Dulcolax
Dulcolax: instructions for use and reviews
- 1. Release form and composition
- 2. Pharmacodynamics and pharmacokinetics
- 3. Indications for use
- 4. Contraindications
- 5. Method of application and dosage
- 6. Side effects
- 7. Overdose
- 8. Special instructions
- 9. Drug interactions
- 10. Analogs
- 11. Terms and conditions of storage
- 12. Terms of dispensing from pharmacies
- 13. Reviews
- 14. Price in pharmacies
Latin name: Dulcolax
ATX code: A06AB02
Active ingredient: Bisacodyl (Bisacodyl)
Producer: Boehringer Ingelheim International GmbH (Germany)
Description and photo update: 2019-05-08
Prices in pharmacies: from 177 rubles.
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Dulcolax is a laxative that stimulates intestinal peristalsis.
Release form and composition
Dosage forms:
- Enteric-coated tablets: yellow-beige, biconvex round, with a shiny, smooth surface, white core (10 pcs. In blisters, 3 blisters in a cardboard box);
- Rectal suppositories: torpedo-shaped with a depression at the base, slightly yellow or white, with an oily or smooth surface (6 pcs. In aluminum foil strips, 1 strip in a cardboard box).
The active substance is bisacodyl:
- 1 tablet - 5 mg;
- 1 suppository - 10 mg.
Auxiliary components:
- Tablets: corn starch, lactose, glycerol 85%, magnesium stearate, soluble corn starch;
- Suppositories: Witepsol W45.
Additionally, as part of the enteric coating of tablets: sucrose, acacia gum, copolymer of methacrylic acid and methyl methacrylate (1: 2) (Eudragit S100), titanium dioxide, copolymer of methacrylic acid and methyl methacrylate (1: 1) (Eudragit L100), castor oil (seed oil castor bean), magnesium stearate, macrogol 6000, carnauba wax, white beeswax, shellac, iron dye yellow oxide (E172), talc.
Pharmacodynamics and pharmacokinetics
Dulcolax is a prodrug. Its active ingredient bisacodyl is a topical laxative belonging to the group of diphenylmethane derivatives. This compound has an antiresorptive effect and is hydrolyzed in the large intestine, which leads to an increase in the secretion of electrolytes and water and an acceleration and intensification of peristalsis. This stimulates the act of defecation, promotes softening of the stool and reduces the elimination time of bisacodyl. The laxative effect lasts for 6-12 hours.
The laxative effect of bisacodyl is manifested only at the level of the large intestine, stimulating the natural process of evacuation of feces in the lower gastrointestinal tract. Therefore, there is no effect of this substance on the absorption or digestion of essential nutrients or high-calorie foods in the small intestine.
The absorption of the drug is negligible: it is almost completely metabolized in the walls of the intestine and liver, forming an inactive glucuronide.
Bisacodyl passes into the form of metabolites under the action of enzymes of the mucous membrane of the large intestine. Its half-life is approximately 16.5 hours. Enteric-coated tablets do not change their composition upon contact with gastrointestinal juice. Bisacodyl is released in the large intestine, converting to an active metabolite of bis- (p-hydroxyphenyl) -pyridyl-2-methane. It has an irritating effect on the lining of the colon.
The maximum level of the active metabolite in plasma after taking Dulcolax is recorded after 4-10 hours, and the laxative effect appears after 6-12 hours. In this case, the laxative effect of bisacodyl does not depend on the content of the active metabolite in plasma.
The active metabolite is excreted mainly in the feces (up to 51.8%), only about 10.5% of the substance is excreted in the urine.
Indications for use
- Constipation with hypotension of the large intestine (including in the chronic form);
- Bowel cleansing in preparation for surgery, X-ray and instrumental examinations.
In addition, the use of tablets is shown:
- Postoperative therapy;
- Facilitation of defecation in various clinical conditions.
Contraindications
- Intestinal obstruction;
- Obstructive bowel pathology;
- Appendicitis and other acute diseases of the abdominal organs;
- Acute forms of inflammatory bowel disease;
- Severe abdominal pain of unknown etiology, accompanied by nausea and vomiting;
- Severe dehydration;
- Hypersensitivity to drug components.
Age contraindications:
- Tablets: up to 4 years old;
- Suppositories: up to 10 years.
Only after consulting a doctor, it is necessary to use a laxative with caution during pregnancy (especially in the first trimester) and breastfeeding.
In addition, tablets should not be used in patients with hereditary intolerance to galactose, fructose, glucose-galactose malabsorption syndrome.
With caution, tablets should be prescribed for renal and / or hepatic insufficiency.
Instructions for use of Dulcolax: method and dosage
Enteric-coated
tablets Dulcolax tablets are administered orally with a small amount of water.
For the onset of a laxative effect in the morning, the drug is recommended to be taken the night before (before bedtime).
Do not take pills with milk, antacids, proton pump inhibitors and other products that lower acidity in the upper gastrointestinal tract (GIT) and contribute to the premature dissolution of the enteric membrane.
