Pikoprep, sachets of 16.1g 2 pcs.

Pharmacokinetics

The active ingredients act locally in the colon, with none being absorbed in significant amounts.

The time of passage through the gastrointestinal tract is individual for each person, but most often the orocecal passage time is 4-5 hours and the passage through the colon is 12-24 hours. The osmotic effect of Picoprep begins to develop in the small intestine, meaning that within 2 hours after taking the drug a significant amount of fluid is excreted into the intestine. The motor effect of the drug develops only in the large intestine and depends on how much fluid was excreted and how much additional fluid the patient took. The effect of the drug completely stops after the bowel is emptied, which is 6 to 18 hours.

Pharmacodynamics

Pikoprep is a laxative; the active substances of the drug are sodium picosulfate, which stimulates the laxative effect and works in the large intestine, and magnesium citrate, which shows a laxative effect due to osmotic retention of moisture in the large intestine. The action of the drug manifests itself in a strong flushing effect which is combined with the effect of stimulation of peristalsis of the intestine, which is the reason of its use for colon cleansing before radiographic examinations, colonoscopy or surgical procedures.

Indications

Cleansing of the bowel before X-rays, endoscopy or surgery

Preparing for diagnostic procedures

Cleansing of the bowel before X-rays, endoscopy or surgery

Active ingredient

Composition

1 packet contains:

Active ingredients:

sodium picosulfate 10 mg,

magnesium oxide 3.5 g,

hydrous citric acid 12 g;

Auxiliary substances:

Potassium bicarbonate,

Sodium saccharin,

Natural orange flavoring dry (gum arabic (E414),

lactose,

ascorbic acid (E300),

butyl hydroxyanisole (E320).

How to take, the dosage

The day before hospitalization, it is recommended to switch to a low-calorie diet. To prevent dehydration during drug administration, it is recommended to drink sufficient amount of water (about 250 ml per hour). The drug is taken orally.

Rules for preparing the powder

The contents of one sachet are dissolved in a glass of water at room temperature (approximately 150 ml), stirred for 2-3 minutes and the resulting solution is drunk. If the solution has become warm, wait until the solution has cooled to a drinkable temperature.

Adults (including the elderly)

The contents of one sachet are diluted with water as described above and taken in the evening the day before and repeated 6-8 hours later.

Children

1-2 years: 1/4 of the contents of the packet in the morning and 1/4 of the contents of the packet in the afternoon;

2-4 years old: 1/2 of the contents of the bag in the morning and 1/2 of the contents of the bag in the afternoon;

4-9 years: 1 bag contents in the morning and 1/2 of the contents of the bag in the afternoon;

9 years and older: dosing as with adults.

The remainder of the solution is discarded. The prepared solution should not be stored.

Interaction

As Pikoprep is a laxative, it increases the rate of gastrointestinal transit. Consequently, taking the drug may alter the absorption of other oral medications (e.g. antiepileptic and anti-diabetic drugs, contraceptives and antibiotics).

The effectiveness of the drug Pikoprep is reduced if concomitantly taken with laxatives that increase the volume of intestinal contents.

Picoprep should be used with caution in patients already taking drugs which cause hypokalemia (such as diuretics or corticosteroids or drugs which are especially prone to hypokalemia, such as cardiac glycosides). Caution should be exercised when Picoprep is administered to patients taking non-steroidal anti-inflammatory drugs or drugs that induce inadequate secretion of antidiuretic hormone, such as tricyclic antidepressants, selective serotonin reuptake inhibitors, antipsychotics and carbamazepine preparations, as they can increase the risk of water retention and/or electrolyte imbalance.

Special Instructions

Particular caution should be exercised when using the drug after recent gastrointestinal surgical procedures and in patients with impaired liver function, cardiac disease or inflammatory bowel disease.

The drug should be used with caution in patients using medications which can affect fluid and/or electrolyte balance, e.g., diuretics, corticosteroids, lithium.

Because Picoprep can change absorption of the drugs intended for regular oral administration, this is a case of caution with which to use with caution; for example, there have been isolated reports of convulsive seizures in patients taking anti-epileptic drugs which have previously been successful in controlling epilepsy.

Inadequate oral intake of water and electrolytes can lead to clinically significant deficits, especially in frail patients. Therefore, elderly and debilitated patients as well as patients at risk of hypokalemia should be under medical supervision. In patients with signs or symptoms of hyponatremia, rapid corrective measures may be required to restore the balance of fluids and electrolytes. Sufficient fluids should be consumed.

The period of colon cleansing should not exceed 24 hours, as a longer procedure may increase the risk of fluid or electrolyte imbalances.

The product contains lactose, so it should not be used in patients who are lactose intolerant.

The product is not intended to be used as an ordinary laxative.

In children

The drug is used in children from 1 year of age under medical supervision in a hospital setting.

Picoprep use during pregnancy or lactation

Picoprep has limited clinical experience during pregnancy; therefore, the drug should be used with caution, especially in the first trimester of pregnancy.

Sodium picosulfate and magnesium citrate are not excreted in breast milk.

Particular effects of the drug on the ability to drive vehicles and operate moving mechanisms

With regard to the possibility of convulsions, seizures or mental confusion, one should refrain from driving vehicles or operating other mechanisms while using the drug.

Contraindications

Side effects

Overdose

Symptoms: possible development of profuse diarrhea.

Treatment: general supportive care and adequate fluid intake.