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Adult Dosing .
Dosage forms: convenience pack
Special Note
- [convenience pack components]
- Info: pack for adult pts contains sodium sulfate 17.5 g/potassium sulfate 3.13 g/magnesium sulfate 1.6 g per 6 oz bottle for oral solution x2
bowel prep
- [3 quarts PO in divided doses]
- Info: drink 16 oz of mixed solution x1, then drink 32 oz of water over 1h evening before procedure; on day of procedure and 10-12h after 1st dose, drink 16 oz of mixed solution x1, then drink 32 oz of water, complete regimen at least 2h before procedure
renal dosing
- [see below]
- renal impairment: not defined, caution advised
- HD/PD: not defined, caution advised
hepatic dosing
- [not defined]
Peds Dosing .
- Dosage forms: convenience pack
Special Note
- [convenience pack components]
- Info: pack for pediatric pts contains sodium sulfate 13.13 g/potassium sulfate 2.35 g/magnesium sulfate 1.2 g per 4.5 oz bottle for oral solution x2
bowel prep
- [12 yo and older]
- Dose: 2.25 quarts PO in divided doses; Info: drink 12 oz of mixed solution x1, then drink 24 oz of water over 1h evening before procedure; on day of procedure and 10-12h after 1st dose, drink 12 oz of mixed solution x1, then drink 24 oz of water, complete regimen at least 2h before procedure
renal dosing
- [see below]
- renal impairment: not defined, caution advised
- HD/PD: not defined, caution advised
hepatic dosing
- [not defined]
Contraindications / Cautions .
- hypersensitivity to drug or ingredient
- fluid abnormalities, uncorrected
- electrolyte abnormalities, uncorrected
- intestinal perforation
- GI obstruction
- gastric retention
- ileus
- toxic megacolon
- toxic colitis
- caution: ulcerative colitis, severe
- caution: nephrotoxic agent use, concurrent
- caution: renal impairment
- caution: renal impairment risk
- caution: elderly pts
- caution: seizure hx
- caution: seizure risk
- caution: arrhythmia risk
- caution: gag reflex, impaired
- caution: aspiration risk
- caution: gout
- caution: uric acid metabolism disorder
- caution: botulism
Drug Interactions .
Overview
sulfate bowel prep
osmotic laxative; bowel prep
- colonic mucosal ulceration
- decreases renal perfusion/fxn
- fluid/electrolyte loss
- hyperuricemic effects
- hypokalemia
- hyponatremia
- lowers seizure threshold
- polyvalent cation
- separate admin. from other oral drugs by at least 1h; sulfate bowel prep may decr. absorption of concomitant oral drugs
Avoid/Use Alternative
- aldesleukin
- amifampridine
- amikacin
- arsenic trioxide
- bisacodyl
- bisacodyl rectal
- castor oil
- clofarabine
- ginkgo
- iohexol
- irinotecan
- magnesium citrate
- polyethylene glycol
- polyethylene glycol/electrolytes
- potassium acid phosphate
- potassium phosphate
- sennosides
- sodium acid phosphate
- sodium phosphate (bowel prep)
- sodium phosphate rectal
- sodium picosulfate
- sodium polystyrene sulfonate
- trientine
Monitor/Modify Tx
- abiraterone acetate
- acetazolamide
- acyclovir
- adefovir dipivoxil
- albuterol
- albuterol inhaled
- alendronate
- aliskiren
- allopurinol
- aloe
- amikacin inhaled
- amiloride
- aminophylline
- amphotericin
- anthrax immune globulin
- arformoterol inhaled
- asparaginase
- aspirin
- auranofin
- azilsartan medoxomil
- azithromycin
- baloxavir marboxil
- balsalazide
- benazepril
- betamethasone
- bictegravir
- botulism immune globulin
- budesonide
- bumetanide
- bupropion
- cabotegravir
- candesartan cilexetil
- capecitabine
- captopril
- carbamazepine
- carboplatin
- carfilzomib
- cefaclor
- cefdinir
- celecoxib
- cetuximab
- chloroquine
- chlorothiazide
- chlorpromazine
- chlorthalidone
- cidofovir
- ciprofloxacin
- cisplatin
- citalopram
- clindamycin
- clomipramine
- colistimethate
