LAXATIVES (Rectal)

Some commonly used brand names are:

In the U.S.?

• Bisco-Lax ¹
• Ceo-Two ⁵
• Dacodyl ¹
• Deficol ¹
• Dulcolax ¹
• Fleet Babylax ³
• Fleet Bisacodyl ¹
• Fleet Enema ⁷
• Fleet Enema for Children ⁷
• Fleet Enema Mineral Oil ⁴
• Fleet Glycerin Laxative ³
• Fleet Laxative ¹
• Sani-Supp ³
• Senokot ⁶
• Theralax ¹
• Therevac Plus ²
• Therevac-SB ²

In Canada?

• Apo-Bisacodyl ¹
• Bisacolax ¹
• Dulcolax ¹
• Enemol ⁷
• Fleet Enema ⁷
• Fleet Enema Mineral Oil ⁴
• Fleet Pediatric Enema ⁷
• Gent-L-Tip ⁷
• Laxit ¹
• PMS-Bisacodyl ¹
• Senokot ⁶

Category

• Laxative, carbon dioxide-releasing?Potassium Bitartrate and Sodium Bicarbonate
• Laxative, hyperosmotic?Glycerin
• Laxative, hyperosmotic, saline?Sodium Phosphates
• Laxative, lubricant?Mineral Oil
• Laxative, stimulant(contact)?Bisacodyl; Senna
• Laxative, stool softener (emollient)?Docusate

Description

Rectal laxatives are usedas enemas or suppositories to produce bowel movements in a short time.

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

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Carbon dioxide-releasing?Carbon dioxide-releasing laxatives (e.g., potassium bitartrate and sodiumbicarbonate) are suppositories that encourage bowel movements by forming carbondioxide, a gas. This gas pushes against the intestinal wall, causing contractionsthat move along the stool mass.

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Hyperosmotic?Hyperosmotic laxatives (e.g., glycerin; sodium phosphates) draw water intothe bowel from surrounding body tissues. This provides a soft stool mass andincreased bowel action.

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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 ismade easier.

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Stimulants?Stimulant laxatives (e.g., bisacodyl; senna), also known as contact laxatives,act on the intestinal wall. They increase the muscle contractions that movealong the stool mass.

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Stool softeners (emollients)?Stool softeners (emollient laxatives?e.g., docusate) encourage bowelmovements by helping liquids mix into the stool and prevent dry, hard stoolmasses. This type of laxative has been said not to cause a bowel movement but instead allows thepatient to have a bowel movement without straining.

?Rectal laxatives may provide relief in a number of situationssuch as:

• before giving birth.
• for a few days after giving birth.
• preparation for examination or surgery.
• to aid in developing normal bowel function following a period ofpoor eating habits or a lack of physical exercise (glycerin suppositoriesonly).
• following surgery when straining should be avoided.
• constipation caused by other medicines.

Some of these laxatives are available only with your doctor's prescription.Others are available without a prescription; however, your doctor may havespecial instructions for the proper use and dose for your medical condition.They are available in the following dosage forms:

Rectal
• Bisacodyl
  • Rectal solution (U.S. and Canada)
  • Suppositories (U.S. and Canada)
• Docusate
  • Rectal solution (U.S.)
• Glycerin
  • Rectal solution (U.S.)
  • Suppositories (U.S. and Canada)
• Mineral Oil
  • Enema (U.S. and Canada)
• Potassium Bitartrate and Sodium Bicarbonate
  • Suppositories (U.S.)
• Senna
  • Suppositories (U.S. and Canada)
• Sodium Phosphates
  • Enema (U.S. and Canada)

Before Using This Medicine

Importance of diet, fluids, and exercise to prevent constipation?Laxatives are to be used to provide short-term relief only, unless otherwisedirected by your doctor. A proper diet containing roughage (whole grain breadsand cereals, bran, fruit, and green, leafy vegetables), with 6 to 8 full glasses(8 ounces each) of liquids each day, and daily exercise are most importantin maintaining healthy bowel function. Also, for individuals who have problemswith constipation, foods such as pastries, puddings, sugar, candy, cake, andcheese may make the constipation worse.

If you are using this medicine without a prescription, carefully read andfollow any precautions on the label. For rectal laxatives, the following shouldbe considered:

Allergies?Tell your doctor if you have ever had any unusual orallergic reaction to rectal laxatives. Also tell your health care professionalif you are allergic to any other substances, such as preservatives or dyes.

Children?Laxatives should not be givento young children (up to 6 years of age) unless prescribed by their doctor. Since children cannot usually describe their symptoms very well,they should be checked by a doctor before being given a laxative. The childmay have a condition that needs other treatment. If so, laxatives will nothelp and may even cause unwanted effects or make the condition worse.

Also, weakness, increased sweating, and convulsions (seizures) may be especiallylikely to occur in children receiving enemas or rectal solutions, since theymay be more sensitive than adults to their effects.

Older adults?Weakness, increased sweating, and convulsions (seizures)may be especially likely to occur in elderly patients, since they may be moresensitive than younger adults to the effects of rectal laxatives.

Other medical problems?The presence of other medical problems may affectthe use of rectal laxatives. Make sure you tell your doctor if you have anyother medical problems, especially:

• Appendicitis (or signs of) or
• Rectal bleeding of unknown cause?These conditions need immediateattention by a doctor

• Intestinal blockage?The use of laxatives may create other problemsif this condition is present

Proper Use of This Medicine

For safeand effective use of laxatives:

• Follow your doctor's orders if this laxative was prescribed.
• Follow the manufacturer's package directions if you are treatingyourself.

For patients using the enema or rectal solution form of this medicine:

• This medicine usually comes with patient directions. Read them carefullybefore using this medicine.
• Lubricate anus with petroleum jelly before inserting the enema applicator.
• Gently insert the rectal tip of the enema applicator to prevent damageto the rectal wall.
• Results often may be obtained with:
  • bisacodyl enema in 15 minutes to 1 hour.
  • docusate enema in 2 to 15 minutes.
  • glycerin enema in 15 minutes to 1 hour.
  • mineral oil enema in 2 to 15 minutes.
  • senna enema in 30 minutes, but may not occur for some individualsfor up to 2 hours.
  • sodium phosphates enema in 2 to 5 minutes.

For patients using the suppository form ofthis medicine:

• If the suppository is too soft to insert, chill the suppository inthe refrigerator for 30 minutes or run cold water over it, before removingthe foil wrapper.
• To insert suppository: First remove the foil wrapper and moistenthe suppository with cold water. Lie down on your side and use your fingerto push the suppository well up into the rectum.
• Results often may be obtained with:
  • bisacodyl suppositories in 15 minutes to 1 hour.
  • carbon dioxide-releasing suppositories in 5 to 30 minutes.
  • glycerin suppositories in 15 minutes to 1 hour.
  • senna suppositories in 30 minutes, but may not occur for some individualsfor up to 2 hours.

Dosing?There are a large number of laxative productson the market. The dose of laxatives will be different for different products.The amount of enema or the number of suppositories that you use depends onthe strength of the medicine. Follow your doctor's ordersif this medicine was prescribed, or follow the directions on the box if youare buying this medicine without a prescription.

Storage?To store this medicine:

• Keep out of the reach of children.
• Store away from heat and direct light.
• Do not store in the bathroom, near the kitchen sink, or in otherdamp places. Heat or moisture may cause the medicine to break down.
• Do not keep outdated medicine or medicine no longer needed. Be surethat any discarded medicine is out of the reach of children.

Precautions While Using This Medicine

Do not use any type of laxative:

• if you have signs of appendicitis or inflamedbowel (such as stomach or lower abdominal pain, cramping, bloating,soreness, nausea, or vomiting). Instead, check with your doctor as soon aspossible.
• more often than your doctor prescribed. Thisis true even when you have had no results from the laxative.
• if you do not need it, as for the commoncold, ``to clean out your system,'' or as a ``tonic to make you feel better.''
• if you miss a bowel movement for a day or two.

If you notice a sudden change in bowel habits or functionthat lasts longer than 2 weeks, or keeps returning off and on, checkwith your doctor before using a laxative. This will allow the cause of yourproblem to be determined before it becomes more serious.

The ``laxative habit''?Laxative products are overused by many people.Such a practice often leads to dependence on the laxative action to producea bowel movement. In severe cases, overuse of some laxatives has caused damageto the nerves, muscles, and tissues of the intestines and bowel. If you haveany questions about the use of laxatives, check with your health care professional.

For patients using the enema or rectal solution form of this medicine:

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

For patients using the suppository form ofthis medicine:

• Do not lubricate the suppository with mineral oil or petroleum jellybefore inserting into the rectum. To do so may affect the way the suppositoryworks. Moisten only with water.

Side Effects of This Medicine

Along with its needed effects, a medicine may cause some unwanted effects.Although not all of these side effects may occur, if they do occur they mayneed medical attention.

Check with your doctor as soon as possible if any of the following sideeffects occur:

Less common

Rectal bleeding, blistering, burning, itching, or pain (withenemas only)

Other side effects may occur that usually do not need medicalattention. These side effects may go away during treatment as your body adjuststo the medicine. However, check with your doctor if the following side effectcontinues or is bothersome:

Less common

Skin irritation surrounding rectal area

Other side effects not listed above may also occur insome patients. If you notice any other effects, check with your doctor.