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Clenpiq (Generic Sodium Picosulfate, Magnesium Oxide, and Anhydrous Citric Acid)

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Why is this medication prescribed?

In order to give the doctor a clear view of the colon walls during a colonoscopy, which is an examination of the inside of the colon to look for colon cancer and other abnormalities, sodium picosulfate, magnesium oxide, and anhydrous citric acid are used in adults and children 9 years of age and older. The pharmaceutical sodium picosulfate belongs to the group of drugs known as stimulant laxatives. A drug known as magnesium citrate is created by combining magnesium oxide and anhydrous citric acid. Osmotic laxatives are a group of drugs that include magnesium citrate. These drugs function by generating watery diarrhea, which allows the colon to empty of the stool.

How should this medicine be used?

As a powder (Prepopik®) to combine with water and as a solution (liquid) to take orally, sodium picosulfate, magnesium oxide, and anhydrous citric acid are available. For colonoscopies, it is typically administered in two doses. The first dose is often given the evening before the colonoscopy, and the second dose is typically taken the morning of the procedure. The medicine may also be administered in two doses the day before the colonoscopy, with the first dose being taken in the late afternoon or early evening prior to the colonoscopy and the second dose being taken six hours later. The exact time that you should take your prescription will be specified by your doctor. If there is anything you do not understand about the instructions on your prescription label, contact your doctor or pharmacist to clarify it. Follow the manufacturer’s instructions for using the combination of magnesium oxide, sodium picosulfate, and anhydrous citric acid. Use it only as directed by your doctor, neither more nor less than that amount or more frequently.

You must start abstaining from solid meals and milk the day before your colonoscopy in order to get ready for the procedure. At this period, you should only consume clear drinks. Water, light-colored fruit juices without pulp, clear broth, coffee or tea without milk, flavored gelatin, popsicles, and soft drinks are examples of clear liquids. Avoid consuming alcoholic beverages and any red or purple liquids. If you have any concerns about what liquids you may consume prior to your colonoscopy, ask your doctor.

You must mix the pharmaceutical powder (Prepopik®) with cold water just before taking it if you’re taking it as a powder. There is a higher likelihood that you will encounter unpleasant or hazardous side effects if you ingest the powder without first combining it with water. Fill the dosing cup that was included with the drug with cold water until it reaches the lower line (5 ounces, 150 mL), which is marked on the cup, to prepare each dose. One packet of sodium picosulfate, one packet of magnesium oxide, and one packet of powdered anhydrous citric acid should be added. Stir for two to three minutes to fully dissolve the powder. As the powder dissolves, the mixture could get a little heated. Immediately consume the entire combination. Do not prepare the drug and water mixture in advance; simply combine them when you are ready to take the medication.

Drink the full contents of one bottle of sodium picosulfate, magnesium oxide, and anhydrous citric acid solution immediately from the bottle for each dose you are to take if you are taking the solution (Clenpiq®). The ready-to-drink mixture of sodium picosulfate, magnesium oxide, and anhydrous citric acid should not be combined with any other liquids before use.

You should take your first dose of the medication between 5:00 and 9:00 p.m. on the evening before your colonoscopy if you are taking it both the night before and the morning of the procedure. You must have five 8-ounce (240 mL) glasses of clear liquid within the following five hours before going to bed after taking this dose. The next morning, about 5 hours prior to your colonoscopy appointment, you will take your second dose. Within the following five hours after taking the second dose, you must have three 8-ounce glasses of clear liquid, but you must finish them all at least two hours before your colonoscopy.

You should take your first dosage of the medication between 4:00 and 6:00 p.m. on the evening before your colonoscopy if you are taking both doses the day before. You must have five 8-ounce glasses of clear liquid within five hours of taking this dose. Your second dose will be administered between 10:00 p.m. and 12:00 a.m., six hours later. You must have three 8-ounce glasses of clear liquid within five hours of taking the second dose.

During your treatment, it’s crucial that you consume the recommended amounts of clear liquid to replenish the fluid your body will lose when your colon is emptied. To measure your 8-ounce servings of fluids, fill the dosage cup that came with your medication all the way to the top. If you select a variety of distinct clear liquid drinks, you can find it simpler to consume the entire amount of liquid.

