1 What is Biscolax?

Brand: Biscolax, Colace, Dulcolax, Dulcolax Bowel Cleansing Kit, Enemeez Mini Enema, Enemeez Plus Mini Enema, Fleet Babylax, Fleet Bisacodyl, Fleet Glycerin, Fleet Mineral Oil, Sani-Supp, The Magic Bullet

Generic: Laxative

Biscolax is used as enemas or suppositories to promote defecation largely by reducing the viscosity of the contents of the lower colon.

These medicines also produce bowel movements in a short time which encourage evacuation of bowels. However, rectally administered laxatives may provide relief in a number of situations such as:

  • Before delivery
  • For a few days after delivery
  • Bowel preparation for examination (e.g., endoscopy, colonoscopy) or surgery
  • Following surgery when straining should be avoided
  • Constipation caused by other medicines (e.g., opioid analgesics, antimuscarinic agents, tricyclic antidepressants, calcium channel blockers)
  • To aid in developing normal bowel function following a period of poor eating habits or a lack of physical exercise (glycerin suppositories only)

There are several types of rectal laxatives and they work in different ways. Since directions for use are different for each type, it is important to know which one you are taking. The different types of rectal laxatives include:

Carbon dioxide-releasing: Carbon dioxide-releasing laxatives (e.g., potassium bitartrate and sodium bicarbonate) are suppositories that facilitate bowel movements by forming carbon dioxide gas. This gas pushes against the intestinal wall, causing contractions that move along the stool mass.

Hyperosmotic: Hyperosmotic laxatives (e.g., glycerin; sodium phosphates) are not absorbed in the intestine, retain water osmotically and distend the bowel. This provides a soft stool mass and increased peristalsis indirectly.

Lubricant: Mineral oil coats the bowel and the stool mass with a waterproof film. This keeps moisture in the stool. The stool remains soft and its passage is made easier.

Stimulants: Stimulant laxatives (e.g., bisacodyl; senna), also known as contact laxatives,act by increasing motility and secretion. They are powerful; often produce griping. Large doses can cause excess purgation resulting in fluid and electrolyte imbalance.

Stool softeners (emollients): Stool softeners (emollient laxatives—e.g., docusate) act by lowering the surface tension of fluids in the bowel which allows more water to remain in the stool. Thus, they encourage bowel movements by helping liquids mix into the stool and prevent dry, hard stool masses.

Some of these laxatives are available only with your doctor's prescription. Others are available as over-the-counter medicines; however, your doctor may have special instructions for the proper use and dose for your medical condition.

These products are available in the following dosage forms:

  • Enema
  • Suppository

2 What to Know Before Using

Before using Biscolax, you must know all about the risks and complications associated with it. The suitable drug therapy is usually chosen by a doctor with the active participation of the patient.

There are some important factors such as drug interactions, the presence of any metabolic impairment, history of hypersensitivity reaction, pregnancy, lactation etc. which may alter the desired therapeutic effects of a medicine.

Sometimes the presence of other health disorders affects the beneficial effects of this medicine and even may cause serious toxic effects. If you have had any allergic reactions to any medicine then you must tell your doctor about that.

All laxatives are contraindicated in a patient with undiagnosed abdominal pain, colic, or vomiting and in those with known hypersensitivity and organic constipation due to stricture or obstruction in the bowel, hypothyroidism, malignancies, and certain drugs (e.g., opiates).

ake sure you inform your doctor if you have any other medical problems, especially:

  • Appendicitis—laxatives may rupture inflamed appendix.
  • Rectal bleeding of unknown cause—these conditions need immediate attention by a doctor.
  • Intestinal blockage—laxatives may create other problems if this condition is present.

Because of drug-drug interactions, certain medicines should not be used along with this medicine. It is always recommended to consult with your doctor if you are in need of some other medications or even any over-the-counter medicine for another health problem in order to avoid unwanted toxic effects.

3 Proper Usage

To use Biscolax properly, you must follow all instructions given by your doctor. The dosage schedule and the duration of drug therapy should be individualized and determined based on the physician’s advice.

