Picolax

Picolax

What Picolax is and what it is used for

Picolax is a powder that contains sodium picosulfate, a laxative that works by increasing the activity of the intestine, Picolax also contains magnesium citrate, another type of laxative that works by holding back fluid in the bowel to provide a wash-out effect.

Picolax is used to clear your bowel before you have an x-ray examination, endoscopy or surgery.

Before you take Picolax

Do not take Picolax  if you:

• are allergic (hypersensitive) to sodium picosulfate or any of the other ingredients.
• have reduced ability of the stomach to empty (gastric retention)
• have stomach or intestinal ulcers.
• have severe problems with your kidneys.
• have a blockage or perforation of your bowel.
• are currently suffering from feeling or being sick.
• have a condition requiring abdominal surgery such as appendicitis.
• have been told by a doctor that you have congestive heart failure (the heart is unable to pump blood efficiently around the body)
• have a condition called:

1. ileus (intestinal blockage or failure of normal bowel movements),
2. toxic colitis (damage to the intestinal wall)
3. toxic megacolon (expansion of the large bowel).

In these conditions, the movement of the contents of the bowel may be impaired or prevented. Symptoms include nausea, vomiting, diarrhoea, abdominal pain, tenderness or swelling, colicky pain and fever

Take special care with Picolax if you:

• have recently had abdominal surgery.
• have a heart disease or kidney problems
• have inflammatory bowel disease such as ulcerative colitis or Crohn’s disease

If any of these apply to you, or if you are not sure, contact your doctor before taking Picolax

Taking other medicines:

Please inform your doctor or pharmacist if you are taking or have recently taken any other medicines – including medicines obtained without a prescription. It is especially important to tell your doctor if you are taking; bulk forming laxatives e.g. bran prescribed oral medication, especially if it is regularly prescribed as their effects may be modified e.g. contraceptives, antibiotics, or anti-epileptics.

prescribed medication that may affect water and/or electrolyte balance e.g. water tablets, steroids, lithium, digoxin, antidepressants, carbamazepine

Pregnancy and breast-feeding:

If you are pregnant, trying to become pregnant, or are breast-feeding ask your doctor or pharmacist for advice before taking Picolax

How to take Picolax

Always take Picolax exactly as your doctor has told you. You should check with your doctor if you are not sure.

Picolax powder should be dissolved in a cup of cold water (approximately 150ml). Stir for 2-3 minutes and then drink the solution. Sometimes the solution becomes hot as Picolax dissolves. If this happens, wait until it cools sufficiently before drinking it.

Adults (including the elderly) and children 9 and over:

The usual dose is one sachet in the morning and one sachet in the afternoon on the day before your procedure.

The first sachet taken before 8am and the second sachet between 2pm and 4pm.

Children

(under 9 years):

Timings as above From 1 and below 2 years: 1/4 sachet morning, 1/4 sachet afternoon

From 2 and below 4 years:

1/2 sachet morning, 1/2 sachet afternoon

From 4 and below 9 years:

1 sachet morning, 1/2 sachet afternoon,

9 years and above:

adult dose.

You should expect frequent, loose bowel motions to start at any time after taking a dose of Picolax®. Please ensure that you have access to a toilet at all times following each dose, until the effects wear off.

In order to replace fluid lost from the body, it is important to drink plenty of clear fluids throughout the treatment with Picolax until the bowel movements have ceased. In general, you should try to drink a glass of water (about 250ml) or other clear fluid every hour whilst the effects of Picolax persist.

The success of your hospital procedure that you undergo depends on the bowel being as clear as possible. The procedure may need to be repeated if you do not achieve a clear bowel. Unless otherwise directed by your doctor, please follow the treatment plan overleaf.

If you take more Picolax than you should:

If you have taken more Picolax than you should, contact your doctor immediately or go to the casualty department at your nearest hospital.

If you forget to take Picolax:

Please consult your doctor, nurse or pharmacist for advice.

Possible side effects

Like all medicines, Picolax can cause side effects, although not everybody gets them. However, side effects of Picolax are very rare.

There have been isolated reports of severe prolonged abdominal pain in some patients which may indicate a serious condition and require urgent medical care, and isolated reports of severe allergic reactions which may lead to difficulty in breathing. Isolated cases of mild ulcers in the small bowel have also been reported

In the case of allergic reaction or severe prolonged abdominal pain, contact your doctor or nearest casualty department immediately.

The following very rare side effects affect less than 1 in 10,000 patients treated:

• Rash and/or itching, wheezing, swelling, difficulty breathing
• Vomiting
• Diarrhoea
• Mild/moderate abdominal pain
• Feeling sick
• Proctalgia (anal pain)
• Low levels of sodium in the blood (hyponatraemia) with or without associated fits. Fits have occasionally been reported in epileptic patients
• Vomiting and severe diarrhoea can lead to dehydration with headache and confusion without proper fluid and salt replacement.

If you experience one or more of these side effects or any other side effect not listed in the leaflet, please contact your doctor or pharmacist immediately.