Throughout your treatment with the sodium picosulfate, magnesium oxide, and anhydrous citric acid combination, you will experience frequent bowel movements. From the moment you take your first dose of the medication until the day of your colonoscopy appointment, make sure to stay close to a bathroom. Inquire with your doctor about any comfort measures you can use at this time.

After taking the first dose of this medication, if you suffer extreme bloating or stomach pain, wait until these symptoms subside before taking the second dose.

When you start treatment with sodium picosulfate, magnesium oxide, and anhydrous citric acid, your doctor or pharmacist will give you the manufacturer’s patient information leaflet (Medication Guide). If you have any questions, carefully read the material and contact your doctor or pharmacist. The Medication Guide is also available on the manufacturer’s website or the Food and Drug Administration (FDA) website.

Other uses for this medicine

Ask your doctor or pharmacist for more details if you believe this drug should be used for something else.

What special precautions should I follow?

Before taking sodium picosulfate, magnesium oxide, and anhydrous citric acid,

  • If you have any allergies to any of the ingredients in sodium picosulfate, magnesium oxide, or anhydrous citric acid powder or solution, let your doctor and pharmacist know right away. You should also let them know if you are taking any other drugs. For a list of the ingredients, consult the Medication Guide or speak with your pharmacist.
  • Inform your doctor and pharmacist about any vitamins, nutritional supplements, herbal items, and prescription and over-the-counter medicines you are now taking or intend to take. Any of the following should be mentioned: amitriptyline; alprazolam (Xanax); amiodarone (Cordarone, Pacerone); ACEIs, or angiotensin converting enzyme inhibitors, include benazepril (Lotensin, in Lotrel), captopril, enalapril (Epanid, Vasotec, in Vaseretic), fosinopril, lisinopril (Prinivil, Qbrelis, Zestril, in Zestoretic), moexipril, perindopril (Aceon, in Prestalia), candesartan (Atacand), eprosartan (Teveten), irbesartan (Avapro, in Avalide), losartan (Cozaar, in Hyzaar), olmesartan (Benicar, in Azor and Tribenzor), telmisartan (Micardis, in Micardis HCT and Twynsta), or valsartan (Diovan, in Byvalson, Diovan HCT, aspirin, other NSAIDs including ibuprofen (Advil, Motrin, and others) and naproxen (Aleve, Naprosyn, and others), desipramine (Norpramin), diazepam (Diastat, Valium), disopyramide (Norpace), diuretics (water pills), and dofetilide (Tikosyn); drugs for seizures, erythromycin (E.E.S., Erythrocin), estazolam, flurazepam, lorazepam (Ativan), pimozide (Orap), quinidine (Quinidex, in Nuedexta), sotalol (Betapace, Betapace AF, Sorine), thioridazine, or triazolam. Additionally let your doctor know whether you are currently taking or recently stopped taking antibiotics. Your physician might need to adjust the dosage of your drugs or keep a close eye on you for side effects. Magnesium oxide, anhydrous citric acid, and sodium picosulfate may all interact with other medicines, so be sure to tell your doctor about all of the drugs you’re taking, even if they don’t appear on this list.
  • Throughout your therapy with sodium picosulfate, magnesium oxide, and anhydrous citric acid, do not use any additional laxatives.
  • Take any oral drugs at least an hour before taking sodium picosulfate, magnesium oxide, and anhydrous citric acid if you are taking any oral medications. Sodium picosulfate, magnesium oxide, and anhydrous citric acid should be taken 2 hours prior to or 6 hours after any of the following medications, if you are taking any of them: Digoxin (Lanoxin), chlorpromazine, tetracycline, iron supplements, penicillamine (Cuprimine, Depen), and fluoroquinolone antibiotics such ciprofloxacin (Cipro), delafloxacin (Bexdela), gemifloxacin (Factive), levofloxacin, and moxifloxacin (Avelox).
  • Inform your doctor if you have or have ever had kidney disease, a condition that prevents food and liquids from being normally emptied from the stomach, a blockage in your stomach or intestine, an opening in the wall of your stomach or intestine, toxic megacolon (a life-threatening widening of the intestine), or any other of these conditions. Your doctor could advise against taking magnesium oxide, anhydrous citric acid, and sodium picosulfate.
  • If you have been consuming excessive amounts of alcohol or using drugs for seizures or anxiety and are suddenly cutting back, let your doctor know. Additionally, inform your doctor if you have or have ever had heart failure, an irregular heartbeat, an enlarged heart, a prolonged QT interval (a rare heart issue that can result in an irregular heartbeat, fainting, or sudden death), seizures, a low sodium level in your blood, inflammatory bowel disease (conditions like Crohn’s disease, in which the body attacks the lining of the digestive tract, and others), an irregular heartbeat, an irregular heartbeat, an irregular heartbeat, an irregular heartbeat, resulting in inflammation and ulcers in the lining of the colon (large intestine) and rectum that cause swelling and irritation in all or part of the intestines, ulcerative colitis (a condition that causes discomfort, diarrhea, weight loss, and fever), difficulties swallowing, or gastric reflux.
  • Inform your physician if you are nursing a baby, intend to get pregnant, or are already pregnant.

