Magnesium Sulfate Potassium Sulfate Sodium Sulfate

Magnesium Sulfate Potassium Sulfate Sodium Sulfate Brand Name– Suprep

What is Magnesium Sulfate Potassium Sulfate Sodium Sulfate

Magnesium sulfate potassium sulfate sodium sulfate is an osmotic laxative used for bowel cleansing prior to colonoscopy in adults. 

This sulfate salt laxative is administered as a two-day regimen containing poorly absorbed sulfate ions that cause water to be retained in the GI tract.

The ions and ingested water flush the bowel and produce a purgative effect.

Several safe and effective bowel preparations are currently marketed; however, issues surrounding their use have been raised. Disadvantages include complaints of large volumes for ingestion with some products and an increased risk of acute phosphate nephropathy associated with sodium phosphate salt laxatives.

A sulfate salt osmotic laxative may represent a low-volume alternative that provides effective bowel cleansing without significant fluid and electrolyte shifts.

A non-inferiority study evaluated the cleansing efficacy of a split-dose sulfate regimen (SUPREP) compared to a polyethylene glycol electrolyte solution with ascorbic acid regimen (MoviPrep).

Among the 364 subjects in the split-dose strategy trial (181 SUPREP, 183 MoviPrep), 97.2% of patients who received the sulfate solution were considered to have a successful preparation for colonoscopy compared to 95.6% of patients who received the polyethylene glycol electrolyte solution. In addition, more preparations in the sulfate salt group (63.3%) were considered ‘excellent’ compared to the polyethylene glycol electrolyte group (52.5%) (p = 0.043).

Related gastrointestinal adverse events were generally mild and infrequent. SUPREP Bowel Prep Kit was approved by the FDA in August 2010.

Indications

  • bowel preparation

For use as a bowel evacuant to clean the colon prior to colonoscopy (bowel preparation)

NOTE: On the day before the colonoscopy, a light breakfast or clear liquids may be consumed. On the day of the colonoscopy, only clear liquids should be consumed. Avoid red and purple liquids, milk, and alcoholic beverages

Side Effects

  1. abdominal pain
  2. arrhythmia exacerbation
  3. AV block
  4. bowel ischemia
  5. colitis
  6. fecal incontinence
  7. fecal urgency
  8. headache
  9. hyperbilirubinemia
  10. hypercalcemia
  11. hyperchloremia
  12. hyperkalemia
  13. hyperuricemia
  14. hypocalcemia
  15. hypokalemia
  16. hypomagnesemia
  17. hyponatremia
  18. nausea
  19. seizures
  20. vomiting

Monitoring Parameters

  • serum creatinine
  • serum creatinine/BUN
  • serum electrolytes

Contraindications

  • angina
  • breast-feeding
  • cardiac arrhythmias
  • cardiomyopathy
  • children
  • colitis
  • dehydration
  • electrolyte imbalance
  • gag reflex depression
  • gastroparesis
  • geriatric
  • GI obstruction
  • GI perforation
  • gout
  • heart failure
  • hyperuricemia
  • hypocalcemia
  • hypokalemia
  • hypomagnesemia
  • hyponatremia
  • ileus
  • infants
  • inflammatory bowel disease
  • myocardial infarction
  • neonates
  • pregnancy
  • pyloric stenosis
  • QT prolongation
  • renal impairment
  • seizure disorder
  • toxic megacolon
  • ulcerative colitis
  • vomiting

Interactions

  • Acetaminophen; Hydrocodone
  • Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
  • Aliskiren; Hydrochlorothiazide, HCTZ
  • Aliskiren; Valsartan
  • Amiloride
  • Amiloride; Hydrochlorothiazide, HCTZ
  • Amlodipine; Benazepril
  • Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
  • Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
  • Amlodipine; Olmesartan
  • Amlodipine; Telmisartan
  • Amlodipine; Valsartan
  • Angiotensin II receptor antagonists
  • Angiotensin-converting enzyme inhibitors
  • Atenolol; Chlorthalidone
  • Atropine; Difenoxin
  • Atropine; Diphenoxylate
  • Azilsartan
  • Azilsartan; Chlorthalidone
  • Benazepril
  • Benazepril; Hydrochlorothiazide, HCTZ
  • Bendroflumethiazide; Nadolol
  • Bisoprolol; Hydrochlorothiazide, HCTZ
  • Brompheniramine; Guaifenesin; Hydrocodone
  • Brompheniramine; Hydrocodone; Pseudoephedrine
  • Bumetanide
  • Candesartan
  • Candesartan; Hydrochlorothiazide, HCTZ
  • Captopril
  • Captopril; Hydrochlorothiazide, HCTZ
  • Carbinoxamine; Hydrocodone; Phenylephrine
  • Carbinoxamine; Hydrocodone; Pseudoephedrine
  • Chlorothiazide
  • Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Hydrocodone
  • Chlorpheniramine; Hydrocodone; Phenylephrine
  • Chlorpheniramine; Hydrocodone; Pseudoephedrine
  • Chlorthalidone
  • Chlorthalidone; Clonidine
  • Dichlorphenamide
  • Diphenhydramine; Hydrocodone; Phenylephrine
  • Diuretics
  • Enalapril, Enalaprilat
  • Enalapril; Felodipine
  • Enalapril; Hydrochlorothiazide, HCTZ
  • Eprosartan
  • Eprosartan; Hydrochlorothiazide, HCTZ
  • Ethacrynic Acid
  • food
  • Fosinopril
  • Fosinopril; Hydrochlorothiazide, HCTZ
  • Furosemide
  • Guaifenesin; Hydrocodone
  • Guaifenesin; Hydrocodone; Pseudoephedrine
  • Homatropine; Hydrocodone
  • Hydralazine; Hydrochlorothiazide, HCTZ
  • Hydrochlorothiazide, HCTZ
  • Hydrochlorothiazide, HCTZ; Irbesartan
  • Hydrochlorothiazide, HCTZ; Lisinopril
  • Hydrochlorothiazide, HCTZ; Losartan
  • Hydrochlorothiazide, HCTZ; Methyldopa
  • Hydrochlorothiazide, HCTZ; Metoprolol
  • Hydrochlorothiazide, HCTZ; Moexipril
  • Hydrochlorothiazide, HCTZ; Olmesartan
  • Hydrochlorothiazide, HCTZ; Propranolol
  • Hydrochlorothiazide, HCTZ; Quinapril
  • Hydrochlorothiazide, HCTZ; Spironolactone
  • Hydrochlorothiazide, HCTZ; Telmisartan
  • Hydrochlorothiazide, HCTZ; Triamterene
  • Hydrochlorothiazide, HCTZ; Valsartan
  • Hydrocodone
  • Hydrocodone; Ibuprofen
  • Hydrocodone; Phenylephrine
  • Hydrocodone; Potassium Guaiacolsulfonate
  • Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
  • Hydrocodone; Pseudoephedrine
  • Indapamide
  • Irbesartan
  • Lisinopril
  • Losartan
  • Methyclothiazide
  • Metolazone
  • Moexipril
  • Nebivolol; Valsartan
  • Nonsteroidal antiinflammatory drugs
  • Olmesartan
  • Perindopril
  • Perindopril; Amlodipine
  • Quinapril
  • Ramipril
  • Sacubitril; Valsartan
  • Spironolactone
  • Telmisartan
  • Torsemide
  • Trandolapril
  • Trandolapril; Verapamil
  • Triamterene
  • Valsartan
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