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Polyethylene Glycol Electrolytes Bisacodyl Brand Names
GaviLyte-H | HalfLytely and Bisacodyl Tablet Bowel Prep Kit | PEG-Prep and Bisacodyl
What is Polyethylene Glycol Electrolytes Bisacodyl
Polyethylene glycol (PEG-3350) and electrolytes are used in combination with bisacodyl delayed-release tablets for bowel cleansing prior to colonoscopy in adults.
HalfLytely and Bisacodyl Bowel Prep Kit (PEG-3350, sodium chloride, sodium bicarbonate, potassium chloride for oral solution and bisacodyl delayed-release tablets) is a combination kit that contains a 2-liter electrolyte lavage solution and two 5 mg (10 mg total dose) bisacodyl tablets.
By starting with a dose of bisacodyl, a stimulant laxative, patients are able to ingest a reduced volume (2-liters) of PEG-3350; electrolytes solution, as compared to the usual 4 liters that are typically required with other PEG-3350; electrolytes bowel preparations.
The reduced solution volume may result in greater patient compliance as well as decreased discomfort (nausea, bloating) while maintaining comparable bowel cleansing efficacy.
In a clinical study comparing the safety and efficacy of a 2 liter PEG-3350; electrolytes lavage solution verses the standard 4 liter, participating patients (n=300) were randomized into two groups.
One group received a dose of 20 mg bisacodyl at 12 noon followed by 2 liters PEG-3350; electrolytes solution at 6PM the evening before the procedure; a second group received 4 liters PEG-3350; electrolytes solution at 6PM the evening before the procedure.
Among patients receiving the bisacodyl plus 2 liter regimen, only 1 patient (0.6%) could not finish the bowel preparation due to adverse GI complaints (abdominal cramps, bloating, nausea/vomiting) as opposed to 11 patients (7.3%) receiving the 4 liter regimen; no patients in the 4 liter group reported abdominal cramps.
Bowel cleanliness, as assessed by an endoscopist, was scored from 0% to 100% with 100% representing a perfectly clean bowel. Scores averaged 95.9% in the bisacodyl plus 2 liter regimen group and 95.3% in the 4 liter regimen group.
Clinicians should note that HalfLytely and Bisacodyl Bowel Prep Kit, when first approved, contained a total bisacodyl dose of 20 mg.
However, postmarketing adverse events of abdominal cramping following the 20 mg bisacodyl dose lead the manufacturer to evaluate if a 10 mg bisacodyl dose would result in reduced adverse events while preserving bowel cleansing efficacy. In a multicenter-controlled trial, the patients (n=455) undergoing colonoscopy were randomized into two groups receiving 10 or 20 mg bisacodyl tablets plus a 2 liter PEG-3350; electrolytes lavage solution.
Endoscopists, blinded to group assignments, observed no differences in the colon cleansing effects between the two groups. In addition, the group receiving 10 mg bisacodyl had lower symptom scores for abdominal cramping (p < 0.001) and overall discomfort (p = 0.001).
HalfLytely and Bisacodyl Bowel Prep Kit was first approved by the FDA in May 2004.
On September 24, 2007 the FDA accepted a supplemental new drug application which provided for the reduction of the bisacodyl dosage from 20 mg to 10 mg.
Indications
- bowel preparation
For use as a bowel evacuant to clean the colon prior to colonoscopy (bowel preparation)
NOTE: Patients should be well hydrated before, during, and after the colon preparation. However, patients should not drink large quantities of clear liquids after taking the polyethylene glycol; electrolytes solution until the colonoscopy has been completed.
Side Effects
- abdominal pain
- anaphylactoid reactions
- asystole
- colitis
- diarrhea
- dizziness
- dyspnea
- edema
- fecal incontinence
- fecal urgency
- flatulence
- GI bleeding
- GI perforation
- nausea
- pulmonary edema
- rhinorrhea
- seizures
- syncope
- urticaria
- vomiting
Monitoring Parameters
- serum creatinine/BUN
- serum electrolytes
Contraindications
- abdominal pain
- acute abdomen
- appendicitis
- breast-feeding
- children
- colitis
- diverticulitis
- gag reflex depression
- geriatric
- GI bleeding
- GI obstruction
- GI perforation
- hypokalemia
- hyponatremia
- ileus
- pregnancy
- renal disease
- renal failure
- renal impairment
- seizure disorder
- seizures
- toxic megacolon
- ulcerative colitis
- vomiting
Interactions
- Acetaminophen; Hydrocodone
- Aluminum Hydroxide
- Aluminum Hydroxide; Magnesium Carbonate
- Aluminum Hydroxide; Magnesium Hydroxide
- Aluminum Hydroxide; Magnesium Hydroxide; Simethicone
- Aluminum Hydroxide; Magnesium Trisilicate
- Antacids
- Aspirin, ASA; Citric Acid; Sodium Bicarbonate
- Atropine; Difenoxin
- Atropine; Diphenoxylate
- Bisacodyl
- Brompheniramine; Guaifenesin; Hydrocodone
- Brompheniramine; Hydrocodone; Pseudoephedrine
- Bumetanide
- Calcium Carbonate
- Calcium Carbonate; Magnesium Hydroxide
- Calcium Carbonate; Risedronate
- Calcium Carbonate; Simethicone
- Calcium Phosphate, Supersaturated
- Carbinoxamine; Hydrocodone; Phenylephrine
- Carbinoxamine; Hydrocodone; Pseudoephedrine
- Casanthranol; Docusate Sodium
- Castor Oil
- Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
- Chlorpheniramine; Hydrocodone
- Chlorpheniramine; Hydrocodone; Phenylephrine
- Chlorpheniramine; Hydrocodone; Pseudoephedrine
- Cimetidine
- Dichlorphenamide
- Diphenhydramine; Hydrocodone; Phenylephrine
- Ethacrynic Acid
- Famotidine
- Famotidine; Ibuprofen
- food
- Furosemide
- Guaifenesin; Hydrocodone
- Guaifenesin; Hydrocodone; Pseudoephedrine
- H2-blockers
- Homatropine; Hydrocodone
- Hydrocodone
- Hydrocodone; Ibuprofen
- Hydrocodone; Phenylephrine
- Hydrocodone; Potassium Guaiacolsulfonate
- Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
- Hydrocodone; Pseudoephedrine
- Lactulose
- Loop diuretics
- Magnesium Hydroxide
- Nizatidine
- Omeprazole; Sodium Bicarbonate
- Pimozide
- Proton pump inhibitors
- Ranitidine
- Senna
- Sodium Bicarbonate
- Sodium Phosphate Monobasic Monohydrate; Sodium Phosphate Dibasic Anhydrous
- Sodium picosulfate; Magnesium oxide; Anhydrous citric acid
- Stimulant Laxatives
- Torsemide