The therapeutic dose may also vary with the patient’s condition or requirement and the strength of the medicine as well; however, different preparations and doses are listed below:

  • Bisacodyl (i.e. stimulant laxative) – should be taken 10 mg suppository rectally once daily
  • Docusate (i.e. stool softener) – the recommended dose is 50-100 mg of docusate liquid to enema fluid (saline or water); give as retention or flushing enema.
  • Glycerin (i.e. hyperosmotic laxative) – in the case of children >6 years and adults, 1 suppository is recommended 1 to 2 times/day as needed.
  • Mineral Oil – 118 ml rectally once daily as an enema.
  • Sorbitol (hyperosmotic laxative) – in the case of children >12 years and adults, 120 ml as 25% to 30% solution can be used as a rectal enema. The dose for children of 2-11 years is 30-60 mL as 25% to 30% solution (to be used as a rectal enema).

These medicines come with patient information. You should read and follow the instructions carefully before using this medicine. For safe and effective use of laxatives, you should follow your doctor's orders if this laxative was prescribed. In addition, general instructions are given below:

To use the rectal suppository:

  • Remove the wrapper from the suppository. Avoid handling the suppository too long or it will melt in your hands. If the suppository is soft, you may hold it under cool running water or refrigerate it for a few minutes.
  • Lie on your left side with your right knee up toward your chest. Gently insert the suppository into your rectum about 1 inch, pointed tip first.
  • Stay lying down for a few minutes. The suppository will melt quickly and you should feel little or no discomfort while holding it in.
  • Do not use more than one rectal suppository per day.

To use the rectal enema:

  • Shake the rectal enema before using it. Remove the cap from the enema tip.
  • Lie on your left side with your right knee up toward your chest, leaning forward slightly. Gently insert the tip of the enema bottle into your rectum, aiming toward your navel.
  • Gently squeeze the bottle until it is empty, and then remove it from your rectum.
  • For best results, hold the enema liquid in your rectum for up to 10 minutes. Then empty your rectum while seated on a toilet.

If you miss a dose of this medicine, take it as soon as possible. But, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not use this drug in larger amounts, more often, or for a longer time than your doctor ordered.

Further, it is advised to store the medicine in a closed container at room temperature away from heat, moisture, and direct light. All kinds of medicines should be kept out of the reach of children. However, outdated medicines should be disposed of by an appropriate way.

4 Precautions to Take

Before using Biscolax, there are some precautions you must take. Firstly, regular visits to your doctor are recommended to check that this medicine is working properly or not.

Additionally, the following guidelines should be followed to prevent unwanted complications as well as for the better prognosis of the patients:

If you have signs of appendicitis or inflamed bowel (such as stomach or lower abdominal pain, cramping, bloating, soreness, nausea, or vomiting), you should not use any type of laxatives without checking with your doctor.

If you miss a bowel movement for a day or two, or you notice a sudden change in bowel habits or function that lasts longer than 2 weeks, check with your doctor before using a laxative.

If you are using the suppository form of this medicine, you need not lubricate the suppository with mineral oil or petroleum jelly before inserting into the rectum. To do so may affect the way the suppository works.

Check with your doctor if you notice rectal bleeding, blistering, pain, burning, itching, or other sign of irritation not present before you started using this medicine.

Some individuals are obsessed with using laxatives regularly. Such a practice often leads to dependence on the laxative action to produce a bowel movement.

In severe cases, overuse of some laxatives has caused damage to the nerves, muscles, and tissues of the intestines and bowel. If you have any questions about the use of laxatives, check with your healthcare professional.

5 Potential Side Effects

As with many medications, there are several potential side effects associated with Biscolax. These side effects usually go away during the treatment episode as your body adjusts to the medicine.

Your healthcare professional may advise you about the ways how to prevent or reduce those unwanted side effects.

Sometimes you may need to consult with the doctor if you notice any of the following toxic effects:

  • Stomach cramps or pain
  • Skin irritation surrounding rectal area
  • Rectal burning, itching, or pain
  • Rectal bleeding
  • Nausea
  • Lightheadedness
  • Colonic atony and mucosal pigmentation – may occur in long-term use.

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.