Sodium picosulfate

Medical uses

Sodium picosulfate used in combination with magnesium oxide and anhydrous citric acid is indicated for cleansing of the colon as a preparation for colonoscopy.

Effects

Orally administered sodium picosulfate is generally used for thorough evacuation of the bowel, usually for patients who are preparing to undergo a colonoscopy. It takes 12–24 hours to work, since it works in the colon.

Abdominal cramps and diarrhea are normal effects of picosulfate and should be expected.

The use of sodium picosulfate has also been associated with certain electrolyte disturbances, such as hyponatremia and hypokalemia. Patients are often required to drink large amounts of clear fluids, to compensate for dehydration and to reestablish normal electrolyte balance.

Mechanism of action

Sodium picosulfate is a prodrug. It has no significant direct physiological effect on the intestine; however, it is metabolised by gut bacteria into the active compound 4,4'-dihydroxydiphenyl-(2-pyridyl)methane (DPM, BHPM). This compound is a stimulant laxative and increases peristalsis in the gut.

Sodium picosulfate is typically prescribed in a combined formulation with magnesium citrate, an osmotic laxative. This combination is a highly effective laxative, often prescribed to patients for bowel cleansing prior to colonoscopies.

Society and culture

Brand names

It is sold under the brand names Sodipic Picofast, Laxoberal, Laxoberon, Purg-Odan, Picolax, Guttalax, Namilax, Pico-Salax, PicoPrep, and Prepopik, among others.

Clenpiq is a combination of sodium picosulfate, magnesium oxide, and citric acid.

References

References

1. (3 March 2023). "2022 First Generic Drug Approvals".
2. (17 July 2012). "FDA News Release – FDA approves new colon-cleansing drug for colonoscopy prep". [[Food and Drug Administration]].
3. ADRAC. (February 2002). "Electrolyte disturbances with sodium picosulfate bowel cleansing products". Aust Adv Drug React Bull.
4. (January 2011). "Mechanism of action and toxicities of purgatives used for colonoscopy preparation". Expert Opinion on Drug Metabolism & Toxicology.
5. (1 March 1972). "The hydragogue and laxative effect of the sulfuric acid ester and the free diphenol of 4,4'-dihydroxydiphenyl-(pyridyl-2)-methane". Naunyn-Schmiedeberg's Archives of Pharmacology.
6. (November 1975). "Bis-(p-hydroxyphenyl)-pyridyl-2-methane: The common laxative principle of Bisacodyl and sodium picosulfate". Arzneimittel-Forschung.
7. (September 1998). "Comparison of two bowel preparations for colonoscopy: sodium picosulphate with magnesium citrate versus sulphate-free polyethylene glycol lavage solution". The American Journal of Gastroenterology.
8. [http://www.merck.pk/en/pharmaceutical_products/merck_serono/Copy_of_neurocare/laxoberon/laxoberon.html Website of Merck Pakistan]
9. [http://www.pico-salax.ca/product-information.html PICO SALAX Product Information] {{webarchive. link. (22 March 2012)
10. (May 2006). "Oral sodium phosphate (Fleet) is a superior colonoscopy preparation to Picopre (sodium picosulfate-based preparation)". Diseases of the Colon and Rectum.
11. (5 September 2023). "Clenpiq- sodium picosulfate, magnesium oxide, and anhydrous citric acid liquid".