Atzirut is an Isreali brand of Bisacodyl (Ducolax, Alcolax), an over-the-counter medication used to treat constipation. Bisacodyl belongs to the class of medications called stimulant laxatives. It is used for the relief of occasional constipation. It can also be used for the preparation of certain medical tests (e.g., colonoscopy), before and after surgery, and in other situations where a bowel movement to required.
Atzirut works by stimulating the bowel muscles and also accumulates water in the intestines. This helps to soften the stool and produce a bowel movement more quickly. The tablets should be taken at bedtime to produce a bowel movement the next morning. Atzirut usually take about 15 minutes to 1 hour to work.
How should I use Atzirut?
For constipation, the usual dose for adults and children over 12 years of age is 1 to 2 tablets (5 mg to 10 mg) taken by mouth. For children 6 to 12 years of age, the usual dose is 1 tablet (5 mg) taken by mouth.
Before a medical test or surgery, the usual dose for adults is 2 to 4 tablets (10 mg to 20 mg) taken by mouth the night before the procedure, followed by 1 suppository inserted rectally the morning of the procedure. For children 6 years of age and older, the usual dose is 1 tablet (5 mg) taken by mouth at bedtime and 1 pediatric suppository (5 mg) inserted rectally the following morning.
Take the tablets at night to produce a bowel movement the following morning. Do not take the tablets with milk or antacids as this may dissolve the coating on the tablet. Swallow the tablets whole with liquids. Do not crush or chew the tablets.
To use the suppositories, unwrap and insert high into the rectum with the pointed end first. Then, push the flat end of the suppository sideways so that part of it touches the wall of the rectum. Keep the suppository in the rectum for as long as possible. If inserting the suppository is difficult because you have had anal fissures or hemorrhoids, coat the end of the suppository with a lubricant such as petroleum jelly before inserting. The suppositories will start to work within 15 minutes to 1 hour.
Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are using the medication without consulting your doctor.
Do not take this medication for longer than one week, unless directed by a health care professional. If you use this medication for one week and you do not produce a bowel movement, contact your doctor immediately.
It is important to take this medication exactly as prescribed by your doctor or recommended by your pharmacist. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not administer a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.
What are the side effects of Atzirut?
The following side effects have been reported by at least 1% of people taking Atzirut. Many of these side effects can be managed, and some may go away on their own over time.
Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.
- abdominal cramps, pain, or discomfort
Although most of the side effects listed below don’t happen very often, they could lead to serious problems if you do not seek medical attention.
Check with your doctor as soon as possible if any of the following side effects occur:
- blood in the stool
- rectal discomfort or pain
- symptoms of an allergic reaction (e.g., rash, itching)
- symptoms of irritation of the intestines (e.g., severe abdominal cramping, diarrhea)
Stop taking the medication and seek immediate medical attention if any of the following occur:
- symptoms of a severe allergic reaction (e.g., hives, swelling of the face or throat)
Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.
Are there any other precautions or warnings for this medication?
Before you begin taking a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should take this medication.
Abdominal pain, nausea, vomiting, fever: If you have abdominal pain, nausea, fever, or vomiting, do not take this medication. Talk to your doctor or pharmacist for advice.
Dizziness and fainting: People taking this medication have reported experiencing dizziness and fainting. This may be from straining to produce a bowel movement or from the pain that can be associated with constipation. If you feel dizzy or faint while taking this medication, contact your doctor.
Long-term use: This medication should not be taken daily or for long periods of time as this may lead to dehydration and low potassium levels. Long-term use can make your bowels dependent on this medication to function.
Rectal conditions: If you have rectal fissures or ulcerative proctitis, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. People with these conditions may experience pain and irritation when using the suppository form of this medication. If you experience rectal bleeding after using the suppositories, contact your doctor.
Tartrazine: This medication contains tartrazine (a colouring agent) and should not be taken by people who are allergic to tartrazine.
Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.
Breast-feeding: This medication does not pass into breast milk. It is therefore considered safe to use while breast-feeding.
Children: The safety and effectiveness of this medication have not been established for children less than 6 years old. Do not give this medication to children unless recommended by your doctor.
What other drugs could interact with this medication?
Do not take other medications 2 hours before or 2 hours after taking bisacodyl tablets. Atzirut tablets may reduce the effectiveness of other medications.
There may be an interaction between Atzirut and any of the following:
- antacids (e.g., aluminum hydroxide, calcium carbonate, magnesium hydroxide)
- corticosteroids (e.g., dexamethasone, hydrocortisone, prednisone)
- diuretics (e.g., furosemide, hydrochlorothiazide)
- H2-antagonists (e.g., ranitidine, cimetidine)
- proton pump inhibitors (PPIs; e.g., omeprazole, pantoprazole)
If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:
- stop taking one of the medications,
- change one of the medications to another,
- change how you are taking one or both of the medications, or
- leave everything as is.
An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.
Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.
What are warnings and precautions for Atzirut?
This medication contains bisacodyl. Do not take Atzirut if you are allergic to bisacodyl or any ingredients contained in this drug.
Keep out of reach of children. In case of overdose, get medical help or contact a Poison Control Center immediately.
• Obstruction or severe impaction
• Symptoms of appendicitis or acute surgical abdomen
• Rectal bleeding