Colonoscopy with Miralax
For this preparation, you will need:
- One 238 gram bottle of Miralax (available over the counter without a prescription)
- Four Dulcolax tablets
- 64 oz of your favorite clear liquid (preferably Gatorade or Crystal Light,) – do not purchase a red colored liquid
Medication and Diet Instructions:
Seven days before the procedure:
Stop taking aspirin (and aspirin-containing products) and Plavix (clopidogel). Acetaminophen (Tylenol) can be continued or substituted as a pain-reliever for aspirin.
Three days before the procedure:
- Stop taking Coumadin (warfarin). If you have an artificial heart valve, you need to talk to your primary care physician or cardiologist about using an alternative anticoagulant.
- Stop taking anti-inflammatory medicines such as Aleve, Motrin, Advil, Ibuprofen and Naproxyn.
- Avoid eating nuts, seeds, popcorn, grapes, green peas, beans and tomatoes. Fibers from these foods can clog the colonoscope.
On the day before the procedure:
You may have a regular breakfast. After breakfast, you will need to go on a clear liquid diet. You can drink clear liquids up to 2 hours prior to the appointment. Avoid juices with pulp such as orange or grapefruit juice. No dairy products, cream or soy. Coffee and tea are O.K. Examples of clear liquids include broth or bouillon, Jell-O, clear juices (white grape or apple), sports drinks such as Gatorade or PowerAde, sodas such as Sprite, 7-Up, or gingerale, lemonade, Popsicles, coffee or tea and of course, water. Avoid red or purple colored liquids. You may use sugar, honey or lemon. It is important that you drink as much fluid as you can throughout the day. It is also worthwhile to get a supply of aloe wet wipes and Desitin ointment to ward off a sore bottom.
STEP 1: Beginning at approximately 3:00PM
Take two (2) Dulcolax tablets with 8 oz of water. Swallow the tablets whole with a full glass of water. Mix bottle of Miralax in 64 oz of clear liquid. Shake the solution until the Miralax is dissolved and refrigerate it.
STEP 2: Beginning at approximately 6:00PM
Shake the solution again to make sure the Miralax is dissolved. Drink 8 oz of the solution every 10-15 minutes until you have finished about ¾ of the solution. You may drink as much clear liquids as you wish prior to going to sleep.
STEP 3: Beginning at approximately 8:00PM
- Take two (2) additional Dulcolax tablets with 8 oz of water. Swallow the tablets whole with a full glass of water.
- Drink the remaining solution
- If your colonoscopy is scheduled for 11am or earlier, beginning at 5am, drink 8 oz of the solution every 10-15 minutes until finished.
- If your colonoscopy is scheduled for after 11am, beginning at 6am, drink 8 oz of the solution every 10-15 minutes until finished.
DAY OF THE PROCEDURE:
- Do not drink anything 2 hours before the procedure.
- You should be accompanied by a friend or relative to drive or assist you home. You will not be allowed to drive for 12 hours after the procedure.
- You should take your regular medications with sips of water unless you are instructed otherwise.
- If you are a diabetic taking insulin, hold the morning dose of insulin the day of the procedure
- If you have an artificial heart valve, or have a previous history of endocarditis, or other specific indication, please notify our office to determine if you require a pre-procedure antibiotic.
- Be sure to remember any allergies to medications and to Latex, or conditions that would make you sensitive to sedation such as sleep apnea syndrome.
Commonly asked Questions:
How do I know if my prep is adequate?
The stool should be watery in consistency. It does not have to be clear in color like water since digestive juices will continue to tint the stool yellow and small flecks of debris are not a problem as long as the stool is not muddy or thick. If there is any question, you can self administer a fleet enema prior to leaving home for the procedure..
What side effects may I expect?
Since the prep works by flooding the intestinal tract with fluid, abdominal bloating and cramping may occur, as well as some nausea and vomiting. This is usually temporary, and as the diarrhea develops, symptoms will gradually improve. Weakness can also occur, especially if you have not taken enough fluid with the prep, and can be remedied by increasing fluid intake (especially with sports drinks such as Gatorade or PowerAde).
Will the prep interfere with my other medications?
Medications taken at least an hour before beginning the prep should be adequately absorbed, but thereafter, they are likely to be washed away by the prep.
What if I have other questions?
Call our office to address any other concerns not answered here.