Mechanism of Action

HalfLytely and Bisacodyl Tablets Bowel Prep Kit induces diarrhea which cleanses the colon.

Pharmacodynamics

Bisacodyl, a stimulant laxative, is hydrolyzed by intestinal brush border enzymes and colonic bacteria to form an active metabolite [bis-(p-hydroxyphenyl) pyridyl-2 methane; (BHPM)] that acts directly on the colonic mucosa to produce colonic peristalsis.

Pharmacokinetics

The osmotic activity of HalfLytely solution results in no net absorption or excretion of ions or water.

Clinical Studies

The colon cleansing efficacy of HalfLytely and Bisacodyl Tablets Bowel Prep Kit (with 10 mg of bisacodyl) was evaluated in a randomized, single blind, active-controlled, multicenter study. In this study, 444 adult patients were included in the efficacy analysis. Patients ranged in age from 19 to 86 years old (mean age 57 years old) with 53% female and 47% male patients. Race was distributed as follows: 86% Caucasian, 9% African American, 7% Hispanic or Latino, and 3% other.

Patients were randomized to one of the following two colon preparations: 1) HalfLytely and Bisacodyl Tablets Bowel Prep Kit [20 mg of bisacodyl tablets were given at noon on the day before colonoscopy followed by 2 liters of HalfLytely (after the first bowel movement or maximum of 6 hours)] at a rate of 8 ounces every 10 minutes and 2) a modified HalfLytely and Bisacodyl Tablets Bowel Prep Kit [containing 10 mg of bisacodyl tablets given at noon on the day before colonoscopy followed by 2 liters of HalfLytely (after the first bowel movement or maximum of 6 hours)] at a rate of 8 ounces every 10 minutes.

Patients were instructed to refrain from solid food and to have clear liquids on the day before colonoscopy. In addition, patients were instructed to consume nothing by mouth, except clear liquids, from the time the preparation was completed until midnight. Patients were instructed not to eat or drink anything from midnight until after the colonoscopy was completed. The primary efficacy endpoint was the proportion of patients with successful colon cleansing (assessed by the colonoscopists), see Table 3 below.

Table 3: Colon Cleansing Efficacy*

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