Dulcoflex
Reading File
Finding Sources
Searching the Web
Dulcoflex bisacodyl drug information mechanism indications
Reading File
Reading File
Reading File
Dulcoflex (Bisacodyl)
Dulcoflex is a brand name for bisacodyl, a stimulant laxative belonging to the diphenylmethane derivative class.
Drug Class
Stimulant (irritant) laxative — diphenylmethane derivative
Formulations & Dosing
| Formulation | Adult Dose | Paediatric Dose | Onset |
|---|---|---|---|
| Enteric-coated tablet (5 mg) | 5–15 mg once daily (oral) | 3–10 yr: 5 mg; >10 yr: 5–10 mg | 6–10 hours |
| Suppository (10 mg) | 10 mg once daily (rectal) | 2–10 yr: 5 mg; >10 yr: 5–10 mg | 15–60 minutes |
| Enema (10 mg/30 mL) | 10 mg (30 mL) once | 2–10 yr: 5 mg (15 mL) | 15–60 minutes |
Mechanism of Action
Bisacodyl requires hydrolysis by endogenous intestinal esterases for activation. Once active, it works by a dual mechanism:
- Pro-secretory: Stimulates accumulation of water and electrolytes in the bowel lumen (acts on enterocytes and enteric neurons to promote low-grade mucosal inflammation).
- Pro-motility: Induces powerful propulsive colonic motor activity when applied to the colonic mucosa.
After oral ingestion, bisacodyl acts in both the small and large intestine (unlike senna/sodium picosulfate, which are confined to the colon). Only ~5% is absorbed systemically and excreted in urine as a glucuronide; the rest is excreted in stool. — Goodman & Gilman's Pharmacological Basis of Therapeutics
Indications
- Short-term / occasional constipation
- Bowel preparation before surgery, endoscopy, or colonoscopy
- Situations requiring a predictable, single-dose bowel response
Clinical Evidence
A multicenter RCT (n=247) found bisacodyl 10 mg/day for 4 weeks significantly increased complete spontaneous bowel movements (CSBMs) vs. placebo (5.2 vs. 1.9/week). A systematic review and meta-analysis confirmed bisacodyl and sodium picosulfate both met primary endpoints (≥3 CSBMs/week with increase over baseline). — Sleisenger & Fordtran's GI and Liver Disease
Important Precautions & Side Effects
- Do not use for >10 consecutive days — risk of developing atonic nonfunctioning colon
- Do not crush or chew tablets — must be swallowed whole (enteric coating is essential)
- Do not administer within 1 hour of antacids or milk — premature dissolution of the enteric coating
- Not for use in neonates
- Common adverse effects: abdominal cramps, nausea, vomiting, diarrhea, rectal irritation (with suppository)
- Overdose: catharsis, fluid and electrolyte deficits
- Long-term use may cause colonic mucosal apoptosis; at pharmacological doses can cause colonic ischemia and mucosal damage
Key Differentiator vs. Related Drugs
| Drug | Activated by | Site of action |
|---|---|---|
| Bisacodyl | Intestinal enzymes | Small + large intestine |
| Sodium picosulfate | Colonic bacteria | Colon only (unpredictable) |
| Senna/anthraquinones | Colonic bacteria | Colon only |
— Harriet Lane Handbook, 23rd ed.; Goodman & Gilman's; Sleisenger & Fordtran's GI and Liver Disease
This is a shared conversation. Sign in to Orris to start your own chat.