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 procedure called colonoscopy. This medicine is a laxative.

Brand Name(s)


When This Medicine Should Not Be Used

How to Use This Medicine


  • Take your medicine as directed.
  • This medicine should come with a Medication Guide. Ask your pharmacist for a copy if you do not have one.
  • You may take this medicine in two dosing regimens: Split-Dose dosing regimen and Day-Before dosing regimen. Your doctor will tell you how to take this medicine depending on your colonoscopy schedule, distance traveled, and other personal circumstances.
  • Split-dose dosing regimen: Take your first packet the night before colonoscopy, and the second dose the next day, in the morning or at least 5 hours before your colonoscopy.
  • Day-Before dosing regimen: Take your first packet in the afternoon or early evening, and the second dose at least 6 hours after the first dose, the night before colonoscopy.
  • To use the medicine:
    • One dose of this medicine consists of two packets of powder, each packet is mixed with cold water and taken at separate dosing times. Drink the liquid right away after mixing. 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 when preparing the oral liquid.
    • Drink the additional prescribed amount of clear fluids (such as water, apple juice, white cranberry juice, white grape juice, or ginger ale) after every dose of this medicine.
    • Do not eat solid foods or drink milk while taking this medicine.
    • Drink clear liquids before your colonoscopy.

If a dose is missed:

  • 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.

How to Store and Dispose of This Medicine

  • Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.
  • Ask your pharmacist, doctor, or health caregiver about the best way to dispose of any outdated medicine or medicine no longer needed.
  • Keep all medicine out of the reach of children. Never share your medicine with anyone.

Drugs and Foods to Avoid

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

  • Make sure your doctor knows if you are also using a diuretic (water pill, such as furosemide, torsemide, Lasix®), certain blood pressure medicines (such as benazepril, enalapril, lisinopril, Avalide®, Avapro®, Benicar®, Cozaar®, Diovan®, Lotrel®, Micardis®, Vasotec®, Zestoretic®, Zestril®), a steroid medicine (such as hydrocortisone, methylprednisolone, prednisolone, prednisone), or pain or arthritis medicine (NSAID, such as aspirin, diclofenac, ibuprofen, naproxen, Advil®, Aleve®, Celebrex®, Voltaren®). Tell your doctor if you are also using carbamazepine (Tegretol®), medicine to treat depression (such as amitriptyline, citalopram, fluoxetine, nortriptyline, sertraline, Elavil®), or medicine to treat mental illness (such as promethazine, Phenergan®).
  • Make sure your doctor knows if you are taking chlorpromazine (Thorazine®), digoxin (Lanoxin®), penicillamine (Cuprimine®, Depen®), iron supplements, and certain antibiotics (such as ciprofloxacin, doxycycline, minocycline, tetracycline, Avelox®, Levaquin®, Vigamox®). These medicines should be taken at least 2 hours before starting Prepopik? and 6 hours after taking Prepopik?.
  • Avoid taking any medicine by mouth within 1 hour before taking Prepopik?.
  • Avoid taking other laxatives while you are taking this medicine.

Warnings While Using This Medicine

  • Make sure your doctor knows if you are pregnant or breastfeeding, or if you have kidney problems, a recent heart attack, angina (severe chest pain), congestive heart failure, heart disease, heart rhythm problem (such as arrhythmia, prolonged QT), mineral imbalance (such as low calcium, magnesium, potassium, sodium in the blood), stomach or bowel problems, trouble swallowing, ulcerative colitis, or a history of seizures. Tell your doctor if you are withdrawing from alcohol or benzodiazepines (such as alprazolam, clonazepam, diazepam, lorazepam, Xanax®).
  • Contact your doctor right away if you have decreased urination, dizziness, headache, or vomiting. These could be symptoms of a loss of too much body fluid (dehydration).
  • Stop taking this medicine if you have severe bloating, distension, or stomach pain after taking the first packet of Prepopik?. You may delay taking the second dose until your symptoms improve.
  • Your doctor will do lab tests at regular visits to check on the effects of this medicine. Keep all appointments.

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, and muscle twitching
  • Decrease in how much or how often you urinate
  • Fast or uneven heartbeats
  • Headache, dizziness, nausea, vomiting
  • Seizures
  • Severe stomach pain, bleeding from the rectum
  • Trouble swallowing

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

Version Info

  • Last reviewed on 8/4/2014

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