Citric Acid/magnesium Oxide/sodium Picosulfate Side Effects

Medically reviewed by Drugs.com. Last updated on Oct 20, 2024.

Applies to citric acid/magnesium oxide/sodium picosulfate: oral solution.

Precautions

It is important that your doctor check your or your child's progress closely for any problems or unwanted effects that may be caused by this medicine. Blood and urine tests may be needed to check for unwanted effects.

Contact your doctor right away if you or your child have decreased urination, dizziness, headache, or vomiting. These could be symptoms of a loss of too much body fluid (dehydration).

Contact your doctor right away if you have any changes to your heart rhythm. You might feel dizzy or faint, or you might have a fast, pounding, or uneven heartbeat. Make sure your doctor knows if you had a heart rhythm problem, including QT prolongation.

This medicine may increase your risk for seizures. This is more likely to occur if you take medicine for depression, if you are withdrawing from alcohol or benzodiazepine use, or if you have low sodium level in the blood (hyponatremia). Talk to your doctor if you have any concerns.

If you or your child have severe bloating, distension, or abdominal or stomach pain after taking the first dose, Stop taking citric acid/magnesium oxide/sodium picosulfate or delay taking the second dose until your symptoms improve.

This medicine may cause serious stomach or bowel problems (eg, colon ulcers, ischemic colitis). Check with your doctor right away if you have stomach pain and tenderness, bloody stools, or rectal bleeding.

Fainting may occur during treatment with this medicine, which may increase risk of falls, head injuries, and fractures. Your doctor may ask you to drink more clear liquids.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Serious side effects

Along with its needed effects, citric acid/magnesium oxide/sodium picosulfate may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking citric acid/magnesium oxide/sodium picosulfate:

Other side effects

Some side effects of citric acid/magnesium oxide/sodium picosulfate may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

For healthcare professionals

Applies to citric acid/magnesium oxide/sodium picosulfate: oral liquid, oral powder for reconstitution.

General adverse events

The most commonly reported side effects included headache, nausea, vomiting, and proctalgia.^[Ref]

Renal

• Very common (10% or more): Low glomerular filtration rate (up to 28.5%)
• Common (1% to 10%): High creatinine^[Ref]

Low GFR occurred in 28.5% of patients using the day-before regimen compared to 25.1% of patients using the split-dose regimen at 24 to 48 hours after the colonoscopy.^[Ref]

Cardiovascular

• Very common (10% or more): Orthostatic changes (up to 20%)
• Uncommon (0.1% to 1%): Orthostatic hypotension
• Frequency not reported: Cardiac arrhythmias^[Ref]

Orthostatic changes included changes in blood pressure and heart rate.

In a study, approximately 20% of pediatric patients 9 to 16 years of age given this drug had orthostatic changes for up to 5 days compared to 7% of patients given the comparator drug regimen (polyethylene glycol and electrolytes solution plus bisacodyl).^[Ref]

Metabolic

• Very common (10% or more): Hypermagnesemia (up to 11.6%)
• Common (1% to 10%): Electrolyte abnormalities, hypochloremia, hypokalemia, hyponatremia, thirst
• Uncommon (0.1% to 1%): Hypocalcemia
• Frequency not reported: Abnormally low glucose levels (40 to 47 mg/dL), dehydration, serious fluid and electrolyte abnormalities^[Ref]

Hypermagnesemia occurred in 11.6% of patients using the split-dose regimen compared to 8.7% of patients using the day-before regimen the day of the colonoscopy.

Abnormally low glucose levels were reported in asymptomatic pediatric patients, with one occurring at the colonoscopy, and one at the 5-day follow-up visit.

Hyponatremia has occurred with/without convulsions.^[Ref]

Gastrointestinal

• Common (1% to 10%): Abdominal distention, abdominal fullness, abdominal pain, anal discomfort, bloating, dry mouth, nausea, proctalgia, vomiting
• Uncommon (0.1% to 1%): Abdominal cramps, anal irritation, aphthoid ileal ulcers/mild reversible aphthoid ileal ulcers, diarrhea, ileal ulcers. fecal incontinence
• Rare (0.01% to 0.1%): Anal incontinence
• Frequency not reported: Abdominal bloating, colonic mucosal ulceration, flatulence, ischemic colitis, ulcerative colitis, watery diarrhea
• Postmarketing reports: Severe diarrhea^[Ref]

Since abdominal bloating, distention, pain/cramping, and watery diarrhea were predicted to occur as part of the colon cleansing regimen, these side effects were included only if patients required medical attention or the condition significantly worsened during the study and was not in the frame of the usual clinical course.^[Ref]

Nervous system

• Common (1% to 10%): Headache
• Uncommon (0.1% to 1%): Convulsions, decreased/loss of consciousness, dizziness, epilepsy, generalized tonic-clonic seizures, grand mal convulsion, seizures, syncope
• Rare (0.01% to 0.1%): Presyncope^[Ref]

Generalized tonic-clonic seizures occurred with and without hyponatremia in patients with epilepsy.^[Ref]

Psychiatric

• Common (1% to 10%): Sleep disorder
• Uncommon (0.1% to 1%): Confusional state, disorientation
• Frequency not reported: Sleep disturbance^[Ref]

Other

• Common (1% to 10%): Fatigue
• Frequency not reported: Pain^[Ref]

Dermatologic

• Uncommon (0.1% to 1%): Erythematous rash, maculopapular rash, purpura, rash, urticaria
• Frequency not reported: Pruritus^[Ref]

Hypersensitivity

• Uncommon (0.1% to 1%): Anaphylactic reaction, hypersensitivity
• Frequency not reported: Anaphylactoid reaction, anaphylaxis^[Ref]

Respiratory

• Frequency not reported: Aspiration

See also:

Further information

Citric acid/magnesium oxide/sodium picosulfate side effects can vary depending on the individual. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Note: Medication side effects may be underreported. If you are experiencing side effects that are not listed, submit a report to the FDA by following this guide.

Medical Disclaimer