Constipation and bowel cleansers:
Indications for PREPOPIK:
Bowel cleansing before colonoscopy.
Adults and Children:
<9yrs: not established. ≥9yrs: Split-Dose regimen (preferred): Take 1st dose evening before colonoscopy followed by drinking five 8oz cups of clear liquids within 5hrs and before bed. Take 2nd dose, the next day approx. 5hrs before colonoscopy followed by at least three 8oz cups of clear liquids, at least 2hrs before procedure. Day-Before regimen (alternative): Take 1st dose in the afternoon or early evening before colonoscopy followed by drinking five 8oz cups of clear liquids within 5hrs and before the next dose. Take 2nd dose approx. 6hrs later in the evening, the night before colonoscopy followed by three 8oz cups of clear liquids within 5hrs and before bed.
Severe renal impairment (CrCl <30mL/min). GI obstruction. Ileus. Bowel perforation. Toxic colitis or megacolon. Gastric retention.
Correct fluid/electrolyte abnormalities before use. CHF. History or risk of seizures. Alcohol or benzodiazepine withdrawal. Known or suspected hyponatremia. Mild-to-moderate renal impairment; consider baseline and post-colonoscopy lab tests. Increased risk of arrhythmias (eg, history of prolonged QT, uncontrolled arrhythmias, recent MI, unstable angina, CHF, cardiomyopathy); consider pre-dose and post-colonoscopy ECGs. Mucosal ulcerations may occur; consider when interpreting findings in inflammatory bowel disease. Rule out GI obstruction/perforation before administering. Severe active ulcerative colitis. Impaired gag reflex: risk of regurgitation or aspiration. Maintain adequate hydration. Children: monitor for hypoglycemia. Pregnancy. Nursing mothers.
Stimulant + osmotic laxative.
Caution with drugs that increase risk of fluid/electrolyte abnormalities or that may affect renal function (eg, diuretics, ACEIs, ARBs, NSAIDs). Administer oral meds at least 1hr before Prepopik administration. Separate dosing of tetracyclines, fluoroquinolones, iron, digoxin, chlorpromazine, or penicillamine by at least 2hrs before or >6hrs after Prepopik. Antibiotics may reduce efficacy. Caution with drugs that lower seizure threshold (eg, tricyclics). Increased risk of colonic mucosal ulcerations or ischemic colitis with stimulant laxatives.
Nausea, headache, vomiting; children: also abdominal pain.
Generic Drug Availability:
Carton—1 (2 packets w. dosing cup)