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Bisacodyl oral

Updated 2 Feb 2023 | Stimulant laxatives


Oral formulations containing bisacodyl.

Drugs List

  • bisacodyl 5mg gastro-resistant tablets
  • DULCOLAX ADULT 5mg gastro-resistant tablets
  • DULCOLAX TWELVE PLUS 5mg gastro-resistant tablets
  • Therapeutic Indications



    Unlicensed Uses

    Bowel evacuation - prior to investigative procedure
    Bowel evacuation - prior to surgical procedure


    The onset of action is approximately 6 to 12 hours.


    Relief of constipation
    5mg to 10mg at night before bedtime.

    The following unlicensed alternative dose may be suitable: 20mg once daily at night if necessary.

    For preparation of diagnostic procedures and preoperatively (unlicensed)
    10mg twice daily to be taken in the morning and evening on the day before the procedure and 10mg rectally (using suppository) 1 to 2 hours before the procedure.


    Relief of constipation
    Children aged 12 to 18 years
    5mg to 10mg at night before bedtime.

    The following alternative dosing schedule may be suitable (not licensed for children under 12 years or over 10mg daily):
    Children aged 4 to 18 years
    5mg to 20mg once daily at night.

    For preparation of diagnostic procedures and preoperatively (unlicensed)
    Children aged 10 to 18 years
    10mg once daily at bedtime for 2 days before the procedure and 10mg rectally (using suppository) if required 1 hour before the procedure.
    Children aged 4 to 10 years
    5mg once daily at bedtime for 2 days before the procedure and 5mg rectally (using suppository) if required 1 hour before the procedure.


    Children under 4 years
    Acute surgical abdomen
    Gastrointestinal obstruction
    Hereditary fructose intolerance
    Inflammatory bowel disease
    Paralytic ileus
    Severe dehydration

    Precautions and Warnings

    Children aged 4 to 12 years
    Glucose-galactose malabsorption syndrome
    Lactose intolerance

    Not all available brands/formulations are licensed for use in children
    Contains lactose
    Preparation contains sucrose
    Indigestion remedies should not be taken at the same time
    If daily use is required, investigate the cause of constipation
    Prolonged use may cause fluid/electrolyte imbalance and hypokalaemia
    Discontinue if severe abdominal symptoms develop
    Advise patient not to take with milk
    Advise patient to seek medical advice if symptoms persist for > 5 days

    Prolonged excessive use may lead to fluid and electrolyte imbalance, diarrhoea, hypokalaemia, and may precipitate rebound constipation. Intestinal loss of fluids can promote dehydration. Symptoms may include thirst and oliguria. Bisacodyl must be discontinued in patients suffering from fluid loss where dehydration may be harmful (e.g. renal insufficiency, elderly patients). Prolonged use may also lead to atonic non-functioning colon.

    Concurrent use of antacids or milk products may reduce the resistance of the tablet coating. This may lead to dyspepsia and gastric irritation.

    Patients may experience blood in stool that is generally mild and self-limiting. There have been reports of abdominal pain and bloody diarrhoea in some cases associated with colonic mucosal ischaemia.

    Dizziness or syncope has been reported during use of bisacodyl, consistent with defecation syncope (or syncope attributable to straining at stool), or with vasovagal response to abdominal pain which may be related to the constipation that prompted the use of laxatives.

    Bisacodyl should only be used if bulk-forming and osmotic laxatives are ineffective or contraindicated.

    Pregnancy and Lactation


    Use bisacodyl with caution during pregnancy.

    Manufacturers advise bisacodyl may be used with caution during pregnancy. At the time of writing there are no adequate and well-controlled studies in pregnant women. It is not known if bisacodyl crosses the placenta, however its molecular weight is low enough for passive diffusion to occur. The minimal amounts in systemic circulation (5%) suggest that neither the embryo nor foetus will have clinically significant exposure to the drug (Briggs 2015).


    Use bisacodyl with caution during breastfeeding.

    Manufacturers advise bisacodyl may be used with caution during breastfeeding. At the time of writing, there is no published experience concerning the use of bisacodyl during breastfeeding. Its molecular weight is low enough for excretion into breast milk but minimal amounts (5%) are absorbed into maternal circulation. The effects on the nursing infant are unknown but appear to be negligible (Briggs 2015).

    If laxative treatment is considered necessary, and neither bulk or osmotic laxatives are effective, then bisacodyl may be considered the drug of choice during breastfeeding (Schaefer 2015).


    Advise patient not to take the tablet with milk or antacids.

    Advise patient tablets should be swallowed whole and not chewed or crushed with an adequate amount of fluid.

    Advise patient that tablets should not be taken on a continuous basis for more than 5 days without investigating the cause of constipation.

    Side Effects

    Abdominal cramps
    Abdominal discomfort
    Abdominal pain
    Anaphylactic reaction
    Blood in stool
    Fluid and electrolyte disturbances
    Hypersensitivity reactions
    Intestinal colic
    Ischaemic colitis
    Rectal discomfort


    It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.

    The following number will direct the caller to the relevant local centre (0844) 892 0111

    Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( ) or if this is unavailable at the backup site ( ).

    Further Information

    Last Full Review Date: November 2020

    Reference Sources

    Drugs During Pregnancy and Lactation: Treatment Options and Risk Assessment, 3rd edition (2015) ed. Schaefer, C., Peters, P. and Miller, R. Elsevier, London.

    Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk, 10th edition (2015) ed. Briggs, G., Freeman, R. Wolters Kluwer Health, Philadelphia.

    Summary of Product Characteristics: Bisacodyl 5mg Laxative Tablets 12+ years. Dr. Reddy's Laboratories (UK) Ltd. Revised May 2020.

    Summary of Product Characteristics: Dulcolax Adult 5mg Gastro-Resistant Tablets (GSL). Sanofi. Revised October 2020.

    Summary of Product Characteristics: Dulcolax Twelve Plus 5mg Gastro-Resistant Tablets (P). Sanofi. Revised November 2021.

    NICE Evidence Services Available at: Last accessed: 08 September 2022.

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