Miralax-Sports Drink Bowel Preparation Instructions

What is MiraLAX® bowel preparation?

MiraLAX® works as a laxative to clean out your colon (large intestine) to prepare it for a colonoscopy. MiraLAX is a laxative that softens your stool and helps you have a bowel movement. You mix MiraLAX with Gatorade® or another noncarbonated, clear beverage.

Why is bowel prep important?

Bowel prep is key to a successful colonoscopy because it clears out your colon. It helps your gastroenterologist best identify polyps that can sometimes become cancer during your exam. For your doctor, a clean colon is like driving on a clear, sunny day. A dirty colon is like driving in a rainstorm.

If you’re a Cleveland Clinic patient, you must follow the instructions for bowel preparation exactly as prescribed or your colonoscopy will be canceled.

How do I use MiraLAX bowel prep?

Using this type of bowel preparation involves buying 64 ounces of Gatorade (most people use two 32-ounce bottles), Propel®, Crystal Light® or another non-carbonated, clear liquid sports drink. Don’t use drinks that are red, orange or purple. You’ll also need one 238-gram bottle of MiraLAX and four Dulcolax® tablets.

Key preparation instructions

The following instructions are key to a successful colonoscopy:

• Your bowel must be empty so that your doctor can clearly view your colon. Follow the instructions you get from your gastroenterologist exactly as they are written.
• Don’t eat any solid food the entire day before your colonoscopy. Drink only clear liquids.
• Get the products for your bowel preparation at least five days before your colonoscopy.

Transportation on the day of your colonoscopy

A responsible driver must accompany you when you check for your colonoscopy. They must stay in the waiting area until you’re discharged. You’re not allowed to leave alone after your colonoscopy. If you don’t have a driver to take you home, your exam will be canceled.

Medications

For your safety, certain medications will need to be stopped or adjusted before you can have your procedure. These include:

• Blood thinners: Contact your provider at least two weeks before the procedure to discuss adjusting your medication. Examples of blood thinners include clopidogrel (Plavix®), warfarin (Coumadin®), ticlopidine hydrochloride (Ticlid®), anagrelide (Agrylin®), rivaroxaban (Xarelto®), dabigatran (Pradaxa®), apixaban (Eliquis®) and prasugrel (Effient®).
• Insulin and diabetes medication: Always call the provider who orders these medications for instructions on changing the dosage leading up to your colonoscopy. Don’t take your diabetes pills after midnight on the day of your procedure. If you’re taking insulin, like as insulin glargine injection (Lantus®), insulin lispro (Humalog®), long-acting insulin like insulin isophane (HumulinN®, NovolinN®, ReliOn®) or 70/30 insulin, take half your usual dose the day before your procedure.
• Weight management medication: If you take medications for weight loss, your dosage may need to be adjusted, or you might need to stop taking it several days to a week before. Contact the doctor who prescribes this medication for further instructions. Weight loss medications that you’ll need to stop include canagliflozin (Invokana®), dapagliflozin (Farxiga®, Forxiga®), dulaglutide (Trulicity®), empagliflozin (Jardiance®), ertugliflozin (Steglatro®), exenatide (Byetta®, Bydureon®), liraglutide (Victoza®, Saxenda®), lixisenatide (Adylyxin®), semaglutide (Ozempic®, Wegovy®, Rybelsus®) and tirzepatide (Mounjaro®, Zepbound®).
• Iron pills: Stop taking them one week before your colonoscopy.

Medications like aspirin, antibiotics or diuretics should be taken with a sip of water on the day of the exam. If you’re unsure which medications you can continue to take, please get in touch with your healthcare provider.

Three days before your colonoscopy

Stop eating these high-fiber foods three days before your colonoscopy:

• Popcorn
• Beans
• Seeds (flax, sunflower, quinoa)
• Multigrain bread
• Nuts
• Salad/vegetables
• Fresh and dried fruit

One day before your colonoscopy

You should only drink clear liquids beginning the day before your colonoscopy. Don’t eat any solid foods.

