Suprep Bowel Prep Kit Oral: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing

Uses

Sodium/potassium/magnesium sulfate solution is used to clean out the intestines before a certain bowel exam procedure (colonoscopy). It is a laxative that works by drawing large amounts of water into the colon. This causes watery bowel movements. Clearing stool from the intestines helps your doctor to better examine the intestines during your procedure.

How to use Suprep

Read the Medication Guide and Instructions for Use provided by your pharmacist before you start using this product and each time you get a refill. If you have any questions, ask your doctor or pharmacist.

Follow any special diet instructions provided by your doctor. Usually, you may have a small breakfast or only clear liquids on the day before your procedure. After breakfast, you may only drink clear liquids until after your procedure. Do not drink milk or alcoholic beverages or eat/drink anything colored red or purple. To prevent becoming dehydrated, drink as much clear liquid as you can before, during, and after drinking this medication unless otherwise directed by your doctor.

Do not take any other medications by mouth within 1 hour of starting to drink the mixture. Ask your doctor or pharmacist if you are not sure when to take your other medications.

Use this product as directed by your doctor, usually one dose the evening before the colonoscopy and the second dose the next day in the morning. The dosage is based on your age and medical condition.

Before using this product, pour the contents into the mixing container as directed by the manufacturer. Add cool water, mix, and drink all of the mixture. After drinking the mixture, drink 2 additional containers filled with water over the next hour. Be sure to finish drinking all of the mixture and required water at least 2 hours before your procedure, or as directed.

Ask your doctor or pharmacist if you have any questions about how to mix or take this product or what to expect after taking this product.

Watery bowel movements usually begin about 1 hour after you drink the mixed liquid. The bowel movements can be very large and watery.

Side Effects

Very watery bowel movements are expected with this medication. Nausea, vomiting, bloating, or stomach/abdominal cramping may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.

Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

This medication can cause your body to lose too much fluid and salts (dehydration, electrolyte problems). Tell your doctor right away if you have any of these serious side effects: severe dizziness, fainting, fast/irregular heartbeat, trouble keeping liquids down, prolonged vomiting, headache, seizure.

Tell your doctor right away if you have any serious side effects, including: stomach/abdominal pain that is severe or doesn’t go away, signs of kidney problems (such as change in the amount of urine), bloody stools, rectal bleeding.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US – Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

In Canada – Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Precautions

Before taking this medication, tell your doctor or pharmacist if you have any allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: blocked intestines (gastrointestinal obstruction), hole in the intestines, severe ulcers/swelling of the colon (ulcerative colitis), severe infection in the intestines (such as toxic colitis, toxic megacolon), stomach/intestines that empty slowly or are not moving (gastric retention, ileus), trouble swallowing, trouble keeping food down (regurgitation), history of breathing food/other substances into the lungs (aspiration), gout, heart problems (such as irregular heartbeat, chest pain, heart failure), kidney problems, seizure, regular use of alcohol or other sedatives.

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.

It is unknown whether this drug passes into breast milk. Consult your doctor before breast-feeding.

Interactions

See also How to Use section.

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor’s approval.

Some products that may interact with this drug include drugs that can change the amount of water, sodium, or potassium in your body, such as: heart/blood pressure medications called ARBs (such as valsartan), heart/blood pressure medications called ACE inhibitors (such as captopril, enalapril), nonsteroidal anti-inflammatory drugs – NSAIDs (such as ibuprofen, naproxen), “water pills” such as thiazide diuretics.

Do not take/use other laxatives while taking this product.

Does Suprep interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose

If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.

Do not share this medication with others.

Lab tests (such as sodium, potassium levels) may be done before or after taking this medication. Keep all medical and lab appointments. Consult your doctor for more details.

If you are unable to drink all of the solution and water as directed, call your doctor right away. Your test may need to be rescheduled.

Store the unmixed container at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

Images

Suprep Bowel Prep Kit 17.5 gram-3.13 gram-1.6 gram oral solution

Color: colorlessShape: Imprint:

This medicine is a colorless, clear, berry, solution

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Selected from data included with permission and copyrighted by First Databank, Inc. This copyrighted material has been downloaded from a licensed data provider and is not for distribution, except as may be authorized by the applicable terms of use.

CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.

ASGE | Understanding Bowel Preparation

What bowel preparation steps are involved before the colonoscopy?

