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Sodium picosulfate/magnesium/citric acid (By mouth)

Citric Acid (SIT-rik AS-id), Magnesium Oxide (mag-NEE-zee-um OX-ide), Sodium Picosulfate (SOE-dee-um pye-koe-sul-fate)

Used to cleanse the bowels in preparation for a colonoscopy. This medicine is a laxative.

Brand Name(s):

Clenpiq, Prepopik

There may be other brand names for this medicine.

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 if you have stomach or bowel problems (including blockage, perforation, or problems emptying food or liquids from your stomach).

How to Use This Medicine:


  • Your doctor will tell you how much medicine to use. Do not use more than directed.
  • 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 Clenpiq®:
    • Clenpiq® is ready to drink and is equal to one dose. You will need two doses of this medicine. Drink all of this medicine straight from the bottle.
  • To use Prepopik®:
    • One dose of this medicine contains 2 packets of powder. Each packet is mixed with cold water (5 ounces) for 2 to 3 minutes 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 (including water, apple juice, clear broth, white cranberry juice, white grape juice, or ginger ale) before and after every dose of this medicine, and until at least 2 hours before your colonoscopy.
  • Do not eat solid foods or drink dairy or anything colored red or purple while you are taking this medicine.
  • This medicine should come with a Medication Guide. Ask your pharmacist for a copy if you do not have one.
  • 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. Do not refrigerate or freeze Clenpiq® or the mixed Prepopik®.

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:
    • Carbamazepine
    • Blood pressure medicine
    • Diuretic (water pill)
    • Medicine for heart rhythm problems
    • Medicine to treat depression or mental illness
    • NSAID pain or arthritis medicine (including aspirin, diclofenac, ibuprofen, naproxen)
    • Steroid medicine (including hydrocortisone, methylprednisolone, prednisolone, prednisone)
  • Take chlorpromazine, digoxin, penicillamine, iron supplements, or tetracycline or fluoroquinolone antibiotics at least 2 hours before or 6 hours after you take this medicine.
  • Do not drink alcohol while you are using this medicine.

Warnings While Using This Medicine:

  • Tell your doctor if you are pregnant or breastfeeding, or if you have kidney disease, heart rhythm problems, heart failure, a recent heart attack, trouble swallowing, ulcerative colitis, inflammatory bowel disease, or a history of seizures.
  • This medicine may cause the following problems:
    • Heart rhythm problems (including arrhythmia)
    • Seizures
    • Kidney problems
    • Stomach or bowel problems (including colitis, ulcers)
  • This medicine may cause dehydration. Drink extra liquids before and after you take this medicine.
  • Your doctor will do lab tests at regular visits to check on the effects of this medicine. Keep all appointments.
  • 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, slow, pounding, or uneven heartbeat
  • Headache, dizziness, nausea, vomiting
  • Seizures
  • Severe stomach pain, bleeding from the rectum
  • Trouble swallowing, gagging

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

Last Updated: 5/1/2020

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