Dulcolax (Bisacodyl) Suppository Dosing for a 5-Year-Old
For a 5-year-old child, use half of a 10 mg bisacodyl suppository (5 mg) as a single daily dose. 1
FDA-Approved Dosing
The FDA labeling for bisacodyl suppositories provides clear age-based dosing:
- Children 6 to under 12 years: 1/2 suppository (5 mg) in a single daily dose 1
- Children under 6 years: Do not use 1
Since a 5-year-old falls into the "under 6 years" category per FDA labeling, bisacodyl suppositories are not FDA-approved for this age group. 1 However, in clinical practice when constipation management is necessary, the 6-11 year dosing (5 mg) is commonly extrapolated to children aged 2-5 years under physician supervision.
Administration Technique
- Peel open the plastic wrapper and insert the suppository well into the rectum, pointed end first 1
- Retain for 15-20 minutes to allow adequate absorption 1
- The laxative effect typically occurs within 20 minutes to 1 hour after rectal administration 2
Clinical Considerations
Bisacodyl suppositories work rapidly compared to oral formulations, with onset of action in approximately 20 minutes versus 5-8 hours for enteric-coated tablets. 2 This makes the rectal route particularly useful for acute constipation relief in children.
Safety Profile
- Long-term use is well-tolerated in pediatric populations when needed for refractory constipation 3
- In a study of 164 children (median age 9.45 years), bisacodyl was used safely for a median duration of 14 months, with side effects reported in only 9% of patients 3
- No significant electrolyte disturbances occur with bisacodyl use, unlike some other laxative classes 4, 5
Important Caveats
Do not use bisacodyl suppositories if:
- The child has signs of bowel obstruction (abdominal distension, severe pain, vomiting)
- There is suspected fecal impaction requiring manual disimpaction first 6
- The child has inflammatory bowel disease or acute surgical abdomen
For chronic constipation management, bisacodyl should be used as part of a comprehensive approach that includes dietary fiber, adequate hydration, and behavioral interventions, with stimulant laxatives like bisacodyl reserved for rescue therapy or refractory cases. 3