Your doctor will prescribe the type of bowel prep that is best for you. You will receive specific instructions. In general, here is what you can expect:

• Your doctor will prescribe the type of bowel prep that is best for you. You will receive specific instructions. In general, here is what you can expect:
• Your doctor will tell you to change your diet at least one day before your colonoscopy. Usually you will need to limit your diet to clear broth, tea, gelatin desserts, ginger ale, sherbet, and clear fruit juices (the ones you can see through), such
  as apple juice.
• You need to avoid gelatin desserts and liquids that are red or purple.
• It is important to avoid dehydration during bowel prep. Drink more fluids than you usually do.
• Your doctor will tell you exactly when to stop eating and drinking before your
  colonoscopy.
• Follow carefully all the steps your doctor prescribes. Can I continue to take my current medications? Tell your doctor what medications you’re taking, especially aspirin products, arthritis medications, anticoagulants (blood thinners such as
  warfarin or heparin), clopidogrel, insulin or iron products. Most medications can be continued. Some can interfere with either the prep or the colonoscopy.

Why is bowel prep important?

Many patients feel that the bowel prep is the most
difficult part of a colonoscopy. It is important that you
try your best to fully complete the prep. most difficult part of a colonoscopy. But it is After taking the entire bowel prep, you should be passing liquid that is watery or yellow and clear enough to see through. Your bowel must be clean so that your doctor can thoroughly examine your colon and not miss precancerous growths called polyps. If your colon is inadequately cleansed, your doctor may recommend repeating a colonoscopy sooner than if your colon had been properly cleansed

What are the types of bowel prep?

Several types of bowel prep medications are available. Your physician will recommend which prep you should take. You will need to carefully follow your doctor’s instructions about the exact dose and timing of your prep. Some types of prep may be covered by your medical insurance. You’ll want to find out if you have any out-of-pocket costs.

What determines the type of prep I get?

Your medical condition is the most important factor in deciding which type of bowel prep is best for you. It is best to share your complete medical history with your doctor. Also, tell your doctor if you are pregnant or breast feeding, or if you have a history of bowel obstruction. Let the doctor know if you have diabetes, high blood pressure, heart, kidney or liver disease, or if you have had any of these diseases in the past. You need to mention any allergies you have to medications to the doctor.

If you have had difficulty with a bowel prep in the past, be sure to mention this as well. Other factors in choosing the type of prep are the time of the colonoscopy appointment, individual preferences (taste and amount of medication), and out-of-pocket costs.

What if I forget to take the medication when I should, or remember too late to finish the prep?

Call your doctor and ask what to do if you are not able to complete the bowel prep as advised. The procedure might need to be canceled and rescheduled.

What are the common side effects of bowel prep?

You should expect to have multiple loose bowel movements with minimal discomfort while doing the prep. However, some people will have nausea, vomiting, bloating (swelling in the abdomen) or abdominal pain. Serious side effects are uncommon. Your doctor will explain the possible side effects of the prep selected for you.

Understanding Bowel Preparation Before Colonoscopy

It is extremely important that your colon be thoroughly cleaned before your colonoscopy. This will let the doctor see any abnormalities, such as colon polyps, during the procedure. Polyps are small growths in the colon that could later turn into cancer. Cleansing the colon before a colonoscopy is called bowel preparation, or “prep.” It involves taking medication that causes frequent, loose bowel movements to empty the colon. The medication is taken by mouth, and typically comes in liquid form. You will also need to change what you eat during the day or two before the colonoscopy. Most bowel preparations involve drinking some prep liquid at two different times. The best way to cleanse the colon is with a “split-dose” bowel preparation. This involves drinking the first portion of the liquid preparation the evening prior to the colonoscopy, and then drinking the second part of the liquid preparation on the day of the colonoscopy. If your colonoscopy is scheduled to start in the morning, you must wake up early in the morning on the day of the colonoscopy to drink the second part of the prep. This can be an inconvenience for some people, but it gives your doctor the best chance of finding polyps or cancers in your colon. Taking both portions of the bowel preparation the evening prior to the colonoscopy, instead of taking the second portion of the prep on the morning of your colonoscopy, is an alternative option for cleansing the bowel. However, studies have shown that taking at least half of the prep solution on the same day as the colonoscopy provides the best bowel cleansing, which improves your doctors ability to find polyps and cancers in your colon. You should not drink any liquids (not even prep solution) within 2-3 hours of your colonoscopy. It is important that you understand the prep instructions given to you by your doctor, which will provide instructions on when you should drink your bowel prep.

What are the common side effects of bowel prep?

