Bisacodyl Shortage: What Providers and Prescribers Need to Know in 2026

If your patients have reported difficulty finding bisacodyl suppositories — particularly for colonoscopy or surgical bowel preparation — the supply disruption they're encountering is real and clinically significant. This briefing outlines the current supply landscape, the clinical contexts most affected, alternative protocols, and practical tools for supporting your patients through the shortage.

Current Supply Status by Formulation (2026)

Oral tablets (5 mg, enteric-coated): No current shortage. Multiple manufacturers supply this form. Widely available at all pharmacy channels. Cash price $2–$8 for 25–100 count.

Rectal suppositories (10 mg): Intermittently available. G&W Laboratories exited the market, reducing supply. Perrigo, Major Pharmaceuticals, Geri-Care, and Rugby continue production but have not fully compensated for the gap. ASHP Drug Shortage Database has reflected this disruption at various points. Periodic spot shortages at chain pharmacies remain common.

Rectal enemas (10 mg): Limited availability. Fleet continues some production, but this form is less commonly stocked.

Clinical Contexts Most Affected

Colonoscopy and endoscopic bowel preparation. Bisacodyl suppositories are a standard component of many bowel prep protocols, particularly split-dose and same-day preparation regimens. If your standard protocol includes a bisacodyl suppository on the morning of the procedure, advise patients to confirm suppository availability at their dispensing pharmacy at least 5–7 days prior.

Preoperative bowel preparation. Similar considerations apply to surgical prep protocols that include bisacodyl. Consider proactively confirming suppository availability or having an alternative protocol ready.

Neurogenic bowel management. Patients with spinal cord injury, multiple sclerosis, or other neurogenic bowel conditions often depend on bisacodyl suppositories as part of a structured bowel management program. The intermittent shortage creates particular disruption for this population. Proactive planning and identification of alternate suppliers is warranted.

Alternative Bowel Prep Protocols When Bisacodyl Suppositories Are Unavailable

When suppositories are not available, the following modifications are clinically reasonable for most standard colonoscopy prep regimens:

Substitute oral bisacodyl tablets: Oral tablets are widely available. If the protocol uses a 10 mg suppository the morning of the procedure, a 10–15 mg oral dose the evening before may be substituted in appropriate patients with guidance from your GI protocol team.

Switch to PEG-based prep: Polyethylene glycol-based preparations (GoLYTELY, MoviPrep, Suprep) provide effective bowel cleansing without bisacodyl. Note: Avoid co-administering sodium sulfate bowel preps with bisacodyl due to risk of ischemic colitis.

Senna substitution: Senna is a stimulant laxative with a similar mechanism and 6–12 hour oral onset. It can substitute for oral bisacodyl in many constipation management scenarios.

Key Drug Interactions Relevant to Bisacodyl

When prescribing or recommending bisacodyl, be aware of the following interactions:

Sodium sulfate bowel preps: Avoid co-administration — increased risk of mucosal ulceration and ischemic colitis. (Serious — Use Alternative)

Antacids / H2-receptor antagonists / PPIs: Premature dissolution of enteric coating — advise patients not to take bisacodyl within 1 hour of these agents.

Digoxin: Bisacodyl may reduce digoxin absorption; monitor serum digoxin levels in patients on concurrent therapy.

Diuretics / Corticosteroids: Increased electrolyte imbalance risk, particularly hypokalemia, with excessive bisacodyl use.

How to Help Patients Find Bisacodyl in Stock

When a patient reports being unable to fill bisacodyl suppositories, direct them to medfinder for Providers — a service that calls pharmacies on the patient's behalf to identify which ones have a medication in stock, texting results directly. For a full guide on supporting patients through stock issues, see our provider's guide to helping patients find Bisacodyl.

In general, advise patients to: call independent pharmacies (often better stocked than chains), request special orders from their pharmacy's wholesaler (1–2 day turnaround), and check online retailers for non-urgent OTC needs.