Recommended dosage for constipation:
- Patients over 10 years of age: the initial dose is 1 tablet; to achieve independent regular stool, the dose should be gradually increased, but not more than up to 2 tablets per day;
- Children aged 4 to 10 years: no more than 1 tablet per day.
On the eve of a planned operation or in preparation for a study, the patient is prescribed 2 tablets at night a day before the study and on the eve of the operation or study. It is allowed to use tablets in combination with suppositories (for adult patients, it is recommended to introduce 1 suppository in the morning in addition to the tablets taken in the evening).
Rectal
suppositories The suppository is inserted into the anus with the pointed end forward.
Defecation occurs in about 30 minutes.
The usual dosage regimen for adults and children over 10 years of age is 1 suppository per day.
In preparation for surgery or research and for medical conditions that require easier bowel movements, treatment should be carried out under medical supervision.
Side effects
- Digestive system: cramping pains (when taking tablets - often), diarrhea;
- Nervous system: against the background of intestinal spasm and tension during bowel movements - dizziness, fainting;
- Immune system: possibly - hypersensitivity reactions, angioedema, anaphylactic reactions.
In addition, the drug can cause the following undesirable effects:
- Tablets: abdominal discomfort, nausea, vomiting, dehydration, cramps, muscle weakness, lowering blood pressure (BP), anorectal discomfort, appearance of feces with a small amount of blood, colitis;
- Suppositories: pain and local irritation (more often in patients with ulcerative proctitis or anal fissure).
Overdose
Acute overdose of the drug when taken orally leads to the development of symptoms such as:
- convulsions;
- dehydration;
- diarrhea;
- electrolyte imbalance;
- hypokalemia;
- a significant decrease in blood pressure.
Signs of chronic drug overdose are hyperaldosteronism, chronic diarrhea, abdominal pain, urolithiasis, hypokalemia. In some cases, muscle weakness, renal tubular disorders, metabolic alkalosis are observed.
In all cases, symptomatic treatment is prescribed. In case of acute poisoning with tablets, it is necessary to induce vomiting and wash the stomach. It is also recommended to drink plenty of fluids and adjust the electrolyte balance, sometimes it is advisable to take antispasmodics.
special instructions
Regular or long-term use of Dulcolax is not recommended. If you need laxatives on a daily basis, you should identify the reason for the lack of regular self-defecation.
Prolonged use of high doses can lead to excessive fluid loss, electrolyte imbalance, and hypokalemia. If symptoms of dehydration (thirst, oliguria) appear while taking pills, especially in elderly patients or with concomitant renal failure, therapy should be canceled.
The appearance of a small amount of blood in the feces is usually mild and goes away on its own.
The carbohydrate content in 1 tablet (5 mg) corresponds to 0.006 bread units (XE).
The use of Dulcolax in children is indicated only after consulting a doctor.
In case of intestinal spasm, the patient is advised to refrain from driving vehicles and mechanisms, since dizziness and / or fainting may occur due to a vasovagal reaction.
Drug interactions
According to the instructions, Dulcolax in high doses when combined with glucocorticosteroids or diuretics increases the risk of hypokalemia.
The action of cardiac glycosides increases electrolyte imbalance.
Analogs
Dulcolax's analogs are: Agiolax, Bisacodyl, Bisacodyl-Acri, Bisacodyl-Hemofarm, Bisacodyl-OBL, Bisacodyl-Nizhpharm, Bisacodyl-Altpharm, Glaxenna, Antrasennin, Guttalax, Laxigalax, Sylabadelco, Regulpalica.
Terms and conditions of storage
Keep out of the reach of children, in a dry place at temperatures up to 25 ° C.
Shelf life: tablets - 3 years, suppositories - 5 years.
Terms of dispensing from pharmacies
Available without a prescription.
Reviews about Dulcolax
Reviews of Dulcolax range from very positive to extremely negative. Some patients are completely satisfied with its laxative effect, while others report more frequent abdominal pain, cramps, colic and other side effects. This may be due to improper use of the drug or individual hypersensitivity to bisacodyl in some patients.
According to many doctors, the treatment of constipation with Dulcolax is mostly successful, and they are completely satisfied with the result of the therapy.
Dulcolax price in pharmacies
The price of Dulcolax in the form of tablets is approximately 230-260 rubles (30 pcs per pack). You can buy a package of rectal suppositories containing 6 suppositories in pharmacies for 210–240 rubles.
Dulcolax: prices in online pharmacies
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Drug name Price Pharmacy |
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Dulcolax 10 mg rectal suppositories 6 pcs. 177 r Buy |
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Dulcolax 5 mg enteric-coated tablets 30 pcs. 178 r Buy |
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Dulcolax tablets p.p. enteric solution. 5mg 30 pcs. 212 r Buy |
Maria Kulkes Medical journalist About the author
Education: First Moscow State Medical University named after I. M. Sechenov, specialty "General Medicine".
Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!