You should expect to have multiple loose bowel movements with minimal discomfort while doing the prep. However, some people will have nausea, vomiting, bloating (swelling in the abdomen) or abdominal pain. Serious side effects are uncommon. Your doctor will explain the possible side effects of the prep selected for you.

IMPORTANT REMINDER:
This information is intended only to provide general guidance. It does not provide definitive medical advice. It is very important that you consult your doctor about your specific condition.

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Suprep Bowel Prep Kit (Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate) Side Effects, Warnings, Uses

• Generic Name: Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate
• Brand Name: Suprep Bowel Prep Kit

• Overview
• Professional Information
• Related Resources

Suprep Side Effects Center

Medical Editor: John P. Cunha, DO, FACOEP

Last viewed on RxList11/4/2018

Suprep Bowel Prep Kit (Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate) Oral Solution is an osmotic laxative indicated for colon cleansing in preparation for colonoscopy in adults. Common side effects of Suprep include:

• general discomfort,
• abdominal fullness,
• nausea,
• abdominal cramps,
• vomiting, and
• Headache.

Suprep Bowel Prep Kit is a two day divided dose regimen. The evening before your colonoscopy: dilute one bottle with water to a total of 16 ounces (up to the fill line) and drink the entire amount. Drink 32 ounces of water over the next hour. The next morning: Repeat both steps using the second bottle. Finish your preparations at least 2 hours before your colonoscopy, or as directed by your doctor. Oral medication given within one hour of starting each dose of Suprep Bowel Prep Kit may be washed out of the gastrointestinal tract and the medication may not be absorbed properly. Suprep may interact with medicines for blood pressure or heart problems, medicines for kidney problems, medicines for seizures, water tablets (diuretics), non-steroidal anti-inflammatory drugs (NSAIDs), and laxatives. Tell your doctor about all medications and supplements you are taking. Tell your doctor if you are pregnant before using the Suprep Bowel Prep Kit. It is not known if the components of the Suprep Bowel Prep Kit pass into breast milk. Consult your doctor before breastfeeding.

Our Suprep bowel preparation kit (sodium sulfate, potassium sulfate and magnesium sulfate) Oral Solution Drug and Side Effects Center provides a comprehensive overview of available drug information about potential side effects when taking this medication.

This is not a complete list of side effects and they may occur. Ask your doctor about side effects. You can report side effects to the FDA at 1-800-FDA-1088.

Consumer Information Suprep

Get emergency medical help if you have signs of an allergic reaction: hives; labored breathing; swelling of the face, lips, tongue, or throat.

Call your doctor right away if you have:

• headache or dizziness;
• little or no urination;
• severe nausea or vomiting;
• painful bloating or stomach cramps;
• problems with fluid intake;
• mouth ulcers;
• seizure;
• irregular heartbeat; or
• worsening of gout symptoms (joint pain, redness or swelling).

Common side effects may include:

• abdominal pain or discomfort;
• nausea, vomiting; or
• mild bloating.

This is not a complete list of side effects and they may occur. Ask your doctor about side effects. You can report side effects to the FDA at 1-800-FDA-1088.

Read the entire detailed patient monograph for Suprep (sodium sulfate, potassium sulfate and magnesium sulfate)

Learn more ‘ side effects reactions observed in clinical trials of a medicinal product cannot be directly compared with the frequency in clinical trials of another drug and may not reflect the rates observed in practice.

In a multicentre, controlled clinical trial comparing SUPREP Bowel Preparation Kit with Polyethylene Glycol and Electrolyte (PEG+E) Bowel Preparation administered in a split-dose regimen (2 days), the most common adverse reactions following SUPREP Preparation Kit bowel revealed general discomfort, bloating, abdominal pain, nausea, vomiting, and headache; see Table 1 below. Less common adverse reactions were atrioventricular block (1 case) and increased CC. In this study, patients treated with the SUPREP Bowel Prep Kit were limited to a light breakfast followed by clear liquids; Patients treated with PEG+E bowel preparation were allowed to eat a regular breakfast and a light lunch, followed by clear liquids.

Table 1. Treatment-induced adverse reactions observed in at least 2% of patients treated with a split-dose (2-day) regimen

901 26 33%

Table 2 shows the percentage of patients who developed new abnormalities in important electrolytes and uric acid after completing bowel preparation with the SUPREP Bowel Prep Bowel Prep Kit Kit or PEG + E administered on a split dose schedule (2 days).

