SODIUM PICOSULFATE; MAGNESIUM OXIDE; ANHYDROUS CITRIC ACID (SOE dee um PI koe SUL fate; mag NEE zee um OX ide; an HYE drus SIT rik AS id) cleans the bowel out before a medical procedure. It works by increasing the amount of water your intestine absorbs, which softens the stool. It also helps the muscles in your intestines move stool. This helps produce a bowel movement. It belongs to a group of medications called laxatives.

How should I use this medication?

Take this medication by mouth. Take it as directed on the prescription label.

Some medications should be taken 2 hours before or 6 hours after taking this medication. Talk to your care team about all of the medications you take.

A special MedGuide will be given to you by the pharmacist with each prescription and refill. Be sure to read this information carefully each time.

This medication comes with INSTRUCTIONS FOR USE. Ask your pharmacist for directions on how to use this medication. Read the information carefully. Talk to your pharmacist or care team if you have questions.

Talk to your care team about the use of this medication in children. While this medication may be prescribed for children as young as 9 years for selected conditions, precautions do apply.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.

NOTE: This medicine is only for you. Do not share this medicine with others.

What if I miss a dose?

This does not apply. This medication is not for regular use.

Where should I keep my medication?

Keep out of the reach of children and pets.

Store at room temperature between 20 and 25 degrees C (68 and 77 degrees F). Do not refrigerate. Do not freeze. Get rid of any unused medication after the expiration date.

To get rid of medications that are no longer needed or have expired:

• Take the medications to a medication take-back program. Check with your pharmacy or law enforcement to find a location.
• If your cannot return the medication, check the label or package insert to see if the medication should be thrown out in the garbage or flushed down the toilet. If you are not sure, ask your care team. If it is safe to put it in the trash, pour the medication out of the container. Mix the medication with cat litter, dirt, coffee grounds, or other unwanted substance. Seal the mixture in a bag or container. Put it in the trash.

NOTE: This sheet is a summary. It may not cover all possible information. If you have questions about this medicine, talk to your doctor, pharmacist, or health care provider.

What side effects may I notice from receiving this medication?

Side effects that you should report to your care team as soon as possible:

• Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
• Dehydration—increased thirst, dry mouth, feeling faint or lightheaded, headache, dark yellow or brown urine
• Fast or irregular heartbeat
• Kidney injury—decrease in the amount of urine, swelling of the ankles, hands, or feet
• Seizures
• Sudden or severe stomach pain, bloody diarrhea, fever, nausea, vomiting

Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):

• Dizziness
• Headache
• Nausea
• Stomach pain

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What should I tell my care team before I take this medication?

They need to know if you have any of these conditions:

• Dehydration
• Frequently drink alcohol or use other substances
• Heart disease
• High or low levels of electrolytes, such as magnesium, potassium, or sodium in your blood
• History of fainting
• Irregular heartbeat or rhythm
• Kidney disease
• Seizures
• Stomach or intestine problems
• Trouble swallowing
• An unusual or allergic reaction to sodium picosulfate, magnesium oxide, anhydrous citric acid, other medications, dyes, or preservatives
• Pregnant or trying to get pregnant
• Breastfeeding

What may interact with this medication?

• Alcohol
• Certain antibiotics, such as ciprofloxacin, levofloxacin, tetracycline
• Certain medications for blood pressure, heart disease, irregular heartbeat
• Certain medications for depression, anxiety, or other mental health conditions
• Certain medications for seizures
• Diuretics
• Iron supplements
• NSAIDS, medications for pain and inflammation, such as ibuprofen or naproxen
• Other laxatives
• Penicillamine

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What should I watch for while using this medication?

Talk to your care team about how to prepare for your procedure. You may need to change your diet several days before the procedure. It is important to stay hydrated by drinking plenty of clear liquids, such as sports drinks, apple juice, and water. Ask your care team when you should stop drinking and eating before the procedure. Tell them if you are unable to complete the regimen as directed.

This medication may affect your coordination, reaction time, or judgment. Do not drive or operate machinery until you know how this medication affects you. Sit up or stand slowly to reduce the risk of dizzy or fainting spells. Drinking alcohol with this medication can increase the risk of these side effects.