Description and Brand Names

Drug information provided by: Micromedex

US Brand Name

  1. Prepopik

Descriptions


Citric acid, magnesium oxide, and sodium picosulfate combination is used to cleanse the colon (bowel) in preparation for a procedure called colonoscopy. This medicine is a laxative. It works by causing you to have diarrhea to clean your colon. Cleaning your colon will help your doctor see the inside of your colon more clearly during colonoscopy.

This medicine is available only with your doctor's prescription.

This product is available in the following dosage forms:

  • Powder for Solution

Before Using

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of Prepopik™ in the pediatric population. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of Prepopik™ in the elderly.

Pregnancy

Information about this sodium-picosulfate-magnesium-and-citric-acid-oral-route
Pregnancy Category Explanation
All Trimesters B Animal studies have revealed no evidence of harm to the fetus, however, there are no adequate studies in pregnant women OR animal studies have shown an adverse effect, but adequate studies in pregnant women have failed to demonstrate a risk to the fetus.

Breastfeeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Drug Interactions

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Dabrafenib
  • Eltrombopag
  • Elvitegravir
  • Ketoconazole
  • Levomethadyl
  • Licorice
  • Mycophenolate Mofetil
  • Mycophenolic Acid
  • Phenytoin
  • Ponatinib
  • Raltegravir
  • Rilpivirine
  • Vismodegib

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Amprenavir
  • Atevirdine
  • Cefditoren Pivoxil
  • Chloroquine
  • Chlortetracycline
  • Cholic Acid
  • Ciprofloxacin
  • Dasatinib
  • Delavirdine
  • Demeclocycline
  • Dicumarol
  • Digoxin
  • Dolutegravir
  • Doxycycline
  • Enoxacin
  • Erlotinib
  • Felodipine
  • Fexofenadine
  • Gabapentin
  • Gemifloxacin
  • Grepafloxacin
  • Isradipine
  • Levofloxacin
  • Levothyroxine
  • Lomefloxacin
  • Methacycline
  • Minocycline
  • Moxifloxacin
  • Nicardipine
  • Norfloxacin
  • Oxytetracycline
  • Pefloxacin
  • Potassium Phosphate
  • Potassium Phosphate, Dibasic
  • Potassium Phosphate, Monobasic
  • Quinidine
  • Rolitetracycline
  • Sodium Phosphate
  • Sodium Phosphate, Dibasic
  • Sodium Phosphate, Monobasic
  • Sodium Polystyrene Sulfonate
  • Sparfloxacin
  • Tacrolimus
  • Tetracycline
  • Ticlopidine
  • Tipranavir
  • Zalcitabine

Other Interactions

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Angina (severe chest pain), unstable or
  • Electrolyte imbalance (e.g., low calcium, magnesium, potassium, sodium in the blood) or
  • Fluid imbalance or
  • Heart attack, recent or
  • Heart disease (e.g., cardiomyopathy) or
  • Heart rhythm problems (e.g., prolonged QT, uncontrolled arrhythmia), history of or
  • Withdrawal from alcohol or benzodiazepines (e.g., alprazolam, clonazepam, diazepam, lorazepam, Xanax®)—May increase risk for seizures, arrhythmia, or kidney problems.
  • Congestive heart failure or
  • Dehydration or
  • Inflammatory bowel disease or
  • Kidney problems or
  • Seizures, history of or
  • Trouble swallowing or
  • Ulcerative colitis, active and severe—Use with caution. May make these conditions worse.
  • Gastric retention (problems with emptying of food or fluid from the stomach) or
  • Intestinal problems (e.g., blockage, perforation) or
  • Kidney disease, severe or
  • Toxic megacolon (a very dilated intestine)—Should not be used in patients with these conditions.
  • Kidney disease—Use with caution. The effects may be increased because of slower removal of the medicine from the body.

Proper Use

Take this medicine exactly as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. To do so may increase the chance of side effects.

This medicine comes with a Medication Guide and patient instructions. You must read, understand, and follow these instructions carefully. Ask your doctor if you have any questions.

You may take this medicine in two dosing regimens: Split-Dose dosing regimen and Day-Before dosing regimen. Your doctor will tell you how to take this medicine depending on your colonoscopy schedule, distance traveled, and other personal circumstances.

To use this medicine:

  • One dose of this medicine consists of two packets of powder, each packet is mixed with cold water and taken at separate dosing times. Drink the liquid right away after mixing. Do not prepare the solution in advance.
  • Do not take the powder directly without mixing it with cold water. Doing so, may increase risk of side effects.
  • Use the supplied medicine cup when preparing the solution.
  • Drink the additional prescribed amount of clear fluids (e.g., water, apple juice, white cranberry juice, white grape juice, or ginger ale) after every dose of this medicine to prevent dehydration.
  • Do not eat solid foods or drink milk while taking this medicine.
  • Drink clear liquids until your colonoscopy.

Avoid taking other laxatives while you are taking this medicine.

Avoid taking any medicine by mouth within 1 hour before taking Prepopik™. Oral medicines may not be absorbed completely.

If you are taking chlorpromazine (Thorazine®), digoxin (Lanoxin®), penicillamine (Cuprimine®, Depen®), iron supplements, and certain antibiotics (such as ciprofloxacin, doxycycline, minocycline, tetracycline, Avelox®, Levaquin®, Vigamox®), take these medicines at least 2 hours before starting Prepopik™ and 6 hours after taking Prepopik™.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage form (powder for solution):
    • For cleansing of the colon:
      • Adults—Your doctor will prescribe your dosing regimen to be taken the day or night before your colonoscopy.
        • Split-dose dosing regimen: Take your first packet the night before colonoscopy, and the second dose the next day, in the morning or at least 5 hours before your colonoscopy.
        • Day-Before dosing regimen: Take your first packet in the afternoon or early evening, and the second dose at least 6 hours after the first dose, the night before colonoscopy.
      • Children—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions

It is important that your doctor check you closely for any problems or unwanted effects that may be caused by this medicine. Blood and urine tests may be needed to check for unwanted effects.

Contact your doctor right away if you have decreased urination, dizziness, headache, or vomiting. These could be symptoms of a loss of too much body fluid (dehydration).

If you have severe bloating, distension, or abdominal or stomach pain after taking the first packet of Prepopik™, stop taking this medicine or delay taking the second dose until your symptoms improve.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

Incidence not known

  1. Bloody stools
  2. confusion
  3. convulsions
  4. decreased urine output
  5. dizziness or fainting
  6. dry mouth
  7. fast, slow, or irregular heartbeat
  8. fever
  9. headache
  10. hives, itching or skin rash
  11. jerking or shaking of the muscles
  12. joint pain, stiffness, or swelling
  13. muscle pain or cramps
  14. numbness or tingling in the hands, feet, or lips
  15. pinpoint red or purple spots on the skin
  16. shortness of breath
  17. swelling of the eyelids, face, lips, ankles, hands, or feet
  18. tightness in the chest
  19. troubled breathing or swallowing
  20. unusual tiredness or weakness

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

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