Sodium Picosulfate/Magnesium Oxide/Citric Acid, Oral

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KEY POINTS

• This medicine is taken by mouth to empty the colon for colon, rectal, and bowel examinations. Take it exactly as directed.
• This medicine may cause unwanted side effects. Tell your healthcare provider if you have any side effects that are serious, continue, or get worse.
• Tell all healthcare providers who treat you about all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take.

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What are other names for this medicine?

Type of medicine: bowel evacuant; bowel prep kit

Generic and brand names: sodium picosulfate/magnesium oxide/citric acid, oral; Prepopik

What is this medicine used for?

This medicine is taken by mouth to empty the colon for colon, rectal, and bowel examinations.

This medicine may be used to treat other conditions as determined by your healthcare provider.

What should my healthcare provider know before I take this medicine?

Tell your healthcare provider if you have ever had:

• An allergic reaction to any medicine
• A blockage in the intestines, Crohn's disease, ulcerative colitis, or severe constipation, bowel perforation, megacolon, or an overactive bowel
• Dehydration
• Heart attack, heart disease or irregular heartbeat
• Imbalances of calcium, magnesium, potassium, or sodium in your blood
• Kidney disease
• Seizures
• Trouble swallowing

Tell your provider if you have recently stopped taking anxiety medicine or stopped drinking alcohol.

Females of childbearing age: Tell your healthcare provider if you are pregnant or plan to become pregnant. Do not breast-feed while taking this medicine without your healthcare provider's approval.

How do I use it?

Check the label on the medicine for directions about your specific dose. Take this medicine as directed by your healthcare provider, or follow the directions on the package label. Do not take more or take it more often than directed.

Check with your healthcare provider before using this medicine in children under age 18.

This medicine is a powder and must be mixed with cold water right before you take it. Do not take it dry. Shake the solution well before each dose. You need to drink plenty of clear liquid while taking this medicine. Ask your provider how much liquid to drink the day that you take this medicine.

Do not take other laxative products such as enemas (Fleet Enema) or liquid laxatives such as Fleet Phospho-soda.

This medicine will cause you to have several watery bowel movements until you have only clear movements. Stay close to the bathroom after you take this medicine.

What if I overdose?

If you or anyone else has intentionally taken too much of this medicine, call 911 or go to the emergency room right away. If you pass out, have seizures, weakness or confusion, or have trouble breathing, call 911. If you think that you or anyone else may have taken too much of this medicine, call the poison control center. Do this even if there are no signs of discomfort or poisoning. The poison control center number is 800-222-1222.

Symptoms of an acute overdose may include: nausea, vomiting, diarrhea, stomach pain.

What should I watch out for?

If you have severe bloating or stomach pain while drinking the solution, slow down or stop drinking the solution until these symptoms go away. If the symptoms continue, or if you have severe nausea or vomiting, contact your healthcare provider.

If you need emergency care, surgery, lab tests, or dental work, tell the healthcare provider or dentist you are taking this medicine.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help.): Allergic reaction (hives; itching; rash; trouble breathing; tightness in your chest; swelling of your lips, tongue, and throat).

Serious (Report these to your healthcare provider right away.): Severe nausea and vomiting; severe dizziness or fainting; irregular heartbeat; severe stomach cramps or pain; severe bloating; rectal bleeding; trouble swallowing; urinating less than usual; severe headache; very dry mouth; seizures.

Other: dizziness, headache, itching, mild nausea, rectal irritation.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• ACE inhibitors such as benazepril (Lotensin), captopril, enalapril (Vasotec), fosinopril, lisinopril (Prinivil, Zestril), quinapril (Accupril), and ramipril (Altace)
• Angiotensin receptor blockers (ARBs) such as azilsartan (Edarbi), candesartan (Atacand), eprosartan (Teveten), irbesartan (Avapro), losartan (Cozaar), olmesartan (Benicar), telmisartan (Micardis), and valsartan (Diovan)
• Antacids that contain aluminum or magnesium, such as Gaviscon, Maalox, and Mylanta
• Antibiotics such as ciprofloxacin (Cipro), clarithromycin (Biaxin), demeclocycline, doxycycline (Doryx, Monodox, Vibramycin), erythromycin (E.E.S., Ery-Tab, Erythrocin), levofloxacin (Levaquin), moxifloxacin (Avelox), and tetracycline (Take these antibiotics at least 2 hours before or 6 hours after you take this medicine.)
• Antidepressants such as amitriptyline, citalopram (Celexa), clomipramine, desipramine, escitalopram (Lexapro), fluoxetine (Prozac), fluvoxamine (Luvox), imipramine (Tofranil), nortriptyline (Pamelor), and sertraline (Zoloft)
• Antipsychotic medicines such as haloperidol (Haldol), pimozide (Orap), risperidone (Risperdal), and thioridazine
• Antiseizure medicines such as carbamazepine (Carbatrol, Epitol, Equetro, Tegretol), oxcarbazepine (Trileptal), and valproic acid (Depacon, Depakene, Depakote)
• Chlorpromazine (take chlorpromazine at least 2 hours before or 6 hours after this medicine)
• Corticosteroids such as betamethasone, cortisone, dexamethasone, fludrocortisone, hydrocortisone (A-Hydrocort, Cortef), methylprednisolone (Medrol, Solu-Medrol), prednisolone (Omnipred, Orapred, Prelone), prednisone (Prednisone Intensol), and triamcinolone (Aristospan, Kenalog)
• Diuretics (water pills) such as amiloride, bumetanide, chlorothiazide (Diuril), furosemide (Lasix), hydrochlorothiazide (Microzide), spironolactone (Aldactone), torsemide (Demadex), and triamterene (Dyrenium)
• Doxepin (Silenor)
• Heart medicines such as amiodarone (Cordarone, Pacerone), digoxin (Lanoxin), disopyramide (Norpace), dofetilide (Tikosyn), dronedarone (Multaq), flecainide, procainamide, propafenone (Rythmol), and quinidine
• Iron supplements or multivitamins that contain iron, and iron medicines such as ferric carboxymaltose (Injectafer), ferric gluconate (Ferrlecit), ferumoxytol (Feraheme), and iron sucrose (Venofer) (Take iron 2 hours before or 6 hours after you take this medicine.)
• Nonsteroidal anti-inflammatory medicines (NSAIDs) such as celecoxib (Celebrex), diclofenac (Cambia, Voltaren, Zipsor), ibuprofen (Advil, Motrin), indomethacin (Indocin), ketoprofen, ketorolac, meloxicam (Mobic), nabumetone (Relafen), naproxen (Aleve, Anaprox, Naprelan), oxaprozin (Daypro), piroxicam (Feldene), and sulindac (Clinoril)
• Paroxetine (Brisdelle, Paxil, Pexeva)
• Penicillamine (Cuprimine, Depen) (Take 2 hours before or 6 hours after you take this medicine.)

Any other medicines (prescription, nonprescription, supplements, natural remedies, and vitamins) that you take within 2 hours of taking this medicine may not be properly absorbed. Ask your healthcare provider how and when to take any other medicines you may need.

If you are not sure if your medicines might interact, ask your pharmacist or healthcare provider. Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

How should I store this medicine?

Store this medicine at room temperature. Keep the container tightly closed. Protect it from heat, high humidity, and bright light.

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This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicine in the trash.

Keep all medicines out of the reach of children.

Do not share medicines with other people.