Suprep Bowel Preparation Instructions

What is SUPREP® bowel preparation

SUPREP® is a brand name for a medication that contains polyethylene glycol (PEG) and magnesium sulfate. It cleans out your colon (large intestine) to prepare it for a colonoscopy. PEG works by pulling water into your colon so it’s easy to have a bowel movement. Magnesium sulfate stimulates the nerves that control bowel movements.

Why is bowel prep important?

Bowel prep completely empties your colon of stool. It’s essential because it gives your gastroenterologist the best view of the lining of your colon. It helps them identify polyps that may lead to cancer. For your doctor, a clean colon is like driving on a clear, sunny day. A dirty colon is like driving in a rainstorm.

How do I use SUPREP?

SUPREP bowel prep comes in a kit that contains two small bottles of solution and a mixing container. To make the bowel prep drink, you empty one of the small bottles into the mixing container. Then, you fill the container with cool water to the fill line. Be sure to follow the instructions carefully before making the drink.

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

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’re written.
• Don’t eat any solid food the entire day before your colonoscopy. Drink only clear liquids.
• Get your bowel preparation kit at least five days before your colonoscopy.

Transportation on the day of your colonoscopy

A responsible adult driver must be with you when you check in before 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 with you 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 about 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 normal 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 the day of the exam with a sip of water.

If you’re unsure about which medications you can continue to take, please contact 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 chart shows what you can and can’t drink:

Note: Brand names are registered trademarks.

How to take SUPREP

Take the bowel preparation in two parts. You can refrigerate the solution, but don’t add ice, sugar or any flavorings.

Part 1: 6:00 p.m. on the evening before your colonoscopy

• Pour one 6-ounce bottle of SUPREP liquid into the mixing container
• Add cool water to the 16-ounce line on the container and mix
• Drink all the liquid in the container
• Drink two more 16-ounce glasses of water over the next hour

Part 2: six hours before colonoscopy

• Pour one 6-ounce bottle of SUPREP liquid into the mixing container
• Add cool water to the 16-ounce line on the container and mix
• Drink all the liquid in the container
• Drink two more 16-ounce glasses of water over the next hour
• You may continue drinking clear liquids up to three hours before your procedure

Some people's bowels move slowly, and they may need different instructions. Please see your doctor in 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
  

Can you mix SUPREP with orange juice?

No. Use only water to mix the solution.

How long will I be pooping after SUPREP?

It varies. You’ll continue to poop until you have watery diarrhea.

What if I have constipation?

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

What if I've had poor prep results in the 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 a clear liquid?

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 for your procedure. Your responsible adult must remain in the endoscopy center during your procedure and then drive you home. You can’t drive a vehicle for the rest of the day.