What special dietary instructions should I follow?

Before, during, and after your treatment with sodium picosulfate, magnesium oxide, and anhydrous citric acid, your doctor will advise you on what you can eat and drink. Pay close attention to these guidelines.

What should I do if I forget a dose?

If you forget to take this medication as prescribed or are unable to do so, contact your doctor right once.

What side effects can this medication cause?

Magnesium oxide, sodium picosulfate, and anhydrous citric acid could all have negative effects. If any of these symptoms are severe or do not go away, let your doctor know right once:

  • Nausea
  • Stomach cramps, discomfort, or feeling full
  • Bloating
  • Headache

Some adverse effects may be severe. Call your doctor right away or seek emergency medical attention if you have any of these symptoms:

  • Vomiting, particularly if you find it difficult to consume the fluids you need for your treatment.
  • Dizziness
  • Fainting
  • Trembling, perspiration, hunger, irritability, or anxiousness, especially in kids
  • Up to 7 days following the treatment, there may be variations in heart rate and blood pressure.
  • Dead person urinating
  • Bloody or black and tarry stools
  • Blood on the rectum
  • Seizures
  • Unsteady heartbeat
  • Rash
  • Hives

Further negative effects could be brought on by sodium picosulfate, magnesium oxide, and anhydrous citric acid. If you have any strange side effects while taking this medicine, contact your doctor right once.

You or your doctor can submit a report to the Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting program online or by phone if you have a serious side event.

What should I know about storage and disposal of this medication?

Keep this medication tightly closed in the original container and out of the reach of children. Keep it away from excessive heat and moisture at room temperature.

Unused prescriptions must be disposed of carefully to prevent pets, kids, and other people from ingesting them. You should not, however, dispose of this medication in the toilet. Instead, utilizing a medicine take-back program is the easiest approach to get rid of your medication. To find out about take-back programs in your area, speak with your pharmacist or the garbage/recycling department in your city. If you do not have access to a take-back program, see the FDA’s Safe Disposal of Medications website at for additional information.

Although many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and are simple for young children to open, it is crucial to keep all medications out of sight and out of reach of children. Always lock safety caps and promptly stash medication up and away from young children where it is out of their sight and reach to prevent poisoning.

In case of emergency/overdose

Call the poison control hotline at 1-800-222-1222 in the event of an overdose. Moreover, information can be found online at Call 911 right once if the person has collapsed, experienced a seizure, is having difficulty breathing, or cannot be roused.

What other information should I know?

Keep all of your appointments with your physician and the lab. To determine how your body reacts to magnesium oxide, anhydrous citric acid, and sodium picosulfate, your doctor may prescribe certain lab tests.

No one else should take your medication.

You should keep a written record of every medication you take, including any over-the-counter (OTC) items, prescription drugs, and dietary supplements like vitamins and minerals. This list should be brought with you whenever you see a doctor or are admitted to the hospital. You should always have this information with you in case of emergencies.

Brand names

  • Clenpiq®
  • Prepopik®
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