Bisacodyl Side Effects
The most common side effects of bisacodyl are diarrhea (occurring in 53.4% of patients at 10 mg dose) and abdominal pain/cramping (occurring in 24.7% of patients), with most adverse events occurring in the first week of treatment. 1
Common Side Effects
Gastrointestinal Effects
- Diarrhea is the most frequent adverse effect, occurring in 53.4% of patients taking 10 mg bisacodyl compared to only 1.7% with placebo 1
- Abdominal pain and cramping occur in 24.7% of patients at 10 mg dose versus 2.5% with placebo 1
- These side effects are dose-dependent and most commonly occur during the first week of treatment 1
Timing of Side Effects
- Most adverse events are concentrated in the initial treatment period (first week) 1
- Side effects may be limiting factors, particularly cramping and abdominal discomfort 1
Serious Adverse Effects with Prolonged Use
Long-Term Complications
- Prolonged or excessive use can cause electrolyte imbalances 1
- Chronic use may lead to persistent diarrhea 1
- Bisacodyl can cause acute injury to the rectal mucosa, with histological evidence of mild inflammation persisting up to 30 hours after administration 2
Contraindications and Absolute Avoidance
Bisacodyl is contraindicated in the following conditions: 1
- Ileus
- Intestinal obstruction
- Severe dehydration
- Acute inflammatory conditions in the bowel
Clinical Implications
Recommended Usage Pattern
- Bisacodyl should be used for short-term or rescue therapy only, not for long-term continuous treatment 1
- The long-term safety and efficacy beyond 4 weeks remain unknown 1
- Starting with 5 mg daily rather than 10 mg significantly reduces side effect burden 1, 3
Pediatric Considerations
- In pediatric populations, side effects are reported in approximately 9% of patients during long-term use 4
- Bisacodyl is generally well-tolerated in children when used appropriately 4