Ascorbic Acid (as-KORE-bik AS-id), Polyethylene Glycol 3350 (pol-ee-ETH-i-leen GLYE-kol 3350), Potassium Chloride (poe-TAS-ee-um KLOR-ide), Sodium Ascorbate (SOE-dee-um a-SKOR-bate), Sodium Chloride (SOE-dee-um KLOR-ide), Sodium Sulfate (SOE-dee-um SUL-fate)

Helps cleanse the bowels before a colonoscopy. This medicine is a laxative.

Brand Name(s):

When This Medicine Should Not Be Used:

How to Use This Medicine:

Liquid

• Your doctor will tell you how much medicine to use. Do not use more than directed.
• To prepare the mixture:
  • Empty the contents of the packet (Dose 1) into the mixing container.
  • Add at least 16 ounces (oz) of water to the fill line. Do not add any other liquids or starch-based thickeners to the medicine.
  • Mix with a spoon or put the lid on the container and shake for about 2 to 3 minutes until the mixture is completely dissolved.
  • Drink the mixture within 30 minutes.
  • Rinse the mixing container with water and refill it with clear liquids (16 oz) within 30 minutes.
  • For Dose 2, repeat the steps for Dose 1, but you should empty the contents of the two dose pouches (A and B) into the mixing container at the same time.
• Your doctor will tell you how to use this medicine, either by One-Day Morning Dosing or Two-Day Split Dosing.
  • One-Day Morning Dosing:
    • Take the first dose the morning of your colonoscopy (between 3 AM and 7 AM), then the second dose about 2 hours after.
    • You may eat a light breakfast and lunch one day before the procedure. You may also have clear broth soup or plain yogurt for dinner (about 8 PM). You should not eat the morning of your colonoscopy.
  • Two-Day Split Dosing:
    • Take the first dose in the evening (between 4 PM and 8 PM), then the second dose 12 hours after. You should have taken the second dose at least 2 hours before your colonoscopy.
    • You may eat a light breakfast and lunch one day before the procedure. You should finish eating your lunch at least 3 hours before you start using this medicine.
• Drink extra fluids before, during, and after you use this medicine to help replace the fluids that will be lost during your bowel movement.
• You should only drink clear liquids (including water) before, during, and after you take this medicine, and until 2 hours before your colonoscopy. Also, do not drink alcohol or milk, or eat anything red or purple or foods containing pulp. Do not eat solid food while using this medicine and until after your colonoscopy.
• You should have your first loose stool or mild diarrhea about 1 to 2 hours after you drink the medicine. This is how the medicine cleans out your bowels. You may feel bloated or have stomach discomfort after your first dose of this medicine. You may stop taking it for a short time or wait before taking another dose. If your symptoms get worse, check with your doctor.
• This medicine should come with a Medication Guide. Ask your pharmacist for a copy if you do not have one.
• Missed dose: Take a dose as soon as you remember. If it is almost time for your next dose, wait until then and take a regular dose. Do not take extra medicine to make up for a missed dose.
• You may store the unopened medicine and the oral liquid at room temperature or in the refrigerator. You may use this medicine within 6 hours after mixing it with water. Throw away any unused oral liquid after 6 hours.

Drugs and Foods to Avoid:

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Do not take other laxatives (including bisacodyl, sodium picosulfate) while you are using this medicine. If you take other medicines, take them at least 1 hour before you start this medicine.
• Some foods and medicines can affect how polyethylene glycol 3350/sodium ascorbate/sodium sulfate/ascorbic acid/sodium chloride/potassium chloride works. Tell your doctor if you are using any of the following:
  • Blood pressure medicine (including ACE inhibitors, ARBs)
  • Diuretic (water pill)
  • Medicine to treat depression (including TCAs)
  • NSAID pain or arthritis medicine (including aspirin, celecoxib, diclofenac, ibuprofen, naproxen)
  • Starch-based thickeners
• Do not drink alcohol while you are using this medicine.

Warnings While Using This Medicine:

• Tell your doctor if you are pregnant or breastfeeding, or if you have kidney disease, heart disease, a recent heart attack, angina (chest pain), heart failure, trouble swallowing, G6PD, pheylketonuria, stomach or bowel problems (including inflammatory bowel disease, ulcerative colitis), or a history of seizures or heart rhythm problems (including arrhythmia, QT prolongation).
• This medicine may cause the following problems:
  • Heart rhythm problems
  • Seizures
  • Kidney problems
  • Stomach or bowel problems (including colitis, ulcers)
• This medicine may cause dehydration. Drink extra liquids before and after you take this medicine.
• Your doctor will do lab tests at regular visits to check on the effects of this medicine. Keep all appointments.
• Keep all medicine out of the reach of children. Never share your medicine with anyone.

Possible Side Effects While Using This Medicine:

Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Change in how much or how often you urinate, cloudy urine
• Chest pain, fast, pounding, or uneven heartbeat
• Confusion, weakness, muscle twitching
• Noisy breathing, chest discomfort, blue skin or nails
• Seizures
• Severe stomach pain, nausea, vomiting, bleeding from your anus
• Trouble swallowing, gagging

If you notice these less serious side effects, talk with your doctor:

• Nausea, vomiting, stomach discomfort

If you notice other side effects that you think are caused by this medicine, tell your doctor

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088