Table 2: Patients with Normal Baseline Serum Chemistry with a Shift to Abnormal Value on the Split Dose (2 Day) Regimen

90 116 Copy for Colonos Day
p (%) *

9 0126 0 (0)

90 126 PEG + electrolytes

9 0114

		Day 30 p (%) *
Anion gap (high) and dagger;	SUPREP	14 (8.9)	3 (1.9)
	PEG + electrolytes	12 (7.6)	2 (1.4)
Bicarbonate (low)	SUPREP	20 (12.7) 4)
	PEG + electrolytes	24 (15.2)	4 (2.7)
Total bilirubin (high)	SUPREP	14 (8. 5)
	PEG + electrolytes	20 (11.7)	3 (1.9)
BUN (high)	SUPREP	2 (1.6)	14 (11.2)
	PEG + electrolyte s	4 (2.9)	19 (14.5 )
Calcium (high)	SUPREP	16 (10.4)	8 (5.2)
	6 (3.7)	6 (3 .9)
Chloride (high)	SUPREP	4 (2.4)	6 (3.7)
	PEG + electrolytes	20 (12. 2)	6 (3.8)
Creatinine (high)	SUPREP	3 (1.9)	5 (3.2)
	PEG + electrolytes	2 (1.2)	8 (5.2) )
Osmolality (high)	SUPREP	8 (5.8)	NA
	PEG + electrolytes	19 (12.9)	NA
Osmolality (low)	SUPREP	3 (2.2)	NA
	PEG + electrolytes	2 (1.4)	NA
Potassium (high)	SUPREP	3 (1. 8)	6 (3.7)
	PEG + electrolytes	5 (2, 9)	8 (4.9)
Sodium (low)	SUPREP	5 (3.1)	1 (0.6)
	PEG + electrolytes	4 (2.3)	2 (1.2)
Uric acid (high)	SUPREP	27 (23.5)	13 (11.5)
	PEG + electrolytes	12 (9.5)	20 (16, 7)
* Percentage (n/N) of patients, where N = number of patients with a normal baseline who had abnormal values ​​at the time points of interest. † Patients with normal bicarbonate levels at baseline who developed low bicarbonate (<21 meq/L) and high anion gap (<13 meq/L) on colonoscopy day or day 30.

Also, 408 patients participated in a study in which either SUPREP Bowel Prep Kit or PEG + E was administered only in the evening (day 1). Higher levels of general discomfort, bloating, and nausea were observed with evening-only use (Day 1) compared to the split-dose regimen (Day 2) for both drugs. Patients treated with SUPREP Bowel Prep Kit experienced an increased frequency of vomiting when taken only in the evening (Day 1). An evening-only (day 1) dosing regimen was associated with higher rates of abnormalities for some electrolytes compared with a two-dose (2-day) regimen for both drugs. For the SUPREP Bowel Prep Kit, an evening-only (Day 1) regimen was associated with higher total bilirubin (high), BUN (high), creatinine (high), osmolality (high), potassium (high), and uric acid. (high) than the SUPREP Bowel Prep Kit split dose regimen (2 days). It is not recommended to use SUPREP Bowel Prep Kit only in the evening (1 day).

Read all FDA prescribing information for Suprep (sodium sulfate, potassium sulfate, and magnesium sulfate)

Read More ‘ Related Resources for Suprep

Concomitant Drugs

• Sutab

Information Suprep patients are provided by Cerner Multum, Inc. , and Suprep Consumer information is provided by First Databank, Inc., used under license and subject to their respective copyrights.

instructions for use, dosage, composition, analogues, side effects / Pillintrip

WARNINGS

Included as part of PRECAUTIONS Section

PRECAUTIONS , during and after using the SUPREP Bowel Prep Kit.
If a patient develops significant vomiting or signs of dehydration after taking SUPREP Bowel Prep Kit,
consider post-colonoscopy laboratory tests (electrolytes, creatinine, and BUN). liquid and
Electrolyte disturbances can lead to serious side effects, including cardiac arrhythmias, seizures, and
kidney failure.

Patients with electrolyte disturbances should be corrected prior to treatment with SUPREP
Bowel preparation kit. Also, be careful when prescribing SUPREP Bowel Prep Kit for patients with
conditions or those using medications that increase the risk of fluid and electrolyte disturbances or
may increase the risk of side effects of seizures, arrhythmias, and kidney failure.

