Suprep Bowel Prep Kit contains osmotically active ingredients - sodium, potassium, and magnesium sulfates. It is used as a cleansing agent for bowel preparation before a gastrointestinal procedure.

Suprep Bowel Prep Kit (Sodium, potassium, and magnesium sulfates) Uses:

• Colon cleansing prior to colonoscopy:

  • cleaning of the colon in adults before a colonoscopy.

Suprep Bowel Prep Kit (Sodium, potassium, and magnesium sulfates) Dose in Adults

Colon cleansing prior to colonoscopy with Suprep Bowel Prep Kit:

• The evening before colonoscopy:

  • Take 1 bottle's whole contents, diluted to a final amount of 480 mL, at one sitting (16 oz).
  • Next, throughout the course of the following hour, consume 2 more containers of water, each filled to the 16-ounce mark, for a total of 960 mL. (32 oz).

• Two-day regimen:

  • The number of fluids consumed overall throughout therapy was 2880 mL. (96 oz)

• Morning of the colonoscopy (10 to 12 hours after the evening dose):

  • Apply the same procedure to the second bottle:
  • Having diluted the full contents of the second bottle to a final capacity of 480 mL (16 oz), consume it
  • Then consume 2 more containers of water, each filled to the 16-ounce mark, throughout the course of the following hour, totalling 960 mL. (32 oz).
  • At least two hours before the surgery.

Suprep Bowel Prep Kit (Sodium, potassium, and magnesium sulfates) Dose in Children

Not indicated in children.

Pregnancy Risk Factor C

• This combination has not yet been used in animal reproduction studies.

Uses during breastfeeding:

• If these ingredients are present in breast milk is unknown.
• Manufacturer recommends caution when breastfeeding mothers are being administered.

Suprep Bowel Prep Kit Dose in Kidney Disease:

• There are no adjustments provided in the drug manufacturer's labeling.
• Use with caution, ensure adequate hydration, and consider baseline and post-colonoscopy renal assessment.

Suprep Bowel Prep Kit Dose in Liver disease:

• There are no dosage adjustments provided in the drug manufacturer's labeling.
• However, no adjustment expected due to similar disposition to healthy patients in pharmacokinetic studies.

Common Side Effects:

• Central Nervous System:

  • Malaise

• Endocrine & Metabolic:

  • Increased Uric Acid
  • Decreased Serum Bicarbonate

• Gastrointestinal:

  • Abdominal Distention
  • Abdominal Pain
  • Nausea

Less Common Side Effects:

• Central Nervous System:

  • Headache

• Gastrointestinal:

  • Vomiting

• Renal:

  • Increased Blood Urea Nitrogen
  • Increased Serum Creatinine

• Endocrine & Metabolic:

  • Electrolyte Disorder
  • Serum Hyperosmolarity
  • Decreased Serum Sodium
  • Increased Serum Calcium
  • Hyperchloremia
  • Serum Hyposmolality
  • Increased Serum Potassium

• Hepatic:

  • Increased Serum Bilirubin

Side effects of Suprep Bowel Prep Kit (Frequency Not Defined):

• Neuromuscular & Skeletal:

  • Increased Creatine Phosphokinase In Blood Specimen

Contraindications:

• Toxic megacolon
• Obstructive GI
• Bowel perforation
• Gastric retention
• Ileus
• Hypersensitivity to potassium sulfate or magnesium sulfate
• Toxic colitis

Warnings and precautions

• Arrhythmias:

  • Rarely have serious arrhythmias been caused by the use of ionic laxatives.
  • Patients at higher risk of arrhythmias should be treated with caution (eg, unstable angina or recent MI, cardiomyopathy, history QT prolongation, uncontrolled arrhythmias, or heart failure).
  • Patients at higher risk of serious arrhythmias should be evaluated for ECGs post-colonoscopy and baseline.

• Atypical electrolyte and fluid conditions:

  • Fluid and electrolyte disturbances may occur, especially in patients at higher risk (eg, kidney impairment, concomitant mediations altering electrolyte balance).
  • Patients should be properly hydrated before, throughout, and after any electrolyte abnormalities.

• GI effects

  • Osmotic laxatives can cause colonic mucosal and aphthous ulcerations. This includes cases of ischemic or colitis.
  • Patients with inflammatory bowel diseases should be cautious when reading colonoscopy results.

• Seizures:

  • Epileptic episodes have been linked to electrolyte abnormalities such as hyponatremia, hypokalemia, hypocalcemia, and hypomagnesemia.
  • Use with caution in those who have a history of seizures, underlying electrolyte imbalances, are more susceptible to seizures (such as those who are quitting alcohol or using benzodiazepines), have hyponatremia, or are taking concurrent drugs that decrease the seizure threshold) (known or suspected).

• Gout

  • Could cause temporary increases in uric acids and could precipitate an acute flare.
  • Gout patients should be cautious.

• Gagging reflex in the impaired

  • Patients with a weak gag reflex or those who frequently regurgitate or aspirate should exercise caution.
  • These patients should be observed during administration.

• Renal impairment

  • Patients with impaired renal function should be cautious; proper hydration is especially important for these patients.
  • Take into account baseline and post-colonoscopy electrolyte and creatinine levels, as well as BUN levels.

• Ulcerative colitis

  • Patients with active, severe ulcerative colitis should exercise caution.

Monitoring parameters:

• Seizures
• Who have a history of electrolyte abnormality
• BUN, and creatinine in patients at risk for renal impairment
• ECG (prior to therapy and post colonoscopy) in patients with risks for prolonged QT or arrhythmias.
• Consider baseline and post-procedure electrolytes

How to administer Suprep Bowel Prep Kit?

• Before using an oral solution, each bottle must be diluted.
• Consume the entire contents of each container, then hydrate as directed.
• The day before and the day following the colonoscopy, patients should avoid consuming milk, red or purple drinks, or alcoholic beverages.
• Oral drugs shouldn't be administered within an hour of the start of therapy.
• A day before colonoscopy: Patients can have a light breakfast and no other liquids the rest of the time.
• Day of the colonoscopy

Mechanism of action of Sodium, potassium, and magnesium sulfates (Suprep Bowel Prep Kit):

• Produces catharsis in the GI tract due to the osmotic effects of the unabsorbed ions.

Note:

• Pharmacokinetics are measured in terms of serum sulfate unless otherwise specified.

Absorption:

• Sulfate anions are poorly absorbed in the GI tract

Half-life elimination:

• 8.5 hours

Time to peak:

• ~17 hours after the first dose;
• ~5 hours after the second dose

Excretion:

• Feces (primarily)

International Brands of Sodium, potassium, and magnesium sulfates:

• Suprep Bowel Prep Kit

Sodium, potassium, and magnesium sulfates Brand Names in Pakistan:

No Brands Available in Pakistan.