- corticotropin
- cortisone
- creatine
- crizotinib
- cyclophosphamide
- cyclosporine
- cytomegalovirus immune globulin
- decitabine
- deferasirox
- deferiprone
- deferoxamine
- deflazacort
- delafloxacin
- demeclocycline
- desmopressin
- desvenlafaxine
- dexamethasone
- dichlorphenamide
- diclofenac
- diclofenac topical
- dicyclomine
- diflunisal
- digoxin
- dinutuximab
- dolutegravir
- doxycycline
- duloxetine
- eltrombopag
- elvitegravir
- emapalumab
- enalapril
- enalaprilat
- epinephrine
- escitalopram
- eslicarbazepine acetate
- ethacrynic acid
- ethambutol
- etodolac
- exenatide
- febuxostat
- fenoprofen
- fexofenadine
- flucytosine
- fludrocortisone
- fluoxetine
- flurbiprofen
- fluvoxamine
- formoterol inhaled
- foscarnet
- fosinopril
- furosemide
- gabapentin
- ganciclovir
- gentamicin
- hydrochlorothiazide
- hydrocortisone
- hyoscyamine
- ibandronate
- ibuprofen
- ibuprofen lysine
- ifosfamide
- immune globulin
- indapamide
- indomethacin
- inotersen
- insulin
- iobenguane I 131
- iopamidol
- irbesartan
- isoproterenol
- ketoprofen
- ketorolac
- lenalidomide
- levalbuterol inhaled
- levofloxacin
- levomilnacipran
- levothyroxine
- licorice
- linezolid
- liraglutide
- lisinopril
- lithium
- losartan
- lutetium Lu 177 vipivotide tetraxetan
- magnesium salicylate
- mannitol
- meclofenamate
- mefenamic acid
- meloxicam
- mesalamine
- mesalamine rectal
- methazolamide
- methotrexate
- methscopolamine
- methylprednisolone
- metolazone
- mexiletine
- mifepristone
- milnacipran
- minocycline
- mirtazapine
- mitomycin
- moexipril
- motixafortide
- moxifloxacin
- mycophenolate mofetil
- mycophenolic acid
- nabumetone
- naproxen
- necitumumab
- neomycin
- nilotinib
- nusinersen
- ofloxacin
- olmesartan medoxomil
- olodaterol inhaled
- olsalazine
- omadacycline
- osilodrostat
- oxaliplatin
- oxaprozin
- oxcarbazepine
- oxytocin
- pamidronate
- paromomycin
- paroxetine
- pegloticase
- pemetrexed
- penicillamine
- pentamidine
- pentostatin
- perindopril
- phenytoin
- piroxicam
- plazomicin
- polymyxin B
- posaconazole
- prednisolone
- prednisone
- probenecid
- quinapril
- raltegravir
- ramipril
- ramucirumab
- rasburicase
- Rho(D) immune globulin
- rifampin
- riociguat
- risedronate
- rituximab
- romidepsin
- ropeginterferon alfa-2b
- rosuvastatin
- sacituzumab govitecan
- salmeterol inhaled
- salsalate
- sarecycline
- selinexor
- sertraline
- sirolimus
- sirolimus albumin-bound
- sitagliptin
- sodium benzoate
- sodium phenylacetate
- sodium phenylbutyrate
- sodium phosphate (supplement)
- sodium thiosulfate
- sotalol
- sparsentan
- spironolactone
- streptomycin
- streptozocin
- sulindac
- tacrolimus
- tafasitamab
- telavancin
- telmisartan
- temsirolimus
- tenofovir alafenamide
- tenofovir disoproxil
- terbutaline
- tetracycline
- theophylline
- thyroid
- tiopronin
- tipranavir
- tobramycin
- tobramycin inhaled
- tolmetin
- topiramate
- torsemide
- tramadol
- trandolapril
- trastuzumab
- trazodone
- triamcinolone
- triamterene
- vaccinia immune globulin
- valacyclovir
- valganciclovir
- valsartan
- vamorolone
- vancomycin
- vasopressin
- venlafaxine
- vilanterol inhaled
- vilazodone
- voclosporin
- vortioxetine
- zoledronic acid
- zonisamide
Caution Advised
- alfentanil
- amitriptyline
- amoxapine
- amoxicillin
- amphetamine
- ampicillin
- apalutamide
- aripiprazole
- aripiprazole bimonthly injection
- aripiprazole lauroxil
- asenapine
- axicabtagene ciloleucel
- baclofen
- baclofen intrathecal
- benzphetamine
- brexpiprazole
- brexucabtagene autoleucel
- brivaracetam
- buprenorphine
- busulfan
- butorphanol
- cannabidiol
- cannabis
- cariprazine
- cefazolin
- cefepime
- cefiderocol
- ceftaroline fosamil
- ceftazidime
- cenobamate
- chlorambucil
- ciltacabtagene autoleucel
- cisatracurium