SUPREP Bowel Prep Kit may cause a temporary increase in uric acid. . Urik
acid fluctuations in patients with gout can cause an acute flare-up. Potential for uric acid
elevation should be considered before administering SUPREP Bowel Prep Kit to patients with gout or
other disorders of uric acid metabolism.

Cardiac arrhythmias

There have been rare reports of serious arrhythmias associated with the use of an ionic osmotic laxative.
bowel preparation products. Use caution when prescribing SUPREP Bowel Prep Kit to patients in
increased risk of arrhythmias (eg, patients with a history of long QT, uncontrolled arrhythmias
recent myocardial infarction, unstable angina, congestive heart failure, or cardiomyopathy). Predose
and post-colonoscopy ECG should be considered in patients at increased risk of major heart attack
arrhythmias.

Seizures

There have been reports of generalized tonic-clonic seizures and/or loss of consciousness associated
using bowel preparation products in patients without a previous history of seizures. Cases of confiscation
have been associated with electrolyte normality (for example, hyponatremia, hypokalemia, hypocalcemia, etc.
hypomagnesemia) and low serum osmolality. Neurological disorders are eliminated with correction
fluid and electrolyte abnormalities.

Use caution when prescribing SUPREP Bowel Prep Kit to patients with a history of seizures and
patients at increased risk of seizures, such as patients taking medications that lower the seizure threshold
(eg., tricyclic antidepressants), patients withdrawing from alcohol or benzodiazepines, or patients with
known or suspected hyponatremia.

Renal failure

Use caution when administering SUPREP Bowel Prep Kit to patients with impaired renal function or
patients taking concomitant medications that may affect kidney function (such as diuretics, angiotensin
conversion enzyme inhibitors, angiotensin receptor blockers, or non-steroidal anti-inflammatory drugs).
Educate these patients about the importance of adequate hydration and consider meeting baseline and
laboratory tests after colonoscopy (electrolytes, creatinine and BUN) in these patients.

Colonic mucosal ulcers and ischemic colitis

Administration of osmotic laxative products may lead to ulcerative disease of the colonic mucosa, and
there have been reports of more serious cases of ischemic colitis requiring hospitalization. Simultaneously
the use of stimulant laxatives and the SUPREP Bowel Prep Kit may increase these risks. Potential for
mucosal ulceration occurring during bowel preparation should be taken into account when interpreting
Colonoscopy findings in patients with known or suspected inflammatory bowel disease (IBD).

Use in patients with significant gastrointestinal disease

If gastrointestinal obstruction or perforation is suspected, perform appropriate diagnostic tests
rule out these conditions before administering the SUPREP Bowel Prep Kit.

Use with caution in patients with severe active ulcerative colitis.

Aspiration

Use with caution in patients with impaired gag reflex and patients prone to regurgitation or aspiration.
These patients should be monitored while taking SUPREP Bowel Prep Kit Solution.

Not for direct use

Each bottle must be diluted with water to a final volume of 16 oz and additional water swallowed
as recommended is important for patient tolerance. Direct ingestion of the undiluted solution may
increase the risk of nausea, vomiting, dehydration and electrolyte disturbances.

Patient Counseling Information

Patient Counseling

• Ask patients to tell you if they have trouble swallowing or are prone to regurgitation or
  pursuit.
• Instruct patients that each bottle must be diluted in water before ingestion and that they need
  drink extra water as instructed. Direct ingestion of the undiluted solution may
  increase the risk of nausea, vomiting and dehydration.
• Advise patients that oral medications may not be absorbed properly if taken within one hour
  start each dose of SUPREP Bowel Prep Kit.
• Tell patients not to take other laxatives while they are taking SUPREP Bowel Prep Kit.

Non-clinical toxicology

Carcinogenesis, mutagenesis, impaired fertility

Long-term animal studies have not been conducted to assess carcinogenic potential
SUPREP Bowel Prep Kit. Studies to evaluate possible impairment of fertility or mutagenic potential
SUPREP Bowel Prep Kit has not been completed.

Use in certain populations

Pregnancy

Teratogenic effects

Pregnancy Category C

Animal reproduction studies have not been conducted since
SUPREP Bowel Prep Kit. It is also unknown if SUPREP Bowel Prep Kit can cause harm to the fetus.
when administered to a pregnant woman or may affect fertility. SUPREP Bowel Prep Kit
should be given to a pregnant woman only when needed.

Nursing mothers

It is not known if this drug is excreted in breast milk. Because many drugs are excreted with a person
milk, caution should be exercised when SUPREP Bowel Prep Kit is administered to a nursing woman.