Antacids
Moderate
Database
Premature dissolution of enteric coating → gastric irritation/cramps
Separate by ≥1 h; do not take within 1 h of antacids/milk
Source: Kimi deep-research + Cla
Drug reference
Bisacodyl
Stimulant laxative (diphenylmethane) · Laxative; Bowel Evacuant
Also known as Dulcolax, Laxit, Contilax, Bisalax, Bico, Gerbisa
START
5–10 mg PO at night; suppository 10 mg PR for rapid effect
TYPICAL MAX
10 mg/day routine (higher only for supervised bowel prep)
STOP IF
Severe abdominal pain, suspected obstruction, persistent diarrhoea/electrolyte disturbance
WATCH
Avoid chronic daily use (dependence), hydration/electrolytes in elderly/bowel prep
CDSCO approvedOTCJan AushadhiATC A06AB02
KDIGO 2024 + manufacturer label
- ONSET
- 6h · oral effect onset
- PEAK
- 10h · evacuation
- t½
- 16h · active metabolite t½
- DURATION
- 12h · single evacuation
EXCRETION
Mainly faecal; minor renal glucuronide
route + CYP
INTERACTIONS
—
none in our sources
PREGNANCY
Considered acceptable for short-term use if dietary/bulk measures fail — minimal absorption
FDA category + note
Available in India
40 branded formulations. Look up specific brands in the Drugs workspace.
Jan Aushadhi — generic available at GoI pharmacies
Mechanism
Hydrolysed to active BHPM which stimulates colonic mucosal sensory nerve endings increasing peristalsis and reduces water/electrolyte absorption (pro-secretory), promoting evacuation.
Indications
Constipation (short-term)Bowel preparation before procedures/surgery (with other agents)
Dosing
- Adult
- 5–10 mg PO at night; up to 15 mg for bowel prep; suppository 10 mg PR for faster effect.
- Pediatric
- ≥4 years 5 mg PO daily; suppository per age (specialist for younger).
- Renal adjustment
- No adjustment.
- Hepatic adjustment
- No adjustment.
- Geriatric
- Short-term use; avoid chronic stimulant laxative dependence.
- Max dose
- 10 mg/day routine (up to 15–30 mg for bowel prep regimens)
Pharmacokinetics
Onset
Oral 6–12 h; suppository 15–60 min
Peak effect
Effect-defined (evacuation)
Duration
Single evacuation
Half-life
Active metabolite ~16 h (minimal systemic relevance)
Bioavailability
Low systemic (<5%) — acts locally
Protein binding
Not clinically relevant (low absorption)
Metabolism
Gut/hepatic hydrolysis to BHPM; conjugation
Excretion
Mainly faecal; some renal (glucuronide)
Contraindications
- Ileus / intestinal obstruction
- Acute surgical abdomen / appendicitis
- Severe dehydration
- Acute inflammatory bowel disease
- Hypersensitivity to bisacodyl
Side effects
Common
Abdominal crampsDiarrhoeaNauseaRectal irritation (suppository)
Serious
- Fluid/electrolyte disturbance (overuse, esp. elderly)
- Severe abdominal pain (possible obstruction)
- Laxative dependence/atonic colon (chronic misuse)
- Ischaemic colitis (rare, high-dose prep)
Pregnancy & lactation
Pregnancy
Considered acceptable for short-term use if dietary/bulk measures fail — minimal absorption
Lactation
Compatible — negligible systemic absorption/milk transfer
Drug interactions
Digoxin
Moderate
Database
Hypokalaemia (laxative overuse) potentiates digoxin toxicity
Avoid chronic stimulant use; monitor K+/digoxin
Source: Kimi deep-research + Cla
Diuretics
Moderate
Database
Additive hypokalaemia with overuse
Avoid chronic use; monitor potassium
Source: Kimi deep-research + Cla
9 additional low-confidence interactions hidden — those rows lack a documented mechanism or management plan in our sources.
Related guidelines
Irritable bowel syndrome
ISG · Gastroenterology · 2023
Inflammatory bowel disease
OTHER · Gastroenterology · 2015
Preoperative cardiac evaluation for non-cardiac surgery
AHA · Cardiology · 2025
Anticoagulant management for dental procedures
ADA_DENTAL · Dentistry · 2015
Preventive care in inflammatory bowel disease
ACG · Gastroenterology · 2025
Ask House about Bisacodyl
Continue into a citation-backed clinical answer with the drug context already attached.
Sources: Goodman & Gilman 14e, Katzung, BNF, Nelson·Verified: 2026-05-19 · House clinical team·Cockpit curated: 2026-05-19