Sodium picosulfate/ magnesium oxide/ anhydrous citric acid

Generic Name: sodium picosulfate/magnesium oxide/anhydrous citric acid (SOE-dee-um PEE-koe-SUL-fate/mag-NEE-zee-um OX-ide/an-HYE-drus SIH-trik AS-id)
Brand Name: Prepopik

Sodium picosulfate/ magnesium oxide/ anhydrous citric acid is used for:

Cleaning out the bowel before a certain procedure (colonoscopy). It may also be used for other conditions as determined by your doctor.

Sodium picosulfate/magnesium oxide/anhydrous citric acid is a laxative. It increases the frequency of bowel movements by retaining water in the stool and by moving contents through the bowel.

Do NOT use sodium picosulfate/ magnesium oxide/ anhydrous citric acid if:

  • you are allergic to any ingredient in sodium picosulfate/magnesium oxide/anhydrous citric acid
  • you have certain stomach or bowel problems (eg, blockage, retention, perforation, toxic inflammation, megacolon, ileus)
  • you have severe kidney problems or abnormal blood electrolyte levels (eg, potassium, sodium, magnesium)

Contact your doctor or health care provider right away if any of these apply to you.

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Before using sodium picosulfate/ magnesium oxide/ anhydrous citric acid:

Some medical conditions may interact with sodium picosulfate/magnesium oxide/anhydrous citric acid. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

  • if you are pregnant, planning to become pregnant, or are breast-feeding
  • if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
  • if you have allergies to medicines, foods, or other substances
  • if you have a history of blood electrolyte problems, seizures, kidney problems, or stomach or bowel problems (eg, inflammatory bowel disease, ulcerative colitis)
  • if you have a history of irregular heartbeat (eg, prolonged QT), a recent heart attack, a certain type of chest pain (unstable angina), or other heart problems (eg, congestive heart failure, heart muscle problems)
  • if you are going through alcohol or benzodiazepine (eg, lorazepam) withdrawal
  • if you have an impaired gag reflex, trouble swallowing, gastric reflux, or you are at risk of aspiration (inhaling foreign matter into the airway or lungs)
  • if you are dehydrated or on a low-salt (sodium) diet
  • if you also take other laxatives (eg, bisacodyl), or medicines for blood pressure, heart problems, infection, kidney problems, mental or mood problems, or seizures

Some MEDICINES MAY INTERACT with sodium picosulfate/magnesium oxide/anhydrous citric acid. Tell your health care provider if you are taking any other medicines, especially any of the following:

  • Tricyclic antidepressants (eg, amitriptyline) because the risk of seizures may be increased
  • Angiotensin-converting enzyme (ACE) inhibitors (eg, lisinopril), angiotensin receptor blockers (eg, valsartan), carbamazepine, corticosteroids (eg, prednisone), digoxin, diuretics (eg, furosemide, hydrochlorothiazide), nonsteroidal anti-inflammatory drugs (NSAIDs) (eg, ibuprofen), selective serotonin reuptake inhibitors (SSRIs) (eg, fluoxetine), or medicines that may harm the kidney (eg, aminoglycoside antibiotics [eg, gentamicin], amphotericin B, cyclosporine, tacrolimus, vancomycin) because the risk of side effects may be increased. Ask your doctor if you are unsure if any of your medicines might harm the kidney

This may not be a complete list of all interactions that may occur. Ask your health care provider if sodium picosulfate/magnesium oxide/anhydrous citric acid may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use sodium picosulfate/ magnesium oxide/ anhydrous citric acid:

Use sodium picosulfate/magnesium oxide/anhydrous citric acid as directed by your doctor. Check the label on the medicine for exact dosing instructions.