You can continue to drink clear liquids until three hours before your colonoscopy. The table below shows what you can and can’t drink:

Note: Brand names are registered trademarks.

How to take MiraLAX and Gatorade bowel preparation

Take the bowel preparation in two parts with several hours between each dose. Your provider will give you specific timing instructions – be sure to follow them.

You’ll need to purchase the following (no prescriptions are needed):

• 64 ounces Gatorade, Propel, Crystal Light or other noncarbonated, clear liquid sports drink (not red, orange or purple). People with diabetes should buy sugar-free Gatorade G2®.
• 4 Dulcolax laxative tablets containing 5mg bisacodyl each (don’t buy the stool softener)
• 8.3 oz MiraLAX (238g) powder or generic polyethylene glycol 3350 (in the laxative aisle)
• The day before your colonoscopy, mix 64 oz of the sports drink with 8.3 oz MiraLAX (238 g) in a pitcher. Stir or shake until MiraLAX completely dissolves. Chill if desired.

Part 1: The evening before your colonoscopy

• At 5:00 p.m., take four Dulcolax tablets.
• At 6:00 p.m., drink 32 ounces of the mixed solution by drinking an 8-ounce glass every 15 minutes
• Continue to drink clear liquids

Part 2: Six hours before your colonoscopy

• Drink 32 ounces of the mixed solution by drinking an 8-ounce glass every 15 minutes
• You may continue to drink clear liquids up to three hours before your exam

Some people's bowels move slowly, and they may need different instructions. Please see your doctor for personalized bowel prep instructions if you have:

• Medical conditions that need special accommodations
• Had a poor bowel prep results or failed bowel prep in the past
• Had difficulty with anesthesia during a past procedure
  

What if I have constipation?

You may take extra laxatives in the days leading to your prep. This should help resolve your constipation prior to entering the bowel prep day.

What if I've had poor preps results in past?

Contact your physician as you’ll likely need additional bowel prep instructions.

What if I have motility issues from a medical condition?

Certain medical conditions and medications can slow bowel emptying or lead to constipation. Conditions like Parkinson’s, multiple sclerosis (MS) or using a wheelchair can slow down your digestion. Medications like narcotics, gabapentin and anticholinergic medications can also have an impact. Contact your physician and be sure to share your medical history and current medication use, as you’ll likely need extra time and additional laxatives to complete your bowel prep.

What if I can’t drink a large volume of liquid?

Start your prep two to three hours earlier to allow yourself more time to complete the entire prep.

What if I can't finish my bowel prep?

If you can’t finish your entire bowel prep, you’ll likely need to reschedule your colonoscopy due to poor prep quality.

Do I still have to complete the entire prep if I’ve had bariatric surgery?

Gastric bypass surgery involves your stomach and small bowel. It doesn’t change the length of your colon. You may need to drink smaller amounts, more slowly. You’ll need to complete the entire bowel prep, it may just take longer time to complete it.

What if I’m on dialysis?

Please consult your nephrologist before scheduling to get instructions that are specific to you. In general, dialysis patients take the Golytely bowel prep and have the procedure on the same day of their dialysis (colonoscopy in AM, dialysis in PM).

How do I know if something is considered a clear liquid diet?

If you can pour it in a glass and you can see through it, it’s considered "clear liquid."

Can I take Uber®, Lyft®, taxi or bus home?

An adult must be present with you at check-in for your colonoscopy and remain in the endoscopy area until you’re discharged. You can hire a driver to take you home only if this adult escort is with you at check-in, remains in the endoscopy area until you’re discharged, and takes the hired ride home with you.

Can I “sleep it off” here and drive myself home?

No, you must have an adult with you when you check in. Your responsible adult must remain in the endoscopy center during your procedure and then drive you home. You can’t drive a vehicle after your procedure for the rest of the day.