Sodum Picosulfate – Morning or afternoon appointment

Please also read any information provided by the manufacturer in the medicine leaflet package but follow these instructions for taking your bowel preparation.

What is SODIUM PICOSULFATE and how does it work?

SODIUM PICOSULFATE is a powder that makes a solution when mixed with water to cleanse your colon. It has a laxative action, clearing the bowel so that it is clean and empty. It is very important that you have a cleansed bowel for your procedure so that any abnormalities in your bowel can be seen by the nurse or doctor performing the procedure.

When should SODIUM PICOSULFATE not be used?

Do not take or use this medicine if you:

• are allergic to any of the ingredients;
• have been diagnosed by your doctor with a blockage of the bowel (this does not include constipation) or perforation (hole) in the bowel;
• have a stomach emptying disorder;
• have toxic mega-colon (a severe complication of colitis);
• have paralysis / loss of muscle action of the gut called ileus that results in a blockage of the intestine;
• have congestive heart failure;
• have a stomach ulcer;
• have recently been sick or feel sick;
• are very thirsty or think you may be severely dehydrated;
• have swollen abdomen / recent abdominal surgery;
• have been told by your doctor you have damaged muscles that are leaking their contents into your blood;
• have severe kidney problems / been told you have too much magnesium in your blood; and
• are suffering from an active flare of inflammatory bowel disease.

If you are not sure if you have any of the above conditions, please contact the Endoscopy pre-assessment nurse on the number below for advice.

Take with extra care and make sure your doctor or
pre-assessment nurse is aware:

• if you have recently had gastrointestinal surgery;
• if you have a medical condition affecting the heart or kidneys;
• if you have inflammatory disease (however, sodium picosulfate is commonly used in patients with these diseases);
• if you are using bulk forming laxatives e.g. bran;
• if you have low blood pressure;
• if you are on prescribed medication, especially if it is regularly prescribed e.g. contraceptives, antibiotics or anti-epileptics as their effects may be modified; and
• If you are on prescribed medication that may affect water and / or electrolyte balance e.g. water tablets, steroids, lithium, digoxin, antidepressants and carbamazepine.

Please ask your doctor or pre-assessment nurse on
0113 392 2585 for advice if you have any of the conditions lisred on page 4 and above, or in the manufacturer’s leaflet BEFORE you start to prepare for your procedure.

How should I take SODIUM PICOSULFATE?

TWO days before your procedure (unless specified)

Please avoid bread and biscuit products that contain seeds before you start to take your bowel preparation. Start having small, low-fibre meals (please refer to low fibre food table below).

Low fibre foods

•  White meat, skinless chicken, grilled or poached fish.
•  Clear soups, tea, coffee.
•  Shredless marmalade or jam.
•  White bead, white rice, pasta, boiled or mashed potatoes.
•  Butter / margarine.
•  Natural plain yoghurt.
•  Cheese, eggs, tofu.
•  Ice Cream, custard.

Unless your doctor or nurse tells you differently, start taking SODIUM PICOSULFATE on the day before your examination.

The day before your examination

From breakfast, you will begin the preparation for your test. Please follow the instructions on what you can eat and drink carefully. After breakfast, you will no longer be able to eat any solid food, milk or other dairy products.

Breakfast – 9 am

•  Tea or coffee (with milk and sweetener if required).

Choose one of the following:

•  30g crisped rice cereal or cornflakes with 100 mls milk.
• 2 slices of white bread / toast with a thin spread of butter / margarine and honey (if desired).
• 1 boiled / poached egg and 1 slice of unseeded white bread / toast with a thin spread of butter / margarine.
• 50g cottage or cream cheese and 1 slice white bread /toast with a thin spread of butter / margarine.

No solid food should be eaten after breakfast and continue having fluids.

Below is a list of things that you can have in unlimited quantities until 8 hours before your procedure and water ONLY until two hours before your procedure:

• Water
•  Tea / coffee WITHOUT milk.
•  Energy or fizzy drinks.
•  Oxo / Bovril.
•  Clear soup (make sure you sieve out any vegetables).
•  Clear jelly (not red or blackcurrant as this can reduce view of the bowel).

Dose One at 10 am

1. Open the box and remove 1 x sachet.
2. Pour the contents of 1 x sachet in a cup of cold tap water (about 150 mls) and stir for 2 – 3 minutes (the solution heats up so you should wait until it cools sufficiently before drinking it).
3. Drink solution until you have drunk it all with additional fluids to keep you hydrated and aid the bowel cleansing process.

Dose Two at 4 pm

1. Make up the second sachet of SODIUM PICOSULFATE and drink in the same way as described above.

REMEMBER – you can continue to drink fluids from the list given on page 7, until 8 hours before your procedure and ONLY water until 2 hours before your procedure.

After you drink SODIUM PICOSULFATE, you will have lots of watery bowel movements (like diarrhoea) 1 – 2 hours after starting your SODIUM PICOSULFATE. This is perfectly normal and shows that it is working.

It is advisable to stay near a toilet because you may need to use it urgently. You should drink plenty of fluids too as this helps to clear the bowel along with the preparations.

Response to SODIUM PICOSULFATE varies considerably with each person. If after taking SODIUM PICOSULFATE you do not have a bowel motion within 24 hours, please seek medical advice from the Endoscopy pre-assessment nurses on
0113 392 2585. If it is out of normal office hours, please seek advice from your GP or ring NHS helpline on 111.

Are there any side-effects?

Most medicines can cause side-effects. The manufacturers leaflet contains a list of the known side-effects. Everyone reacts differently to medicines.

You may have some side-effects or none at all. If you suffer from any of the following whilst taking the bowel preparation:

• difficulty breathing;
• swelling of your face, lips, tongue or throat; and
• hives (a raised itchy rash).

Stop taking SODIUM, PICOSULFATE and get emergency medical help by calling 999.

Will SODIUM PICOSULFATE affect any of my other medicines?

If you take any medicines, take them at least 2 hours before taking SODIUM PICOSULFATE or at least 6 hours afterwards. If you have any questions about medicines, please contact the pre-assessment nurses on 0113 392 2585.

Oral medications may not be absorbed when taking SODIUM PICOSULFATE. If you take any other medicines regularly and you have any questions, talk to your doctor, Endoscopy pre-assessment nurse or pharmacist before you take SODIUM PICOSULFATE.

Women: If you are taking oral contraceptives, their effectiveness may be reduced due to diarrhoea. You are advised to use additional precautions for the rest of your cycle.

Can I drink alcohol while I am taking SODIUM PICOSULFATE?

You should NOT drink alcohol whilst taking SODIUM PICOSULFATE.

Where should I store SODIUM PICOSULFATE at home?

Do not store above 25° C. Do not use this medicine after the expiry date, which is stated on the sachet after EXP.

It is important that all medicines are stored out of reach of children.

* If you are a diabetic, a separate instruction leaflet will be sent to you. This will help you understand how to take your diabetic medications during your bowel preparation. 

Please contact the Endoscopy pre-assessment team if you have any questions about taking your bowel preparation on 0113 392 2585.