When This Medicine Should Not Be Used:
This medicine is not right for everyone. Do not use it if you had an allergic reaction to citric acid, magnesium oxide, or sodium picosulfate, or you have problems emptying food or liquids from your stomach.

How to Use This Medicine:
Liquid

• Your doctor will tell you how much medicine to use. Do not use more than directed.
• This medicine should come with a Medication Guide. Ask your pharmacist for a copy if you do not have one.
• Split-dose dosing: Take the first dose the night before your colonoscopy. Take the second dose the next day, in the morning or at least 5 hours before your colonoscopy. If you have severe bloating, distension, or stomach pain after you take the first dose, you may need to wait until your symptoms improve before you take the second dose.
• Day-before dosing: Take the first dose in the afternoon or early evening. Take the second dose at least 6 hours after the first dose, the night before your colonoscopy.
• To use the medicine:
  
  • One dose of this medicine contains 2 packets of powder. Each packet is mixed with cold water and taken at separate times. Drink the liquid right away after you mix it. Do not prepare the oral liquid in advance.
  • Do not take the powder directly without mixing it with cold water.
  • Use the supplied medicine cup to prepare the oral liquid.
  • Drink the additional prescribed amount of clear liquids (such as water, apple juice, white cranberry juice, white grape juice, or ginger ale) before and after every dose of this medicine, and before your colonoscopy.
  • Do not eat solid foods or drink milk while you are taking this medicine.
• Missed dose: Take a dose as soon as you remember. If it is almost time for your next dose, wait until then and take a regular dose. Do not take extra medicine to make up for a missed dose.
• Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.

Drugs and Foods to Avoid:
Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Do not take other laxatives while you are taking this medicine. Do not take any oral medicine within 1 hour before you take this medicine.
• Some medicines can affect how this medicine works. Tell your doctor if you are taking any of the following:
  
  • Blood pressure medicine
  • Carbamazepine
  • Depression medicine
  • Diuretic (water pill)
  • Medicine to treat mental illness
  • NSAID pain or arthritis medicine, such as aspirin, diclofenac, ibuprofen, naproxen
  • Steroid medicine, such as hydrocortisone, methylprednisolone, prednisolone, prednisone
• Take chlorpromazine, digoxin, penicillamine, iron supplements, or antibiotics at least 2 hours before or 6 hours after you take this medicine.

Warnings While Using This Medicine:

• Tell your doctor if you are pregnant or breastfeeding, or if you have kidney or heart problems, trouble swallowing, ulcerative colitis, or a history of seizures.
• This medicine may cause heart rhythm problems, kidney problems, or seizures.
• This medicine may cause dehydration. Drink extra liquids before and after you take this medicine.
• Keep all medicine out of the reach of children. Never share your medicine with anyone.

Possible Side Effects While Using This Medicine:
Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Confusion, weakness, muscle twitching
• Decrease in how much or how often you urinate
• Fast or uneven heartbeats
• Headache, dizziness, nausea, vomiting
• Seizures
• Severe stomach pain, bleeding from the rectum
• Trouble swallowing

If you notice other side effects that you think are caused by this medicine, tell your doctor.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088