  • Sodium picosulfate/magnesium oxide/anhydrous citric acid comes with an extra patient information sheet called a Medication Guide. Read it carefully. Read it again each time you get sodium picosulfate/magnesium oxide/anhydrous citric acid refilled.
  • Sodium picosulfate/magnesium oxide/anhydrous citric acid is usually taken as 2 separate doses. Your doctor will tell you how to take it. Follow your doctor's instructions. Check with your doctor if you have questions or you are not sure how to take sodium picosulfate/magnesium oxide/anhydrous citric acid.
  • On the day before your procedure, you may have clear liquids only (no solid food or milk). Do not drink alcoholic beverages. Do not eat or drink anything colored red or purple. Do not eat any solid foods from the time you start sodium picosulfate/magnesium oxide/anhydrous citric acid until your procedure is complete.
  • Drinking extra fluids before, during, and after you take sodium picosulfate/magnesium oxide/anhydrous citric acid is recommended. Check with your doctor for instructions.
  • Do NOT take sodium picosulfate/magnesium oxide/anhydrous citric acid without first mixing it with water. Doing so may increase the risk of nausea, vomiting, and dehydration. Be sure you understand how to take sodium picosulfate/magnesium oxide/anhydrous citric acid.
  • To take a dose, mix the contents of 1 packet with 5 oz (150 mL) cold water as directed. Mix sodium picosulfate/magnesium oxide/anhydrous citric acid right before you take your dose. Do not store the mixture for use at a later time.
  • Use the other packet to take your second dose as directed by your doctor.
  • You must finish drinking your final glass of clear liquids at least 2 hours before your procedure, unless your doctor tells you otherwise.
  • If you have severe stomach pain, swelling, or bloating after the first dose, do not take the second dose until they go away. Check with your doctor if you have these symptoms and you are not sure what to do.
  • If you are taking chlorpromazine, digoxin, iron, penicillamine, a quinolone antibiotic (eg, levofloxacin), or a tetracycline antibiotic (eg, doxycycline), take it at least 2 hours before or 6 hours after sodium picosulfate/magnesium oxide/anhydrous citric acid. Check with your doctor if you have questions.
  • Medicines taken by mouth within 1 hour of taking sodium picosulfate/magnesium oxide/anhydrous citric acid may not be absorbed or be effective. Contact your doctor or pharmacist with any concerns you might have about taking your other medicines.
  • Check with your doctor about what to do if you miss a dose of sodium picosulfate/magnesium oxide/anhydrous citric acid. Notify your doctor right away if you are unable to finish taking sodium picosulfate/magnesium oxide/anhydrous citric acid before your test.

Ask your health care provider any questions you may have about how to use sodium picosulfate/magnesium oxide/anhydrous citric acid.

Important safety information:

  • The following are examples of clear liquids that you may drink the day before and the day of your procedure: water, clear broth, apple juice, white cranberry juice, white grape juice, ginger ale, plain gelatin desserts (not red or purple), or frozen juice bars (not red or purple). Check with your doctor or pharmacist if you have questions about whether you may drink a certain liquid.
  • Contact your doctor right away if severe vomiting or diarrhea occurs, or if you become dehydrated after taking sodium picosulfate/magnesium oxide/anhydrous citric acid. These effects may lead to abnormal blood electrolyte levels, which may cause certain serious side effects (eg, irregular heartbeat, kidney problems, seizures). Discuss any questions or concerns with your doctor.
  • Do not take other laxatives (eg, bisacodyl) while you are taking sodium picosulfate/magnesium oxide/anhydrous citric acid, unless your doctor tells you otherwise.
  • Sodium picosulfate/magnesium oxide/anhydrous citric acid should be used with extreme caution in CHILDREN; safety and effectiveness in children have not been confirmed.
  • PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of taking sodium picosulfate/magnesium oxide/anhydrous citric acid while you are pregnant. It is not known if sodium picosulfate/magnesium oxide/anhydrous citric acid is found in breast milk. If you are or will be breast-feeding while you take sodium picosulfate/magnesium oxide/anhydrous citric acid, check with your doctor. Discuss any possible risks to your baby.

Possible side effects of sodium picosulfate/ magnesium oxide/ anhydrous citric acid:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Discomfort; feeling of being full or bloated; mild stomach pain, cramping, or discomfort; nausea.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); bloody diarrhea or rectal bleeding; confusion; decreased urination; dizziness; fainting; headache; irregular heartbeat; mental or mood changes; muscle pain, weakness, or cramping; seizures; severe diarrhea; severe or persistent stomach pain, bloating, cramping, or discomfort; symptoms of dehydration (eg, dry eyes or mouth, sluggishness, weakness); trouble swallowing or drinking liquids; vomiting.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately.

Proper storage of sodium picosulfate/magnesium oxide/anhydrous citric acid:

Store sodium picosulfate/magnesium oxide/anhydrous citric acid between 68 and 77 degrees F (20 and 25 degrees C) in its original container. Store away from heat, moisture, and light. Keep sodium picosulfate/magnesium oxide/anhydrous citric acid out of the reach of children and away from pets.

General information:

  • If you have any questions about sodium picosulfate/magnesium oxide/anhydrous citric acid, please talk with your doctor, pharmacist, or other health care provider.
  • Sodium picosulfate/magnesium oxide/anhydrous citric acid is to be used only by the patient for whom it is prescribed. Do not share it with other people.
  • If your symptoms do not improve or if they become worse, check with your doctor.
  • Check with your pharmacist about how to dispose of unused medicine.

This information should not be used to decide whether or not to take sodium picosulfate/magnesium oxide/anhydrous citric acid or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about sodium picosulfate/magnesium oxide/anhydrous citric acid. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to sodium picosulfate/magnesium oxide/anhydrous citric acid. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using sodium picosulfate/magnesium oxide/anhydrous citric acid.

Issue Date: April 2, 2014
Database Edition 14.2.1.001
Copyright © 2014 Wolters Kluwer Health, Inc.

Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using this medicine.

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