Picoprep

Per sachet Na picosulfate 10 mg, light Mg oxide 3.5 g, anhydrous citric acid 12 g

Cleanse the bowel prior to x-ray exam or endoscopy. Cleanse the bowel prior to surgery when judged clinically necessary.

Adult (including the elderly) Split-dose regimen (evening before & day of the procedure) 1st sachet is taken the night before the procedure & 2nd is taken the next day, in the morning prior to the procedure. On the day before the procedure: 1st reconstituted sachet in the evening (eg, 5:00-9:00 pm) followed by at least five 250-mL drinks of clear liqd spread over several hr. On the day of the procedure: 2nd reconstituted sachet in the morning (5-9 hr before the procedure) followed by at least three 250-mL drinks of clear liqds spread over several hr. Clear liqd may be consumed until 2 hr before the procedure. Day-before regimen (evening before the procedure only) 1st sachet is taken in the afternoon or early evening & 2nd is taken approx 6 hr later, the night before the procedure. On the day before the procedure: 1st reconstituted sachet in the afternoon or early evening (eg, 4:00-6:00 pm) followed by at least five 250 mL drinks of clear liqd spread over several hr. 2nd reconstituted sachet is taken in the late evening (eg, 10:00 pm-12:00 am) followed by at least three 250-mL drinks of clear liqd spread over several hr. Clear liqd may be consumed until 2 hr before the time of the procedure.

Should be taken on an empty stomach: Reconstitute 1 sachet in 1 cup of water (approx 150 mL) & stir for 2-3 min until soln become an off-white, cloudy liqd w/ faint orange odour then, drink immediately. If soln is warm, let it cool before drinking. Reconstitute soln right before administration, do not prepare in advance. Take adequate amount of clear liqd (eg, fruit juice w/o pulp, soft drinks, clear soup, tea, coffee w/o milk/soy/cream & water).

Hypersensitivity. CHF, gastric retention, GI ulceration, toxic colitis, megacolon, ileus, nausea & vomiting, acute surgical abdominal conditions (eg, acute appendicitis), known or suspected GI obstruction or perforation, severe dehydration, rhabdomyolysis, hypermagnesemia, active inflammatory bowel disease. Severely reduced renal function.

Bowel surgery. Patients w/ recent GI surgery, renal impairment, heart or inflammatory bowel disease. Concomitant use w/ drugs that might affect water &/or electrolyte balance eg, diuretics, corticosteroids, lithium. Adequately hydrate before, during & after use. Debilitated patients & those at risk of hypokalaemia or hyponatremia. Patients on antiepileptics w/ previously controlled epilepsy. History of seizures or risk of seizure eg, co-medication w/ TCAs, alcohol or benzodiazepine withdrawal, known or suspected hyponatremia. Increased risk of arrhythmias (eg, history of prolonged QT, uncontrolled arrhythmias, recent MI, unstable angina, CHF or cardiomyopathy). Concurrent use w/ additional stimulant laxatives may increase the risk of colonic mucosal aphthous ulcerations. Consider the potential of mucosal ulcerations when interpreting colonoscopy findings in patients w/ known or suspected inflammatory bowel disease. Patients w/ impaired gag reflex & those prone to regurgitation or aspiration; reduced kidney function or those on a controlled K diet. Period of bowel cleansing should not be >24 hr. Galactose intolerance, Lapp lactase deficiency or glucose-galactose malabsorption. Not to be used as a routine laxative. Avoid use during pregnancy. Lactation. Childn.

Headache; nausea & proctalgia.

May affect absorption of antiepileptics, contraceptives, antidiabetics & antibiotics. Tetracycline & fluoroquinolones, Fe, digoxin, chlorpromazine & penicillamine (take at least 2 hr before & not <6 hr after administration of Picoprep to avoid chelation w/ Mg). Reduced efficacy w/ bulk-forming laxatives. Caution w/ drugs that increase the risk for fluid & electrolyte disturbances or of seizure, arrhythmias & prolonged QT w/ drugs associated w/ hypokalaemia (eg, diuretics or corticosteroids; cardiac glycosides); water retention &/or electrolyte imbalance w/ ACE inhibitors, angiotensin receptor blockers, NSAIDs or drugs known to induce syndrome of inappropriate antidiuretic hormone secretion (eg, TCAs, SSRIs, antipsychotic drugs & carbamazepine).

Laxatives, Purgatives

A06AB58 - sodium picosulfate, combinations ; Belongs to the class of contact laxatives.

POM