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Citric Acid / Magnesium Oxide / Sodium Picosulfate Dosage

Medically reviewed by Drugs.com. Last updated on Aug 15, 2019.

Applies to the following strengths: 12 g-3.5 g-10 mg/160 mL; 12 g-3.5 g-10 mg

Usual Adult Dose for:

Usual Pediatric Dose for:

Additional dosage information:

Usual Adult Dose for Bowel Preparation

Split-Dose Dosing Regimen (Preferred Method):
-Dose 1: 12 grams citric acid-3.5 grams magnesium oxide-10 mg sodium picosulfate orally ONCE in the evening before the colonoscopy (e.g., at 1700 to 2100), followed by at least 40 ounces of clear liquids within 5 hours and before bed
-Dose 2: 12 grams citric acid-3.5 grams magnesium oxide-10 mg sodium picosulfate orally ONCE approximately 5 hours prior to the colonoscopy, followed by at least 24 ounces of clear liquids at least 2 hours before the colonoscopy

Day-Before Dosing Regimen (Alternative Method):
-Dose 1: 12 grams citric acid-3.5 grams magnesium oxide-10 mg sodium picosulfate orally ONCE in the evening before the colonoscopy (e.g., at 16:00 to 18:00), followed by at least 40 ounces of clear liquids within 5 hours and before the next dose
-Dose 2: 12 grams citric acid-3.5 grams magnesium oxide-10 mg sodium picosulfate orally ONCE in the evening before the colonoscopy (e.g., at 20:00 to 00:00), followed by at least 24 ounces of clear liquids within 5 hours and before bed

Comments:
-Patients should consume only clear liquids (e.g., no solid food or dairy) up until 2 hours before the time of the colonoscopy.
-Those who experience severe bloating, distention, or abdominal pain may delay the second dose until the symptoms resolve.

Use: Cleansing the colon as a preparation for colonoscopy

Usual Pediatric Dose for Bowel Preparation

9 years and older:
Split-Dose Dosing Regimen (Preferred Method):
-Dose 1: 12 grams citric acid-3.5 grams magnesium oxide-10 mg sodium picosulfate orally ONCE in the evening before the colonoscopy (e.g., at 1700 to 2100), followed by at least 40 ounces of clear liquids within 5 hours and before bed
-Dose 2: 12 grams citric acid-3.5 grams magnesium oxide-10 mg sodium picosulfate orally ONCE approximately 5 hours prior to the colonoscopy, followed by at least 24 ounces of clear liquids at least 2 hours before the colonoscopy

Day-Before Dosing Regimen (Alternative Method):
-Dose 1: 12 grams citric acid-3.5 grams magnesium oxide-10 mg sodium picosulfate orally ONCE in the evening before the colonoscopy (e.g., at 16:00 to 18:00), followed by at least 40 ounces of clear liquids within 5 hours and before the next dose
-Dose 2: 12 grams citric acid-3.5 grams magnesium oxide-10 mg sodium picosulfate orally ONCE in the evening before the colonoscopy (e.g., at 20:00 to 00:00), followed by at least 24 ounces of clear liquids within 5 hours and before bed

Comments:
-Patients should consume only clear liquids (e.g., no solid food or dairy) up until 2 hours before the time of the colonoscopy.
-Those who experience severe bloating, distention, or abdominal pain may delay the second dose until the symptoms resolve.

Use: Cleansing the colon as a preparation for colonoscopy

Renal Dose Adjustments

Mild to moderate renal dysfunction (CrCl 30 mL/min and greater): Use with caution. Baseline and post-colonoscopy electrolyte, creatinine, and blood urea nitrogen (BUN) monitoring should be considered.
Severe renal dysfunction (CrCl less than 30 mL/min): Contraindicated

Patients taking drugs that could affect renal function (e.g., ACE inhibitors, angiotensin receptor blockers, diuretics, NSAIDs): Use with caution. Baseline and post-colonoscopy electrolyte, creatinine, and BUN monitoring should be considered.

Liver Dose Adjustments

Data not available

Precautions

CONTRAINDICATIONS:
-Hypersensitivity to the active component or any of the ingredients
-Patients with:
---Bowel perforation
---Gastric retention
---Gastrointestinal obstruction/ileus
---Severe renal dysfunction (CrCl less than 30 mL/min)
---Toxic colitis or toxic megacolon

Safety and efficacy have not been established in patients younger than 9 years.

Consult WARNINGS section for additional precautions.

Dialysis

Data not available

Other Comments

Administration advice:
-The manufacturer product information should be consulted.
-Once reconstituted, the powder for oral solution formulations should be consumed immediately. Ice should not be added to the solution.

Storage requirements:
-Oral solutions: Store at 25C; do not refrigerate or freeze.
-Powder for oral solutions: Store between 20 to 25C; protect from moisture prior to preparation.

Reconstitution/preparation techniques:
-Oral solutions: Do not dilute the solution.
-Powder for oral solutions: The manufacturer product information should be consulted.

General:
-Limitation of use: This drug should not be used as a routine laxative.

Monitoring:
-CARDIOVASCULAR: Consider baseline and post-colonoscopy ECGs in patients at risk of serious cardiac arrhythmias
-METABOLIC: Consider baseline and post-colonoscopy laboratory tests (electrolyte panel) in patients with mild to moderate renal dysfunction, preexisting electrolyte disturbances, and/or those taking drugs that could affect renal function
-RENAL: Consider baseline and post-colonoscopy laboratory tests (creatinine, blood urea nitrogen) in patients with mild to moderate renal dysfunction and/or those taking drugs that could affect renal function

Patient advice:
-Patients should be instructed to closely follow their healthcare providers' instructions regarding bowel preparation.
-Inform patients that this drug may cause dizziness and/or fatigue, and they should avoid driving or operating machinery if these side effects occur.
-Advise patients to remain adequately hydrated while using this drug.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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