Bisacodyl suppositories

Scale (mg/suppository) Item Material Name Quantity/1000 Suppositories (g) 

Transfer the molten mass to mixer through filter sieves. Set the temperature at 40° 2°C. Load item 1 to the mixer containing the molten mass. Carefully mix the powder with the molten mass. 

Homogenize at low speed while mixing for 10 minutes. Homogenize at high speed while mixing for 3 minutes. 

Continue mixing of the mass under vacuum in mixer. 

Transfer the molten mass from mixer to the storage vessel. Hold the mass at 40° 2°C while mixing continuously at low speed. 

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Bisacodyl stimulates sensory endings in the colon by direct action from the lumen. It is effective orally in 6-10 h and, as a suppository, acts in 1 h. In geriatric patients, bisacodyl suppositories reduce the need for regular enemas. There are no important imwanted effects. 

Bisacodyl suppositories can make the rectal mucosa appear inflamed (14), and this can be mistaken for idiopathic proctitis. However, the effect is transient. 

Stimulants/irritants Cascara Bisacodyl Senna Bisacodyl suppository 6-10 0.25-1 Direct stimulant effect on colon, increasing peristalsis, alters water and electrolyte secretion. Not for long-term use. Limit to 1 week. 

For most nonhospitalized persons with acute constipation, the infrequent use (less than every few weeks) of most laxative products is acceptable however, before more potent laxative or cathartics are used, relatively simple measures may be tried. For example, acute constipation may be relieved by the use of a tap-water enema or a glycerin suppository if neither is effective, the use of oral sorbitol, low doses of bisacodyl or senna, or saline laxatives (e.g., milk of magnesia) may provide relief. 

Diphenolmethane derivatives (p. 177) were developed from phenolphthalein, an accidentally discovered laxative, use of which had been noted to result in rare but severe allergic reactions. Bisac-odyl and sodium picosulfate are converted by gut bacteria into the active colon-irritant principle. Given by the enteral route, bisacodyl is subject to hydrolysis of acetyl residues, absorption, conjugation in liver to glucuronic acid (or also to sulfate, p. 38), and biliary secretion into the duodenum. Oral administration is followed after approx. 6 to 8 h by discharge of soft formed stooL When given by suppository, bisacodyl produces its effect within 1 h. 

Bisacodyl is available in tablet and suppository formulations for the treatment of acute and chronic constipation. It also is used in conjunction with PEG solutions for colonic cleansing prior to colonoscopy. It induces a bowel movement within 6-10 hours when given orally and 30-60 minutes when taken rectally. It has minimal systemic absorption and appears to be safe for acute and long-term use. Phenolphthalein, another agent in this class, was removed from the market owing to concerns about possible cardiac toxicity. 

Suppositories (bisacodyl, glycerin) may be used to obtain a bowel action in about 1 hour. Enemas produce defaecation by softening faeces and distending the bowel. They are used in preparation for surgery, radiological examination and endoscopy. Preparations with sodium phosphate, which is poorly absorbed and so retains water in the gut, are generally used. Arachis oil is included in enemas to soften impacted faeces. 

Some stimulant laxatives, for example bisacodyl, can be given in suppository form for a rapid action within 15 minutes of administration. 

Bisacodyl is a laxative that is indicated in short-term treatment of constipation evacuation of colon for rectal and bowel evaluation preparation for delivery or surgery. Bisacodyl is the only diphenyhnethane derivative available in the United States. It is marketed as an enteric-coated preparation (Dulcolax, Correctol, others) and as a suppository for rectal administration. The usual oral daily dose of bisacodyl is 10 to 15 mg for adults and 5 to 10 mg for children 6 to 12 years old. The drug requires hydrolysis by endogenous esterases in the bowel for activation, and so the laxative effects after an oral dose usually are not produced in less than 6 hours taken at bedtime, it will produce its effect the next morning. Suppositories work much more rapidly. 

Bisacodyl is the only diphenylmethane derivative available in the U.S. It is marketed as an enteric-coated preparation (dulcolax, coRREcroL, others) arul as a suppository for rectal administration. The usual oral daily dose of bisacodyl is 10-15 mg for adults and 5-10 mg for children 6-12 years old. 

A bisacodyl rectal suppository is given to the patient immediately before CTC... 

Laxatives such as bisacodyl in a suppository docusate sodium and sodium phosphate in an enema. 

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