polyethylene glycol/electrolyte

ROUTE	ONSET	PEAK	DURATION
PO	1 hr	unknown	4 hr

Contraindicated in:

GI obstruction;
Bowel perforation;
Gastric retention;
Toxic colitis;
Toxic megacolon.

Use Cautiously in:

Patients with absent or diminished gag reflex;
Unconscious or semicomatose states, in which administration is via nasogastric (NG) tube;
History of ulcerative colitis (↑ risk of hypoglycemia, dehydration, and hypokalemia);
Barium enema using double-contrast technique (may not allow proper barium coating of mucosa);
Glucose-6-phosphate dehydrogenase deficiency (Moviprep and Plenvu only);
Renal impairment or concurrent use of diuretics, ACE inhibitors, angiotensin II receptor blockers, or NSAIDs (↑ risk of renal injury);
History of prolonged QT interval, arrhythmias, recent MI, unstable angina, HF, or electrolyte abnormality;
Seizure disorders or being at risk for seizures;
Phenylketonuria (Plenvu only; contains phenylalanine);
Abdominal pain of uncertain cause, particularly if accompanied by fever;
OB: Use during pregnancy only if potential maternal benefit justifies potential fetal risk;
Lactation: Use while breastfeeding only if potential maternal benefit justifies potential risk to infant;
Pedi: Children (safety and effectiveness not established; children 2 yr more prone to hypoglycemia, dehydration, and hypokalemia);
Geri: Older adults may be more sensitive to effects.

Adv. Reactions/Side Effects ⬆ ⬇

CV: ARRHYTHMIAS

F and E: fluid and electrolyte abnormalities

GI: abdominal fullness, diarrhea, bloating, cramps, ischemic colitis, nausea, vomiting

Neuro: SEIZURES

Misc: allergic reactions (rare)

Interactions ⬆ ⬇

Drug-drug:

Interferes with the absorption of orally administered medications by decreasing transit time (do not administer within 1 hr of start of therapy).
Stimulant laxatives may ↑ risk of mucosal irritation or ischemic colitis; avoid concurrent use.

Route/Dosage ⬆ ⬇

PO (Adults ): 240 mL every 10 min (up to 4 L) until fecal discharge appears clear and has no solid material; Moviprep: On evening before colonoscopy, give 240 mL every 15 min for 1 hr, followed by 480 mL of clear liquid before going to bed; on morning of colonoscopy, give 240 mL every 15 min for 1 hr, followed by 480 mL of clear liquid ≥2 hr before test (alternative regimen is 240 mL every 15 min for 1 hr ≥3 hr before bedtime on evening before colonoscopy; then 1.5 hr later, give 240 mL every 15 min for 1 hr; may drink clear fluids up to 2 hr before test); Plenvu (2-Day Split-Dosing Regimen): On evening before colonoscopy (between 4 pm and 8 pm), empty contents of Dose 1 into mixing container and then fill container with water to fill line. Drink entire container within 30 min. Refill container with 480 mL of water and drink entire container over next 30 min. On morning of colonoscopy (approximately 12 hr after Dose 1 between 4 am and 8 am), empty contents of Dose 2 Pouch A and Dose 2 Pouch B into mixing container and then fill container with water to fill line. Drink entire container over next 30 min. Consume additional water or clear liquids up to 2 hr before colonoscopy; Plenvu (1-Day Morning-Dosing Regimen): On morning of colonoscopy (between 3 am and 7 am), empty contents of Dose 1 into mixing container and then fill container with water to fill line. Drink entire container within 30 min. Refill container with 480 mL of water and drink entire container over next 30 min. At least 2 hr after start of Dose 1, empty contents of Dose 2 Pouch A and Dose 2 Pouch B into mixing container and then fill container with water to fill line. Drink entire container over next 30 min. Consume additional water or clear liquids up to 2 hr before colonoscopy. Suflave: Pour contents of flavor-enhancing packet into one bottle of medication and then fill container with water to fill line. Drink 240 mL every 15 min until bottle is empty, followed by 480 mL of water before going to bed. On morning of colonoscopy, pour contents of flavor-enhancing packet into one bottle of medication and then fill container with water to fill line. Drink 240 mL every 15 min until bottle is empty, followed by 480 mL of water during the morning. Stop drinking clear liquids 2 hr before test.
PO (Children ≥6 mo): 25 mL/kg/hr until fecal discharge is clear and has no solid material.

Availability ⬆ ⬇

(Generic available)

Powder for oral solutionregular, pineapple, citrus berry, lemon lime, orange, cherry: NuLytely and Suflave—powder in bottles for reconstitution; GoLYTELY—powder in packets and bottles for reconstitution; MoviPrep and Plenvu—powder in pouches for reconstitution

Assessment ⬆ ⬇

Assess color, consistency, and amount of stool produced.
Monitor semiconscious or unconscious patients closely for regurgitation when administering via NG tube.

Lab Test Considerations:

Monitor BUN and serum creatinine at baseline and postcolonoscopy in patients with renal impairment.
Monitor serum glucose and urine osmolality.
Monitor ECG at baseline and postcolonoscopy in patients with serious cardiovascular arrhythmias.
Correct fluid and electrolyte abnormalities before treatment.

Implementation ⬆ ⬇

Do not confuse polyethylene glycol with propylene glycol.
Do not add extra flavorings or additional ingredients to solution prior to administration. Do not combine with starch-based thickeners; ↑ risk of choking and potential aspiration.
- Avoid solid food and milk within 1–2 hr of administration, but adequately hydrate prior to, during, and after administration.
- Patient should be allowed only clear liquids after completion of doses.
PO: Solution may be reconstituted with tap water. Shake vigorously until powder is dissolved. Keep solution refrigerated after mixing.
- Follow two-dose regimen for Moviprep, Suflave, Gavilyte, and Plenvu.
- May be administered via NG tube at a rate of 20–30 mL/min.

Patient/Family Teaching ⬆ ⬇

Explain purpose and side effects of medication to patient. Advise patient to read Patient Information before starting therapy. Take as directed. Explain to the patient they will have diarrhea, which cleanses the bowel within 4 hr. The first bowel movement usually occurs within 1 hr of administration.
Advise patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and to consult with health care professional before taking other medications.
Instruct patient to drink 240 mL every 10 min until 4 L have been consumed or fecal discharge is clear and free of solid matter. Rapidly drinking each 240 mL is preferred over drinking small amounts continuously.
Advise patient not to eat or drink alcohol, milk, anything colored red or purple, or any other foods containing pulp material.
Instruct patient to consume additional clear liquids before, during, and after the use of medication up until 2 hr before colonoscopy.
Advise patient to avoid other laxatives and oral medications within 1 hr of starting and during prep.
Instruct patient to notify health care professional if symptoms of dehydration (vomiting; heart problems; seizures; dizziness; kidney problems; dry mouth; feel faint, weak, or light-headed, especially when standing) occur.
Rep: Advise females of reproductive potential to notify health care professional if pregnancy is planned or suspected or if breastfeeding.

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Pronunciation ⬇

Classifications ⬆ ⬇

Indications ⬆ ⬇

Action ⬆ ⬇

Pharmacokinetics ⬆ ⬇

Time/Action Profile ⬆ ⬇

Contraind./Precautions ⬆ ⬇