Citric acid, magnesium oxide, and sodium picosulfate is a combination medicine that causes diarrhea for the purpose of cleaning your colon before a colonoscopy. Cleaning the colon allows the inside of your colon to be seen more clearly on the colonoscopy.

citric acid, magnesium oxide, and sodium picosulfate is for use in adults and children at least 9 years old.

Citric acid, magnesium oxide, and sodium picosulfate may also be used for purposes not listed in this medication guide.

citric acid, magnesium oxide, and sodium picosulfate can cause severe dehydration, which can lead to a serious electrolyte imbalance, seizures, kidney failure, or abnormal heartbeats that can cause death.

The risk of dehydration is highest in people with heart problems or kidney disease, or if you take certain other medicines. Tell your doctor about all your current medicines and any you start or stop using.

Call your doctor if you are sick with vomiting and cannot drink enough water for your bowel prep, or if you have a headache, dizziness, or decreased urination.

Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed.

Read and carefully follow any Instructions for Use provided with your medicine. Ask your doctor or pharmacist if you do not understand these instructions.

It is especially important to follow all instructions about what to eat or drink in the days before your colon prep.

You must dilute the powder form of citric acid, magnesium oxide, and sodium picosulfate with 5 ounces of cold water before taking it.

The oral solution (liquid) may be taken without adding water.

Do not eat solid food once you start taking this medicine. Stop drinking all fluids at least 2 hours before the colonoscopy.

You will need to drink extra water once you start your colon prep. Drink only clear liquids and avoid alcohol, milk, or any drink that is red or purple.

This medicine can cause severe dehydration, which can lead to a serious electrolyte imbalance, seizures, kidney failure, or abnormal heartbeats that can cause death.

Call your doctor if you are sick with vomiting and cannot drink enough water for your bowel prep, or if you have a headache, dizziness, or decreased urination.

Store at room temperature, away from moisture and heat.

You should not use this medicine if you are allergic to citric acid, magnesium oxide, or sodium picosulfate, or if you have:

• kidney disease;

• a bowel obstruction, ileus, colitis or toxic megacolon;

• a dilated intestine;

• a perforation (a hole or tear) of your intestines; or

• slow digestion.

Tell your doctor if you have ever had:

• dehydration and an electrolyte imbalance (such as low levels of potassium, magnesium, or sodium in your blood);

• a stomach or intestinal disorder, including ulcerative colitis;

• gastroesophageal reflux disease (GERD);

• kidney problems;

• heart problems;

• a seizure;

• alcohol withdrawal; or

• if you have recently used a sedative like Valium or Xanax (diazepam, alprazolam, lorazepam, and others).

Tell your doctor if you are pregnant or breastfeeding.

Call your doctor if you cannot drink the entire amount of medicine and liquids as instructed in time for your colonoscopy.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose can cause severe dehydration (severe headache or dizziness, vomiting, being unable to urinate). An overdose is unlikely to occur if you take citric acid, magnesium oxide, and sodium picosulfate exactly as directed.

Do not take other laxatives during your colon prep.

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor right away if you have:

• a light-headed feeling, like you might pass out;

• confusion;

• irregular heartbeats;

• a seizure;

• little or no urination;

• severe nausea or vomiting;

• painful bloating, severe stomach cramps;

• rectal bleeding; or

• trouble swallowing, trouble drinking liquids.

Common side effects of citric acid, magnesium oxide, and sodium picosulfate may include:

• stomach pain;

• nausea, vomiting; or

• headache.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

citric acid, magnesium oxide, and sodium picosulfate can make it harder for your body to absorb other medicines you take by mouth within 1 hour before your colon prep.

If you take any of the following medicines, take them at least 2 hours before or not less than 6 hours after you take citric acid, magnesium oxide, and sodium picosulfate:

• chlorpromazine;

• digoxin;

• iron;

• penicillamine; o

• certain antibiotics, such as ciprofloxacin, doxycycline, levofloxacin, minocycline, moxifloxacin, norfloxacin, or tetracycline.

Tell your doctor about all your other medicines, especially:

• a laxative;

• a diuretic or "water pill";

• heart or blood pressure medication;

• medicine to treat a kidney problem;

• medicine to treat depression or mental illness;

• seizure medication; or

• NSAIDs (nonsteroidal anti-inflammatory drugs)--aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others.

This list is not complete. Other drugs may affect citric acid, magnesium oxide, and sodium picosulfate, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.