luminal side of cells into the vasculature by aquaporin 3.
5 Sodium ions, potassium ions, and water passively leave the cell while sodium and chloride ions are unable to be reabsorbed. 5īisacodyl stimulates adenylate cyclase, increasing cyclic AMP, leading to active transport of chloride and bicarbonate out of cells. 4, 5, 6 BHPM can stimulate parasympathetic nerves in the colon directly to increase motility and secretions. 9 Mechanism of actionīisacodyl is deacetylated to the active bis-(p-hydroxyphenyl)-pyridyl-2-methane (BHPM) by an intestinal deacetylase. 9 Patients should also be counselled to stop taking the medication if they experience rectal bleeding or no bowel movement in 12 hours. 9 Patients taking bisacodyl should be counselled before taking the medication if they are already experiencing abdominal pain, nausea, vomiting, or a change in bowel function lasting longer than 2 weeks. 9 It has a wide therapeutic index, as patients can take 5-15 mg orally. Patients should be counselled regarding abdominal pain, nausea, vomiting, or a change in bowel function that lasts longer than 2 weeks.
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