Fleet Bisacodyl 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.

Use exactly as directed on the label, or as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended. Overuse of laxatives can cause your bowels to function improperly, or can make you dependent on laxative use.

In some cases, bisacodyl is taken by mouth. The enema and suppository forms of this medicine are for use in the rectum.

Do not crush, chew, or break a bisacodyl tablet. Swallow it whole with a full glass of water.

Bisacodyl taken by mouth should produce a bowel movement within 6 to 12 hours.

Bisacodyl used in the rectum can produce much faster results. You should have a bowel movement within 15 to 60 minutes after using a rectal suppository, or within 5 to 20 minutes after using the rectal enema.

Do not take a rectal suppository or enema by mouth. It is for use only in your rectum.

Try to empty your bladder just before using bisacodyl in the rectum.

Wash your hands before and after using rectal bisacodyl.

To use the rectal suppository:

• Remove the wrapper from the suppository. Avoid handling the suppository too long or it will melt in your hands. If the suppository is soft, you may hold it under cool running water or refrigerate it for a few minutes.

• Lie on your left side with your right knee up toward your chest. Gently insert the suppository into your rectum about 1 inch, pointed tip first.

• Stay lying down for a few minutes. The suppository will melt quickly and you should feel little or no discomfort while holding it in.

• Do not use more than one rectal suppository per day.

To use the rectal enema:

• Shake the rectal enema before using it. Remove the cap from the enema tip.

• Lie on your left side with your right knee up toward your chest, leaning forward slightly. Gently insert the tip of the enema bottle into your rectum, aiming toward your navel.

• Gently squeeze the bottle until it is empty, and then remove it from your rectum.

• For best results, hold the enema liquid in your rectum for up to 10 minutes. Then empty your rectum while seated on a toilet.

Call your doctor if you do not have a bowel movement after using this medicine, or if you have constipation for longer than 7 days.

If you are using bisacodyl to prepare for a medical test, follow your doctor's instructions about when to use the medicine.

Store bisacodyl oral or rectal medicine at room temperature away from moisture and heat.

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.

Applies to bisacodyl: compounding powder, oral delayed release tablet, rectal enema, rectal suppository

Gastrointestinal

Bisacodyl causes acute nonspecific inflammatory injury to the rectal mucosa, which can confound the assessment of patients with suspected inflammatory bowel disease.

The surreptitious abuse of laxatives is a common cause of severe chronic diarrhea. In some cases, the stool contains fecal leukocytes, which, in this case, is indicative of the irritant effect of bisacodyl (the active ingredient contained in Fleet Bisacodyl) (nonspecific colonic mucosal inflammation), and not necessarily of infection. Surreptitious abuse of laxatives due to bisacodyl can be determined by urinalysis for a metabolite, bisacodyl diphenol. In some cases, stool analysis for bisacodyl could be considered in the diagnostic assessment.

Abdominal cramping has been described as a mild, colicky discomfort. This can be a problem since cramping my indicate not only a side effect of bisacodyl, but underlying gastrointestinal pathology.

Abdominal distension and vomiting are less common gastrointestinal side effects.[Ref]

Gastrointestinal side effects have been reported the most frequently. These have included abdominal cramping, diarrhea, abdominal distention, and vomiting. Severe diarrhea has been reported as a possible result of surreptitious laxative abuse. The sensation of rectal "burning" with administration of bisacodyl enema has been reported.[Ref]

Metabolic

The metabolic consequences of some Fleet bisacodyl (the active ingredient contained in Fleet Bisacodyl) enema preparation kits that contain monobasic or dibasic sodium phosphate in patients with renal insufficiency can be profound. Due to the sodium and phosphate absorption, severe hypernatremia, hypophosphatemia, and hypocalcemia may occur.[Ref]

Metabolic side effects have included severe hypernatremia, hypophosphatemia, and hypocalcemia. These effects have been reported primarily with Fleet bisacodyl enema preparation kits that contain monobasic or dibasic sodium phosphate and administered to patients with renal insufficiency. Fleet bisacodyl enemas without these ingredients may be used safely in such patients.[Ref]

Some side effects of Fleet Bisacodyl may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA.