Guttalax express rectal suppositories 10mg, No. 6

• constipation due to hypotension of the colon (including chronic constipation, stool regulation in the postpartum period, in bedridden patients);

• preparation for instrumental and X-ray examinations;

• preoperative preparation, postoperative period.

The drug is used rectally. The suppository should be removed from the packaging and inserted into the rectum with the pointed end first.

For constipation, adults and children over 10 years of age are prescribed 1 supp. / Day. The time for the development of the laxative effect of the drug is 20 minutes (from 10 minutes to 30 minutes, in some cases - 45 minutes).

Do not use the drug daily without consulting a doctor and establishing the cause of constipation for more than 10 days.

In preparation for research, pre- and postoperative treatment, medical conditions that require relief of bowel movements, the drug should be used under medical supervision.

To achieve complete emptying, it is recommended to use in combination with tablets. The decision on the required number of bisacodyl tablets to be taken on the eve of the study / operation is made by the attending physician, based on the clinical condition of the patient and the volume of the forthcoming manipulation.

Rectal suppositories of white or slightly yellowish color, torpedo-shaped, with a smooth or slightly oily surface, with a depression in the base.

1 supp.

bisacodyl 10 mg

Excipients: Witepsol W45 - 1690 mg.

• hypersensitivity to the active substance or auxiliary components of the drug;

• intestinal obstruction;

• obstructive bowel disease;

• acute diseases of the abdominal organs, including appendicitis;

• acute inflammatory bowel disease;

• severe abdominal pain associated with nausea and vomiting, which may be a sign of a more severe condition;

• severe dehydration;

• children under 10 years of age.

With caution: hepatic and / or renal failure, old age.

pharmachologic effect

Bisacodyl is a topically acting laxative from the group of diphenylmethane derivatives with a slight antiresorptive effect. After hydrolysis in the large intestine, bisacodyl stimulates its peristalsis and increases the secretion of water and electrolytes in the large intestine. This leads to the stimulation of bowel movements, a decrease in evacuation time and a softening of the stool.

The action is due to direct stimulation of nerve endings in the mucous membrane of the large intestine.

Bisacodyl, as a laxative at the level of the colon, stimulates the natural evacuation process in the lower gastrointestinal tract. Therefore, bisacodyl has no effect on the digestion or absorption of high-calorie foods or essential nutrients in the small intestine.

Pharmacokinetics

Suction

Absorption is negligible. The time for the development of the laxative effect of the drug is 20 minutes (from 10 minutes to 30 minutes, in some cases - 45 minutes).

Cmax of the active metabolite in plasma after the administration of the suppository is achieved after 0.5-3 hours. There is no relationship between the laxative effect of bisacodyl and the concentration of the active metabolite in plasma.

Metabolism

The drug is almost completely metabolized in the intestinal wall and liver to inactive glucuronide. Metabolism of bisacodyl with the formation of an active metabolite, bis- (p-hydroxyphenyl) -pyridyl-2-methane, occurs under the action of enzymes (esterases) of the mucous membrane of the large intestine.

Withdrawal

T1 / 2 is about 16.5 hours. The active metabolite is excreted mainly through the intestine (up to 90% of the total excretion), up to 3.1% is excreted by the kidneys. A small amount of the unchanged drug is excreted through the intestines.

Side effect

The most common adverse reactions reported during the use of Guttalax Express are abdominal cramping and diarrhea.

From the digestive system: spastic pain or discomfort in the abdomen, diarrhea (dehydration, muscle weakness, cramps, decreased blood pressure), nausea, vomiting, blood in the stool, discomfort in the rectum, colitis, incl. ischemic colitis. The use of suppositories can be accompanied by pain and local irritation, especially with anal fissure or ulcerative proctitis.

From the nervous system: dizziness, fainting. These side effects that occur after using the drug are associated with a vasovagal reaction (i.e., due to intestinal spasm, tension during bowel movements).

Co side of the immune system: hypersensitivity, angioedema, anaphylactic reactions.

Application during pregnancy and lactation

There are no data on reliable and well-controlled studies in pregnant women. At the same time, long-term experience of use did not reveal a negative effect of the drug on pregnancy. During pregnancy, the drug can be used only after consulting a specialist in cases where the potential benefit to the mother outweighs the potential risk to the fetus.

Bisacodyl does not pass into breast milk. Therefore, the drug can be used during lactation.

Clinical studies of the effect of the drug on fertility have not been conducted.

Application for violations of liver function

With caution - with liver failure.

Application for impaired renal function

With caution - in case of renal failure.

Application in children

Contraindicated in children under 10 years of age.

Children should take the drug after consulting a doctor.

Use in elderly patients

The drug should be used with caution in elderly patients.

special instructions

You should not use GuttalaxЃ Express, like all laxatives, regularly or for a long period of time without establishing the cause of constipation. Long-term use can lead to fluid loss, electrolyte imbalance, hypokalemia. Loss of fluid during bowel movements can lead to dehydration, which can be accompanied by symptoms such as thirst and oliguria. Dehydration can harm the body (for example, in case of renal failure, in elderly patients), therefore, with the above symptoms, the drug should be discontinued and can only be resumed under medical supervision.

Patients may have blood in their stool. This phenomenon is usually mild and goes away on its own.

Dizziness and / or fainting were observed in patients taking GuttalaxЃ Express. The analysis showed that these cases are associated with fainting during bowel movements (or fainting caused by straining during bowel movements) or with a vasovagal reaction to abdominal pain, which may be due to constipation, and not associated with the use of the drug.

Stimulant laxatives, including Guttalax Express, do not reduce body weight.

Use in pediatrics

Children should take the drug after consulting a doctor.

Influence on the ability to drive vehicles and use mechanisms

Special clinical studies of the effect of the drug on the ability to drive a car and mechanisms have not been conducted. Despite this, patients should be advised that they may experience dizziness and / or fainting due to a vasovagal reaction (i.e., during a bowel spasm). Therefore, care must be taken when driving vehicles and engaging in other potentially hazardous activities that require increased concentration of attention and speed of psychomotor reactions.

Overdose

Symptoms: in case of an overdose, diarrhea, dehydration, abdominal cramps, imbalance in water and electrolyte balance, hypokalemia are possible. The drug GuttalaxЃ Express, like other laxatives, in chronic overdose can lead to chronic diarrhea, abdominal pain, hypokalemia, secondary hyperaldosteronism, urolithiasis. Chronic laxative abuse can lead to renal tubular damage, metabolic alkalosis, and muscle weakness associated with hypokalemia.

Treatment: there is no specific antidote. Symptomatic therapy is performed. Fluid replenishment and electrolyte balance adjustments may be required, which is especially important for older patients and children. It may also require the appointment of antispasmodics.

Drug interactions

The simultaneous use of the drug Guttalax Express in high doses and diuretics or GCS can increase the risk of electrolyte imbalance (hypokalemia), which, in turn, can lead to increased sensitivity to the action of cardiac glycosides.

The use of the drug Guttalax Express simultaneously with other laxatives may increase side effects from the gastrointestinal tract.