Laxatives promote bowel emptying. Nonprescription laxatives are frequently misued due to lack of understanding of normal bowel function. Restrict self medication to short-term therapy of constipation. Chronic use of laxatives (particularly stimulants) may lead to dependence. Prior to laxative use, consider living habits affecting bowel function including disease state and drug history. Rational therapy and prevention of constipation include: Adequate fluid intake (4 to 6 glasses of water daily), proper dietary habits including sufficient bulk or roughage, responding to the urge to defecate and daily exercise.
How The Drug Works
Stimulant laxatives act directly on the intestines, irritating the digestive tract lining and stimulating intestinal activity.
Uses
For short-term treatment of constipation.
To clean out the bowel before bowel examinations or bowel surgery.
Frequent use of laxatives and inadequate fluid can cause an imbalance in fluid and electrolyte levels. Symptoms may include muscle cramps, muscle weakness or dizziness.
Rectal bleeding o failure of the laxative to produce a bowel movement can indicate a more serious condition which requires medical attention.
Discoloration of the urine (yellow-brown, pink-red, red-violet or red-brown) may occur with phenolphthalein, cascara sagrada or senna.
Tartrazine: Some of these products may contain the dye tartrazine (FD&C Yellow No.5) which can cause allergic reactions in certain individuals. Check package label when available or consult your doctor or pharmalist.
Pregnancy: Adequate studies have not been done in pregnant women, or animal studies may have shown a risk to the fetus. Use only if clearly needed and potential benefits outweigh the possible hazards to the fetus. Improper use of these products can cause a dangerous electrolyte imbalance. Use of a bulk or stool-softening laxative is preferred.
Castor oil – Do not use during pregnancy. It can produce premature labor.
Breastfeeding: Cascara sagrada appears in breast milk. Use can result in diarrhea in the infant. Consult your doctor before you begin breast feeding.
Children: Do not use bisacodyl tannex in children under 10 years of age.
Drug Interactions
Tell your doctor or pharmacist if you are taking or if you are planning to take any over-the-counter or prescription medications or dietary supplements while taking these products. Doses of one or both drugs may need to be modified or a different drug may need to be prescribed. Antacids and milk interact with bisacodyl.
Side Effects
Every drug is capable of producing side effects. Many patients experience no, or minor, side effects. The frequency and severity of side effects depends on many factors including dose, duration of therapy and individual susceptibility. Possible side effects include:
Digestive Tract: Nausea; vomiting; stomach pain; bowel cramping; diarrhea; bloating; gas.
Nervous System: Weakness; dizziness; fainting.
Other: Irritation of the rectal area; sweating; pounding of the chest (palpitations).
Guidelines for Use
- Use exactly as prescribed.
- Laxative use is only a temporary measure. Do not use longer than one week. Stop use of these products when normal bowel habits return. Prolonged, frequent or excessive use may result in dependence or electrolyte imbalance.
- Take with a full glass of water or juice.
- Bisacodyl- Swallow tablets whole (do not crush). Do not take within 1 hours of antacids or milk.
- Suspensions and emulsions – Shake well before use.
- Do not use if abdominal pain, nausea or vomiting occurs.
- Contact your doctor if unrelieved constipation, rectal bleeding, muscle cramps or pain, weakness or dizziness occurs.
- Phenolphthalein may cause a skin reaction. Stop using if this occurs.
- Biscodyl suppositories may cause proctitis and inflammation. Do not take these for long-term use.
- Pink-red, red-violet, yellow-brown or red-brown discoloration of the urine may occur, particularly with phenophthalein, senna or cascara sagrada.
- Some of these products may contain the dye tartrazine (FD&C Yellow No.5) which can cause allergic reactions in certain individuals. Check package label when available or consult your doctor or pharmacist.
- Prevention of constipation includes: Adequate fluid intake (4 to 6 glasses of water daily), proper dietary habits including sufficient bulk or rough age, responding to the urge to defecate and daily exercise.
- Effects usually occur in 6 to 10 hours with most of these products, except castor oil (2 to 4 hours) and bisacodyl suppositories (15 to 60 minutes). Plan accordingly.
- Store at room temperature.