Telephone: 239-275-0728 Fax: 239-275-6947
Miralax Colonoscopy and Surgical Bowel Prep
Miralax Powder, 238g bottle, over-the-counter item Dulcolax, 4 tablets, over-the-counter item 64oz Gatorade Fleets Enema Clear Liquids (see list below)
One week prior to the procedure: DO NOT take medications that may cause bleeding. These medications may include: Plavix, Coumadin, Aspirin. You MUST stop any anti-inflammatory type drugs including: Empirin, Ecotrin, Exedrin, Bufferin, Ascriptin, Ibuprofen, Motrin, Advil, Medipren, Nuprin, Naprosyn, Naproxen, Sulindac, Piroxicam, Feldene, Indomethacin, Indocin, Celebrex, Bextra, Diclofenac, and Voltaren.
STOP all multi-vitamins, herbal supplements, and Vitamin E
Tylenol and other brands which contain ACETAMINOPHEN are safe to use prior to this procedure. One day before the procedure: Have a clear liquid diet throughout the day. Avoid liquids that are red or purple in color such as red grape or cranberry juice. Avoid dairy products. Clear liquids include:
Soups: Clear broth or consommé Sports Drinks: Gatorade, Powerade, Propel Juices: white cranberry, white grape, apple, limeade, lemonade, orange, grapefruit Beverages: tea, black coffee, kool-aid, carbonated beverages, water Desserts: water ices, Italian ices, popsicles, Jello
It is important that you drink as much fluid as you can throughout the day. You may continue to drink clear liquids until midnight. At 1:00pm, take 4 Dulcolax tablets with a glass of water At 5:00pm, mix the entire 238g bottle of Miralax with the 64oz bottle of Gatorade Shake the solution until the Miralax is dissolved. Drink an 8oz glass every 10-15 minutes until the solution is gone (drinking through a straw helps). DO NOT EAT OR DRINK ANYTHING AFTER MIDNIGHT.
Day of the Procedure: DO NOT EAT OR DRINK ANYTHING! Your procedure may be cancelled if you do! If you take medication, you may have it in the morning of the procedure with a small amount of water. This means NO MORE than a few sips of water. You may brush your teeth. Administer one fleets enema one hour before leaving your home for the procedure- this ensures that the rectum is free from all debris. Diabetics: If you normally take insulin at night, take only ½ your regular dose. If you normally take a diabetes pill (hypoglycemic agent) in the morning, skip it, but take your other medications.
Commonly Asked Questions: What to expect… It usually takes about an hour to begin to notice the diarrhea affect. You may notice some bloating or cramping at the beginning of the prep, but this usually gradually improves once the diarrhea begins. Occasionally, some may develop nausea with vomiting. The best remedy for this is to take a break from the Miralax for about an hour to allow it to move downstream, and then to resume drinking at a slower rate. It usually takes two hours to complete the entire amount, and diarrhea generally continues for about an hour or two after completing the prep. Many have found that drinking the prep through a straw and chilling the solution improves tolerance. 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 an additional tap water or 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 in enough fluid with the prep, and can be remedied by increasing fluid intake. 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 Please call us if you have any questions (239) 275-0728 and speak with your physician’s medical assistant. 03/2011
Duetact ® (pioglitazone & glimepiride) FDA-APPROVED INDICATION Duetact® is indicated as an adjunct to diet and exercise as a once-daily combination therapy to improve glycemic control in patients with type 2 diabetes who are already being treated with a combination of pioglitazone and a sulfonylurea, or whose diabetes is not adequately controlled with a sulfonylurea alone, or f
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