- clobazam
- clonazepam
- clorazepate
- clozapine
- cocaine
- codeine
- cyclobenzaprine
- dalfampridine
- darbepoetin alfa
- darolutamide
- desipramine
- dexmethylphenidate
- dextroamphetamine
- diazepam
- dicloxacillin
- diethylpropion
- dihydrocodeine
- donepezil
- doxepin
- dronabinol
- elivaldogene autotemcel
- enzalutamide
- ephedra
- epoetin alfa
- ertapenem
- ethosuximide
- felbamate
- fenfluramine
- fentanyl
- fluphenazine
- fosamprenavir
- fosphenytoin
- galantamine
- ganaxolone
- goserelin
- haloperidol
- histrelin
- hydrocodone
- hydromorphone
- hydroxychloroquine
- idecabtagene vicleucel
- iloperidone
- imipenem
- imipramine
- isocarboxazid
- isoniazid
- ketamine
- lacosamide
- lamotrigine
- leuprolide
- levetiracetam
- levocarnitine
- levorphanol
- lidocaine
- lidocaine topical
- lindane topical
- lisdexamfetamine
- lisocabtagene maraleucel
- lorazepam
- lorlatinib
- loxapine
- lumateperone
- lurasidone
- mefloquine
- meperidine
- meropenem
- methadone
- methamphetamine
- methocarbamol
- methoxy polyethylene glycol-epoetin beta
- methsuximide
- methylphenidate
- metoclopramide
- metronidazole
- midazolam
- molindone
- morphine
- nafarelin
- nafcillin
- nalbuphine
- nefazodone
- nelarabine
- nortriptyline
- olanzapine
- oliceridine
- oxacillin
- oxycodone
- oxymorphone
- paliperidone
- penicillin G
- penicillin V
- pentazocine
- perampanel
- perphenazine
- phendimetrazine
- phenelzine
- phenobarbital
- phentermine
- pimozide
- piperacillin
- pregabalin
- primidone
- procarbazine
- prochlorperazine
- promethazine
- propofol
- protriptyline
- pyridostigmine
- pyrimethamine
- quetiapine
- quinine
- regadenoson
- remifentanil
- risperidone
- rivastigmine
- rufinamide
- scopolamine
- selegiline transdermal
- sevoflurane
- stiripentol
- sufentanil
- sumatriptan
- tapentadol
- teclistamab
- thalidomide
- thioridazine
- thiothixene
- tiagabine
- tisagenlecleucel
- tranexamic acid
- tranylcypromine
- trifluoperazine
- trimipramine
- triptorelin
- valproic acid
- varenicline
- vigabatrin
- ziprasidone
Adverse Reactions .
Serious Reactions
- electrolyte imbalance, severe
- renal impairment
- arrhythmia
- seizures
- ischemic colitis
- colonic mucosal aphthous ulcer
Common Reactions
- discomfort
- abdominal distension
- abdominal pain
- nausea
- hyperuricemia
- bicarbonate low
- hypercalcemia
- bilirubin elevated
- vomiting
- BUN elevated
- hyperchloremia
Safety/Monitoring .
Monitoring Parameters
BUN/Cr, electrolytes at baseline, then if renal impairment risk, vomiting or s/sx dehydration, consider obtaining post-colonoscopy; consider ECG at baseline and post-colonoscopy if arrhythmia risk
Pregnancy/Lactation .
Pregnancy
Clinical Summary
weigh risk/benefit during pregnancy; no human or animal data available; possible risk of serious maternal fluid and electrolyte abnormalities based on drug's mechanism of action
Lactation
Clinical Summary
may use while breastfeeding; no human data available, though risk of infant harm and adverse effects on milk production not expected based on minimal maternal systemic absorption
Pharmacology .
Metabolism: for sodium sulfate, potassium sulfate, magnesium sulfate: none; CYP450: none; Info: minimal systemic absorption
Excretion: for sodium sulfate, potassium sulfate, magnesium sulfate: feces primarily; Half-life: 8.5h
Subclass: Bowel Preps
Mechanism of Action
causes water retention in GI tract, cleansing the colon (osmotic laxative)
Formulary .
No Formulary Selected
Manufacturer/Pricing .
Manufacturer: Braintree Laboratories, Inc.
DEA/FDA: Rx
Approximate Retail Price
from http://www.goodrx.com/suprep-bowel-prep
oral liquid:
- 17.5 g/mL/3.13 g/mL/1.6 g/mL (1 kit, 2 bottles): $115.00
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