How to Store Picolax

Keep Picolax out of the reach and sight of children

Store in the original packaging. Do not store above 25^SC.

Use by date: Do NOT use Picolax if it is past its expiry date on the packaging,

If you are unsure about the storage, ask your pharmacist. It is best to return all old and unused medication to your pharmacist for safe disposal.

Further information

Your medicine is called Picolax. It is a powder for oral solution.

It is presented as a pack containing 2 sachets

Each sachet contains 16.1g of powder which has the active ingredients sodium picosulfate 10mg, magnesium oxide 3.5g and citric acid anhydrous 12g which together form magnesium citrate in solution.

It also contains the inactive ingredients potassium bicarbonate, saccharin sodium and orange flavouring.

Treatment plan

Unless otherwise directed by your doctor, please follow the treatment plan (shown below), the day before the hospital procedure. If you have special dietary requirements, please discuss this in advance with the medical personnel responsible for your treatment at the hospital. This is so that a suitable dietary plan can be prepared for you.

Picolax is normally taken the day before the hospital procedure. On this day, only small meals made up of low residue foods and plenty of clear fluids, preferably water are allowed (see plan below). This is to ensure that the bowel is as clear as possible. The success of the hospital procedure that you undergo depends on this. You should also avoid milk and other dairy products from after lunch on the day before the procedure, until after the procedure has been completed. The procedure may need to be repeated if you do not achieve a clear bowel.

Be prepared for frequent, loose bowel movements to start at any time after taking a dose. Please ensure that you have access to a toilet at all times following each dose, until the effects wear off.

Drink plenty of clear fluids, preferably water, throughout the treatment with Picolax until the bowel movements have ceased. In general, you should try to drink about a glass of water (250ml) or other clear fluid every hour whilst the effects of Picolax persist. Thereafter you should continue to drink only clear fluids, preferably water, sufficient to satisfy thirst, until after the procedure or as directed by your doctor.

Directions for the preparation of Picolax:

Adults (including the elderly):

Mix the contents of one sachet in a cup of cold tap water (approximately 150ml). Stir for 2-3 minutes and drink the solution. If it becomes too hot, wait until it cools sufficiently to drink.

Before breakfast (not later than 8.00am)

Take the 1st sachet of Picolax mixed in water as described above.

Breakfast (8.00 – 9.00 am)

Tea/coffee (with milk and sugar/sweetener if required) or other drink (from drinks list below) Choose one of the following (smaller portions are allowed if you prefer):

30g of crisped rice cereal or corn flakes with up to 100ml of milk.

2 slices of white bread/toast with a thin spread of butter/margarine and honey (if desired)

1 boiled/poached egg and 1 slice of white bread/toast with a thin spread of butter/margarine.

50g cottage or cream cheese and 1 slice white bread/toast with a thin spread of butter/margarine.

Mid morning

Tea/coffee (with milk and sugar/sweetener if required).

Lunch (12.00-1.30 pm)

Choose one of the following (smaller portions are allowed if you prefer):

75g meal/fish (from the list below) with gravy (from list).

2 boiled/poached eggs.

100g cheese (from list).

And one of the following (smaller portions are allowed if you prefer):

2 slices of white bread/toast with a thin spread of butter/margarine.

2 egg sized potatoes without skin (from list) with butter/margarine (use sparingly) if desired.

2 tablespoonfuls plain white pasta/rice (from list).

No further solid food or milk and other dairy products are allowed after lunch until your hospital procedure. Drink Plenty of clear fluids, preferably water (from drinks list). Tea/coffee if taken after lunch should be black.

Mid afternoon (2.00 – 4.00pm)

Take the second sachet of Picolax mixed in water as described above.

Supper (7.00 – 9.00pm)

No solid food is allowed.

Clear soup or a meat extract drink may be taken followed by clear jelly for dessert.

After supper

No further food is allowed until after the procedure. Drink plenty of clear fluids, preferably water (see drinks list) until bowel movements have ceased. Thereafter, you should continue to drink only clear fluids, preferably water, sufficient to satisfy thirst, until after the procedure or as directed by your doctor.

Low residue foods:

Fats (use sparingly): Butter, margarine

Eggs: Boiled, poached

Cereal: Crisped rice cereal, corn flakes (no bran)

Cheese: Cream cheese, cottage cheese, cheese sauce

Potatoes (no skin): Boiled, creamed, mashed, baked

Pasta: Plain macaroni, spaghetti, noodles

Rice: Plain, boiled white rice

Meat/Fish: Minced or well-cooked tender, lean, beef, lamb, ham, veal, pork, poultry, fish, shellfish

Gravy: Using stock cubes (white flour or corn flour may be used to thicken)

Bread: White bread/toast

Sugar/sweetener: White sugar, brown sugar, sweetener

Dessert: Clear jelly

Drinks: Water, energy drinks, soda water, tea/ coffee (black after lunch), fizzy drinks, squashes, strained fruit juice, herbal/ fruit tea, clear soup or drinks made from stock/meat extract cubes.