Recommended Frequency for Taking Ducolax (Bisacodyl)
Bisacodyl (Ducolax) should be taken at a starting dose of 5 mg once daily, with a maximum recommended dose of 10 mg daily, and is primarily intended for short-term use (4 weeks or less) or as rescue therapy for constipation. 1
Dosage and Administration Guidelines
- Initial dose: 5 mg daily 1
- Maximum dose: 10 mg daily 1
- Timing: Take at bedtime for morning bowel movement 2
- Duration: Primarily for short-term use (4 weeks or less) 1
Mechanism of Action
Bisacodyl is a stimulant laxative that works by:
- Irritating luminal sensory nerve endings
- Stimulating colonic motility
- Reducing colonic water absorption 2
This mechanism helps produce a bowel movement within 6-12 hours after oral administration.
Efficacy
Bisacodyl has demonstrated significant efficacy in clinical trials:
- Increases mean number of stools per day (1.8/day with bisacodyl vs. 0.95/day with placebo) 3
- Improves stool consistency from "hard" to between "soft" and "well-formed" 3
- Achieves the goal of one non-forced bowel movement every 1-2 days 1
Safety Considerations
When to Stop Use
Stop using bisacodyl and consult a doctor if:
- You experience rectal bleeding
- You fail to have a bowel movement after using the laxative
- You need to use it for more than one week 4
Common Side Effects
- Abdominal cramping
- Diarrhea
- Perineal skin irritation 2
Drug Interactions
- May reduce serum digoxin concentration when taken simultaneously 5
- If taking digoxin, separate administration times by at least 2 hours 5
Special Populations
Elderly Patients
- Start with lower doses due to potential increased sensitivity 2
- Consider adding polyethylene glycol (PEG) if bisacodyl alone is insufficient 2
- Avoid magnesium-based products in elderly with renal insufficiency 2
Children
- Children 6-12 years: Half the adult dose (2.5 mg)
- Children under 6 years: Consult a doctor 4
- For pediatric functional constipation refractory to conventional therapy, long-term use (median 14 months) has been shown to be effective and well-tolerated 6
Contraindications
Avoid using bisacodyl in patients with:
- Suspected bowel obstruction
- Undiagnosed abdominal pain
- Recent colorectal surgery 2
Long-term Use Considerations
While bisacodyl is primarily recommended for short-term use, recent evidence suggests:
- There is little evidence that routine use of stimulant laxatives is harmful to the colon 2
- In refractory cases, longer-term use may be necessary and has shown efficacy 6
- More data is needed to better understand tolerance and side effects with extended use 1
Formulations
Bisacodyl is available as:
- Oral tablets (enteric-coated)
- Suppositories
For suppositories:
- Insert one suppository rectally and retain for 15-20 minutes
- If suppository seems soft, refrigerate briefly before use 4