Sodium picosulfate/magnesium/citric acid (By mouth)

Introduction

Citric Acid (SIT-rik AS-id), Magnesium Oxide (mag-NEE-zee-um OX-ide), Sodium Picosulfate (SOE-dee-um pye-koe-sul-fate)

Used to cleanse the bowels in preparation for a procedure called colonoscopy. This medicine is a laxative.

Brand Name(s)

Prepopik

There may be other brand names for this medicine.

When This Medicine Should Not Be Used

Do not use this medicine if you have had an allergic reaction to citric acid, magnesium oxide, and sodium picosulfate. Do not use this medicine if you have severe kidney problems, bowel problems (such as blockage, dilated intestines, opening in the wall of your stomach or intestine), or problems with emptying of food or fluid from your stomach (gastric retention).

How to Use This Medicine

Liquid

  • Your doctor will tell you how much of this medicine to use and how often. Do not use more medicine or use it more often than your doctor tells you to.
  • This medicine should come with a Medication Guide. Read and follow these instructions carefully. Ask your doctor or pharmacist if you have any questions. Ask your pharmacist for the Medication Guide if you do not have one.
  • You may take this medicine in two dosing regimens: Split-Dose dosing regimen and Day-Before dosing regimen. Your doctor will tell you how to take this medicine depending on your colonoscopy schedule, distance traveled, and other personal circumstances.
  • Split-dose dosing regimen: Take your first packet the night before colonoscopy, and the second dose the next day, in the morning or at least 5 hours before your colonoscopy.
  • Day-Before dosing regimen: Take your first packet in the afternoon or early evening, and the second dose at least 6 hours after the first dose, the night before colonoscopy.
  • To use the medicine:
    • One dose of this medicine consists of two packets of powder, each packet is mixed with cold water and taken at separate dosing times. Drink the liquid right away after mixing. Do not prepare the oral liquid in advance.
    • Do not take the powder directly without mixing it with cold water.
    • Use the supplied medicine cup when preparing the oral liquid.
    • Drink the additional prescribed amount of clear fluids (such as water, apple juice, white cranberry juice, white grape juice, or ginger ale) after every dose of this medicine.
    • Do not eat solid foods or drink milk while taking this medicine.
    • Drink clear liquids before your colonoscopy.

If a dose is missed:

  • If you miss a dose or forget to use your medicine, use it as soon as you can. If it is almost time for your next dose, wait until then to use the medicine and skip the missed dose. Do not use extra medicine to make up for a missed dose.

How to Store and Dispose of This Medicine

  • Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.
  • Ask your pharmacist, doctor, or health caregiver about the best way to dispose of any outdated medicine or medicine no longer needed.
  • Keep all medicine away from children and never share your medicine with anyone.

Drugs and Foods to Avoid

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

  • Make sure your doctor knows if you are also using a diuretic (water pill, such as furosemide, torsemide, Lasix®), certain blood pressure medicines (such as benazepril, enalapril, lisinopril, Avalide®, Avapro®, Benicar®, Cozaar®, Diovan®, Lotrel®, Micardis®, Vasotec®, Zestoretic®, Zestril®), a steroid medicine (such as hydrocortisone, methylprednisolone, prednisolone, prednisone), or pain or arthritis medicine (NSAID, such as aspirin, diclofenac, ibuprofen, naproxen, Advil®, Aleve®, Celebrex®, Voltaren®). Tell your doctor if you are also using carbamazepine (Tegretol®), medicine to treat depression (such as amitriptyline, citalopram, fluoxetine, nortriptyline, sertraline, Elavil®), or medicine to treat mental illness (such as promethazine, Phenergan®).
  • Make sure your doctor knows if you are taking chlorpromazine (Thorazine®), digoxin (Lanoxin®), penicillamine (Cuprimine®, Depen®), iron supplements, and certain antibiotics (such as ciprofloxacin, doxycycline, minocycline, tetracycline, Avelox®, Levaquin®, Vigamox®). These medicines should be taken at least 2 hours before starting Prepopik? and 6 hours after taking Prepopik?.
  • Avoid taking any medicine by mouth within 1 hour before taking Prepopik?.
  • Avoid taking other laxatives while you are taking this medicine.

Warnings While Using This Medicine

  • Make sure your doctor knows if you are pregnant or breastfeeding, or if you have kidney problems, a recent heart attack, angina (severe chest pain), congestive heart failure, heart disease, heart rhythm problem (such as arrhythmia, prolonged QT), mineral imbalance (such as low calcium, magnesium, potassium, sodium in the blood), stomach or bowel problems, trouble swallowing, ulcerative colitis, or a history of seizures. Tell your doctor if you are withdrawing from alcohol or benzodiazepines (such as alprazolam, clonazepam, diazepam, lorazepam, Xanax®).
  • Contact your doctor right away if you have decreased urination, dizziness, headache, or vomiting. These could be symptoms of a loss of too much body fluid (dehydration).
  • Stop taking this medicine if you have severe bloating, distension, or stomach pain after taking the first packet of Prepopik?. You may delay taking the second dose until your symptoms improve.
  • Your doctor will need to check your blood or urine at regular visits while you are using this medicine. Be sure to keep all appointments.

Possible Side Effects While Using This Medicine

Call your doctor right away if you notice any of these side effects:

  • Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
  • Confusion, weakness, and muscle twitching
  • Decrease in how much or how often you urinate
  • Fast or uneven heartbeats
  • Headache, dizziness, nausea, vomiting
  • Seizures
  • Severe stomach pain, bleeding from the rectum
  • Trouble swallowing

If you notice other side effects that you think are caused by this medicine, tell your doctor

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088

Version Info

  • Last Reviewed on 06/12/2013

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This page was last updated: June 18, 2013

         
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