Before a colonoscopy (an examination of the inside of the colon to check for colon cancer and other abnormalities) or barium enema (a test in which the colon is filled with a fluid and then x-rays are taken), the colon (large intestine, bowel) is emptied with polyethylene glycol-electrolyte solution (PEG-ES) so that the doctor will have a clear view of the walls of the colon. Osmotic laxatives are a class of drugs that includes PEG-ES. To allow the colon to empty of the stool, it causes watery diarrhoea. Electrolytes are also included in the prescription to guard against dehydration and other harmful side effects that could result from fluid loss during colon emptying.

Polyethylene glycol-electrolyte solution (PEG-ES) comes as a powder to mix with water and take by mouth. Certain PEG-ES products may also be given through a nasogastric tube (NG tube; a tube that is used to carry liquid nutrition and medication through the nose to the stomach for people who cannot eat enough food by mouth). It is usually taken the evening before and/or the morning of the procedure. Your doctor will tell you when you should begin taking PEG-ES, and whether you should take all of the medication at one time or take it as two separate doses. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take PEG-ES exactly as directed. Do not take more or less of it than prescribed by your doctor.

You are not allowed to consume any solid foods or milk before or during your PEG-ES treatment. Only drink clear liquids, please. Your doctor will advise you when to start the clear liquid diet and can address any queries you may have regarding the acceptable liquids. Water, light-colored fruit juice without pulp, clear broth, coffee or tea without milk, flavoured gelatin, popsicles, and soft drinks are a few examples of clear liquids. Any red or purple liquid should not be consumed. To lessen the possibility that you will become dehydrated when your colon is being emptied, you will need to consume a particular number of clear liquids throughout your treatment. If you have difficulties getting enough clear liquids while undergoing treatment, let your doctor know.

To make your prescription suitable to consume, you will need to combine it with lukewarm water. To find out how much water to add to the powder and whether you should mix it in the container it came in or in another container, read the instructions that come with your prescription. Be sure to shake or stir the liquid after each step to ensure that the medication is thoroughly incorporated. If your prescription is packaged with flavour packets, you may add the ingredients from one packet to the medication to enhance flavour, but you should not add any additional flavourings. Do not attempt to ingest the prescription powder without first mixing it with water, and only mix your medication with water. To make your prescription simpler to consume after mixing, you can chill it in the refrigerator. But, you shouldn’t chill the medication if you plan to give it to a baby.

To take PEG-ES, your doctor will precisely instruct you. Typically, you will be instructed to consume one 8 ounce (240 mL) glass of PEG-ES every 10 to 15 minutes, and to keep drinking until your liquid stools are clear and devoid of solids. Each pharmaceutical glass should be sipped swiftly rather than slowly for best results. In order to complete this treatment, throw away any unused medication.

Throughout your PEG-ES treatment, 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.

While taking your medication, stomach aches and bloating are possible. If these sensations worsen, sip each prescription glass carefully or space out your medication use by additional time. If these symptoms do not go away, contact your doctor.

When you start therapy with this drug, your doctor or pharmacist will give you the manufacturer’s patient information leaflet (Medication Guide), if one is available for the brand of PEG-ES you’re taking. 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.

Before taking PEG-ES,

• If you have an allergy to PEG-ES, any other medications, or any of the substances in the PEG-ES product you are taking, let your doctor and pharmacist know right away. For a list of the ingredients, consult your pharmacist or look in the patient’s information provided by the manufacturer.
• 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); benazepril, captopril, enalapril, lisinopril, moexipril, perindopril (Aceon, in Prestalia), quinapril (Accupril, in Accuretic, Quinaretic), ramipril (Altace), and trandolapril (in Tarka) are examples of ACE inhibitors. Benazepril is an ACE inhibitor; angiotensin II receptor antagonists, including candesartan (Atacand, in Atacand HCT), eprosartan (Teveten), irbesartan (Avapro, in Avalide), losartan (Cozaar, in Hyzaar), olmesartan (Benicar, in Azor and Tribenzor), telmisartan (Micardis, in Micardis HCT and Twynsta); aspirin, as well as other non-steroidal anti-inflammatory drugs such ibuprofen (Motrin, Naprosyn), naproxen (Aleve, Naprosyn), desipramine (Norpramin), diazepam (Diastat, Valium), disopyramide (Norpace), and diuretics (water pills); drugs for seizures, midazolam (Versed), moxifloxacin (Avelox), pimozide (Orap), quinidine (Quinidex, in Nuedexta), sotalol (Betapace, Betapace AF, Sorine), erythromycin (E.E.S., Erythrocin), estazolam, flurazepam, and lorazepam (Ativan); triazolam or thioridazine (Halcion). Your physician might need to adjust the dosage of your drugs or keep a close eye on you for side effects. Tell your doctor about all the medications you are taking, even any not on this list, as many other drugs may also interact with PEG-ES.
• Avoid using any other laxatives while receiving PEG-ES therapy.
• If you use any other oral drugs, take them at least an hour before starting your PEG-ES treatment.
• Inform your doctor if you have any conditions that prevent your stomach or intestines from emptying properly, such as an obstruction in your intestine, a hole in the lining of your stomach or intestine, toxic megacolon (a significant or life-threatening expansion of the intestine), or any of the above. Very likely, your doctor will advise against taking PEG-ES.
• Inform your doctor if you currently have or have ever had any of the following conditions: irregular heartbeat, prolonged QT interval (inherited condition that may cause irregular heartbeat, fainting, or sudden death), recent heart attack, chest pain, heart failure, an enlarged heart, seizures, acid reflux, trouble swallowing, inflammatory bowel disease (conditions that cause swelling of the lining of the intestine), such as ulcerative colitis (condition that causes swelling and sores in the lining). If you intend to take PEG-ES under the Moviprep® or Plenvu® brands, let your doctor know if you have phenylketonuria (PKU; an inherited condition in which a special diet must be followed to prevent damage to your brain that can cause severe intellectual disability).
• Inform your physician if you are nursing a baby, intend to get pregnant, or are already pregnant.

Before, during, and after your PEG-ES treatment, your doctor will advise you on what you can eat and drink. Carefully follow these instructions.

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

PEG-ES could 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
• Rectal irritation
• Weakness
• Heartburn
• Thirst
• Hunger
• Chills

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

• Rash
• Hives
• Itching
• Eyes, face, lips, tongue, arms, hands, feet, ankles, or lower legs swelling
• Breathing or swallowing challenges
• Vomiting
• Dizziness
• Headache
• Less urinations
• Unsteady heartbeat
• Seizures
• Blood on the rectum

You or your doctor can submit a report to the Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting programme online or by phone if you have a serious side event (1-800-332-1088).

Keep this medication tightly closed in the original container and out of the reach of children. The combined solution should be kept in the fridge. Use brand-name solutions from Colyte®, Nulytely®, or Trilyte® within 48 hours of mixing. Use the Moviprep® brand solution within 24 hours of mixing it. Use the Plenvu® brand solution within six hours of mixing it.

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, utilising a medicine take-back programme is the easiest approach to get rid of your medication. To find out about take-back programmes 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 programme, see the FDA’s Safe Disposal of Medications website at http://goo.gl/c4Rm4p 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. http://www.upandaway.org

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

Keep all of your appointments with your physician and the lab. To determine how your body is responding to PEG-ES, your doctor may request specific laboratory 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.