Stimulant laxatives (patient information)

Why is this medication prescribed
Stimulant laxatives are used to treat constipation or before rectal or bowel examinations or surgery. They work by increasing the movement in your bowel. They also are used to treat certain conditions of the intestinal tract.

This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.

How should this medicine be used
Stimulant laxatives come in many different forms, including liquids, powders, granules, tablets, and suppositories. Follow the directions on your package or prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take stimulant laxatives exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Take stimulant laxatives on an empty stomach with a full 8-ounce glass of water. Results occur more slowly if the medicine is taken with food. Most stimulant laxatives are taken at bedtime, with results by morning; however, some products may take up to 24 hours to produce a bowel movement.

Castor oil acts more quickly than the other laxatives, so do not take castor oil at bedtime. To avoid the bad taste of castor oil, chill it in the refrigerator and mix it with cold orange juice just before drinking. Castor oil should not be used routinely to treat constipation.

Do not crush or chew bisacodyl tablets. Do not take them within 1 hour of drinking milk or taking antacids.

If you are to insert a suppository, follow these steps:


 * Remove the wrapper.
 * Dip the tip of the suppository in lukewarm water.
 * Lie down on your left side and raise your right knee to your chest. (A left-handed person should lie on the right side and raise the left knee.)
 * Using your finger, insert the suppository high into your rectum. Hold it in place for a few moments. Try to keep it there for as long as possible.
 * Wash your hands thoroughly.

Do not use stimulant laxatives for longer than 1 week, unless your doctor tells you to. Do not take more than the recommended dose; overuse of stimulant laxatives may cause serious side effects. Call your doctor if you do not have a bowel movement after taking a stimulant laxative.

Use of stimulant laxatives over a long period may lead to dependence. Overuse results in permanent damage to your intestine and colon. If your symptoms do not improve while using a stimulant laxative, call your doctor. Do not give a stimulant laxative to a child less than 10 years old, unless your doctor tells you to.

What special precautions should I follow
Before taking stimulant laxatives:


 * tell your doctor and pharmacist if you are allergic to any other drugs.
 * tell your doctor and pharmacist what prescription and nonprescription medications you are taking, especially antacids; antibiotics; pain or seizure medicines; medicines for depression, heart disease, or blood pressure; and vitamins.
 * tell your doctor if you have or have ever had diabetes, heart disease, high blood pressure, or intestinal disease.
 * tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking stimulant laxatives, call your doctor.

What special dietary instructions should I follow
A regular diet and exercise program is important for regular bowel function. Eat a high-fiber diet and drink plenty of liquids (six to eight glasses) each day. Avoid food that causes constipation, such as processed cheese. If you are on a low-sugar, low-calorie, or low-sodium diet, check with your doctor or pharmacist before taking a stimulant laxative.

What should I do if I forget a dose
If you are taking scheduled doses of stimulant laxatives, take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for the missed one.

Mild side effects
Stimulant laxatives may cause side effects. Cascara and senna commonly cause yellow-brown urine; this is harmless. Tell your doctor if any of these symptoms are severe or do not go away:


 * diarrhea
 * upset stomach
 * vomiting
 * irritation
 * stomach cramping

Severe side effects
If you have any of the following symptoms, stop taking stimulant laxatives and call your doctor immediately:


 * bloody stools
 * severe cramping
 * pain
 * weakness
 * dizziness
 * unusual tiredness
 * rectal bleeding

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at http://www.fda.gov/MedWatch/report.htm] or by phone [1-800-332-1088].

What storage conditions are needed for this medicine
Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

What other information should I know
Ask your pharmacist any questions you have about taking this medicine.

Brand names

 * Bisacodyl®
 * Cascara Sagrada®
 * Castor Oil®
 * Dulcolax®
 * Ex-Lax Gentle Nature®
 * Fleet Laxative®
 * Gentlax®
 * Senna®
 * Senokot®