Sodium Picosulfate, Magnesium Oxide, Anhydrous Citric Acid Solution

What is this medication?

SODIUM PICOSULFATE; MAGNESIUM OXIDE; ANHYDROUS CITRIC ACID (SOE dee um PI koe SUL fate; mag NEE zee um OX ide; an HYE drus SIT rik AS id ) cleans the bowel out before a medical procedure. It works by increasing the amount of water your intestine absorbs, which softens the stool. It also helps the muscles in your intestines move stool. This helps produce a bowel movement. It belongs to a group of medications called laxatives.

This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

COMMON BRAND NAME(S): CLENPIQ, Prepopik

What should I tell my care team before I take this medication?

They need to know if you have any of these conditions:

• Dehydration
• Difficulty swallowing
• Heart disease
• High or low levels of calcium, magnesium, potassium, or sodium in the blood
• History of irregular heartbeat
• Kidney disease
• Seizures
• Stomach or intestine problems
• An unusual or allergic reaction to sodium picosulfate, magnesium oxide, anhydrous citric acid, other medications, dyes, or preservatives
• Pregnant or trying to get pregnant
• Breast-feeding

How should I use this medication?

Take this medication by mouth. Follow the directions on the prescription label. Clenpiq is ready to drink. Each dose of Prepopik must be mixed with 150 mL (5 ounces) of cold water before taking the dose. Your care team will tell you what time to start this medication. Take exactly as directed. You will need to drink additional clear fluids after each dose. Do not skip a dose or stop your medication early. Take other oral medications 2 hours before or 6 hours after this medication to avoid decreasing their absorption.

You will need to follow a special diet before your procedure. Talk to your care team. You may drink clear liquids while taking this medication and up until 2 hours before colonoscopy.

A special MedGuide will be given to you by the pharmacist with each prescription and refill. Be sure to read this information carefully each time.

Talk to your care team about the use of this medication in children. While this medication may be prescribed for children as young as 9 years for selected conditions, precautions do apply.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.

NOTE: This medicine is only for you. Do not share this medicine with others.

What if I miss a dose?

This does not apply. This medication is not for regular use.

What may interact with this medication?

Do not take this medication with any of the following:

• Alcohol
• Other laxatives

This medication may also interact with the following:

• Certain antibiotics, such as ciprofloxacin, levofloxacin or tetracycline
• Certain medications for blood pressure, heart disease, irregular heartbeat
• Certain medications for depression, anxiety, or mental health conditions
• Certain medications for diabetes
• Certain medications for seizures
• Chlorpromazine
• Diuretics
• Iron supplements
• NSAIDS, medications for pain and inflammation, such as ibuprofen or naproxen
• Penicillamine
• Steroid medications, such as prednisone or cortisone
• Theophylline or aminophylline
• Tramadol

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What should I watch for while using this medication?

You will need to follow a special diet before your procedure. Talk to your care team.

Talk to your care team if you are not able to complete the regimen as prescribed.

Do not use with any other laxatives. Drink clear fluids as directed to prevent dehydration. See your care team right away if you do not have a bowel movement after using this medication.

What side effects may I notice from receiving this medication?

Side effects that you should report to your care team as soon as possible:

• Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
• Dehydration—increased thirst, dry mouth, feeling faint or lightheaded, headache, dark yellow or brown urine
• Fast or irregular heartbeat
• Kidney injury—decrease in the amount of urine, swelling of the ankles, hands, or feet
• Seizures
• Sudden or severe stomach pain, bloody diarrhea, fever, nausea, vomiting

Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):

• Dizziness
• Headache
• Nausea
• Stomach pain

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Where should I keep my medication?

Keep out of the reach of children and pets.

Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F). Do not refrigerate. Do not freeze. Do not add ice to the solution. Get rid of any unused medication after the day of your procedure. Do not store the solution for later use.

To get rid of medications that are no longer needed or have expired:

• Take the medications to a medication take-back program. Check with your pharmacy or law enforcement to find a location.
• If your cannot return the medication, check the label or package insert to see if the medication should be thrown out in the garbage or flushed down the toilet. If you are not sure, ask your care team. If it is safe to put it in the trash, pour the medication out of the container. Mix the medication with cat litter, dirt, coffee grounds, or other unwanted substance. Seal the mixture in a bag or container. Put it in the trash.

NOTE: This sheet is a summary. It may not cover all possible information. If you have questions about this medicine, talk to your doctor, pharmacist, or health care provider.