Usual Adult Dose for Bowel Preparation

4 Liter preparations: 8 oz., orally, every 10 minutes, until the rectal effluent is clear or 4 liters are consumed OR 20 to 30 mL per minute via nasogastric tube

2 Liter preparations:

• Split-dose regimen: 8 oz., orally, every 15 minutes over 1 hour, then 0.5 L (approximately 16 oz.) of clear fluid the evening before colonoscopy
• Repeat this dosing the morning of the colonoscopy

• Evening only regimen: 8 oz., orally, every 15 minutes over 1 hour, the evening before the colonoscopy
• About 1.5 hours later: 8 oz., orally every 15 minutes over 1 hour
• An additional 1 liter (about 32 oz.) of clear liquid should be consumed the evening before the colonoscopy.
• Recommended start time is around 6 PM.

• The product must be reconstituted prior to administration.
• Rapid drinking of each portion is preferred to drinking small amounts continuously.
• Avoid red and purple liquids when consuming clear fluids.

Usual Pediatric Dose for Bowel Preparation

6 months or older: 25 mL/kg/hour orally OR via nasogastric tube until the rectal effluent is clear

Comment: Not all products are approved for pediatric use; the manufacturer product information should be consulted.

Use: Bowel cleansing prior to colonoscopy and barium enema X-ray examination

Renal Dose Adjustments

Use with caution.

• Advise patients of the importance of adequate hydration.
• Consider performing baseline and post-procedure laboratory tests (electrolytes, creatinine, and BUN).

Liver Dose Adjustments

Data not available

Precautions

CONTRAINDICATIONS:

• Known allergy or hypersensitivity to the active components or to any of the ingredients
• Patients with bowel perforation
• Patients with gastrointestinal obstruction, gastric retention, or ileus
• Toxic colitis or toxic megacolon

Dialysis

Data not available

Other Comments

Administration advice:

• Product must be reconstituted prior to administration.
• Rapid drinking of each portion is preferred to drinking small amounts continuously.
• The patient should fast for 3 to 4 hours prior to starting this medication; no solid food should be given for at least 2 hours before the medication.
• Allow three hours for drinking and an additional hour for complete bowel evacuation.
• The solution is more palatable when chilled, but chilled solution is not recommended for infants.

• Store unreconstituted product at controlled room temperature.

• If flavor packs are available, the preparation can be used with or without the flavor packs.
• If flavor packs are used, pour contents into bottle BEFORE reconstitution; shake well to incorporate flavoring into the powder.
• Add water to FILL line, replace cap tightly and shake well until all ingredients have dissolved.
• Do not add additional ingredients or flavorings to the solution.
• Dissolution is facilitated by using lukewarm water.

• This medication produces a watery stool which cleanses the bowel prior to examination.
• Prepare the solution according to the package instructions.
• It is more palatable when chilled.
• For best results, don't consume solid food for 3 to 4 hours before drinking the solution; in no case should solid food be consumed within 2 hours of taking this medication.
• Continue drinking until the watery stool is clear and free of solid matter; this normally requires consuming 3 to 4 liters.
• Rapid drinking of each portion is better than drinking small amounts continuously.
• The first bowel movement occurs about 1 hour after starting this medication.
• If severe discomfort or distension occurs, stop drinking temporarily or drink each portion at longer intervals until the symptoms disappear.
• Oral medications taken within 1 hour of starting this medication may be flushed from the gastrointestinal tract and not absorbed.
• After the medication is taken, only clear liquids should be consumed. Avoid red and purple clear liquids.
• Discard any unused medication.