Sodium picosulfate/magnesium oxide/citric acid solution is used to clean out the intestines before surgery or certain procedures (such as colonoscopy, X-rays). It is a laxative that works by drawing large amounts of water into your intestines and stimulating the colon. This causes watery bowel movements (diarrhea). Clearing stool from the intestines helps your doctor to better examine the inside of your colon.

Read the Medication Guide and, if available, the Instructions for Use provided by your pharmacist before you start using this product and each time you get a refill. Be sure to read and follow all instructions for use from your doctor or the manufacturer before taking this product. If you have any questions, ask your doctor or pharmacist.

Follow any special diet instructions provided by your doctor. Usually, you may only have clear liquids on the day before your procedure. Do not drink milk, other dairy products, red/dark-colored liquids, or alcohol. To prevent becoming dehydrated, drink as much clear liquid as you can before, during, and after drinking this medication. Try to drink not only water, but also other types of clear liquids as directed by your doctor. Follow your doctor's directions carefully.

Take this product in 2 separate doses as directed by your doctor. Carefully follow your doctor's directions for when to take each dose. The dosage is based on your age and medical condition.

This product comes as either a powder in packets that must be mixed with water before taking or as a liquid in bottles that is ready to drink. Carefully follow the instructions for your product. If you are using the powder packets, just before using, mix each dose with 5 ounces/150 milliliters of cold water as directed. Stir well until the powder dissolves completely (2 to 3 minutes), then drink all of it.

If you have bloating or stomach/abdominal pain after taking this product, it may help if you stop drinking clear liquids for a little while or allow a longer time between each dose.

Watery bowel movements usually begin 2 to 4 hours after you drink the medication. This is normal and shows that the medicine is working. You should have access to a toilet until the effects of this medication have worn off.

Do not take any other medications by mouth within 1 hour before you start to drink this product because your body may not absorb the other medications. Some medications (such as digoxin, iron, tetracycline antibiotics, quinolone antibiotics such as ciprofloxacin/levofloxacin, chlorpromazine, penicillamine) should not be taken within 2 hours before or 6 hours after taking this product. Ask your doctor or pharmacist when to take your other medications.

Frequent, very watery bowel movements at any time should occur after you drink this product. Nausea, vomiting, bloating, headache, or stomach/abdominal cramps may also occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.

If your doctor has directed you to use this medication, remember that your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

This medication can cause your body to lose too much fluid and salts (dehydration). Tell your doctor right away if you have any of these serious side effects:

• confusion
• severe dizziness
• fainting
• fast/irregular heartbeat
• seizure

Tell your doctor right away if you have any serious side effects, including:

• stomach/abdominal pain that is severe or doesn't go away
• signs of kidney problems (such as change in the amount of urine)
• bloody stools
• rectal bleeding

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including:

• rash
• itching/swelling (especially of the face/tongue/throat)
• severe dizziness
• trouble breathing

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US - Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Before taking this medication, tell your doctor or pharmacist if you have any allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of:

• heart problems (such as irregular heartbeat, heart attack)
• kidney problems
• salt/mineral imbalance (such as low level of sodium in the blood)
• seizure
• stomach/intestinal problems (such as gastric retention, blockage, ulcers, ulcerative colitis)
• trouble swallowing

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.

It is unknown if this product passes into breast milk. Consult your doctor before breastfeeding.

See also How to Use section.

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.

Do not use other laxatives while taking this product.

If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call 1-800-222-1222. Canada residents can call 1-844-764-7669.

Do not share this medication with others.

Lab tests (such as sodium/potassium blood levels, blood sugar level) may be done before or after taking this medication. Keep all medical and lab appointments. Consult your doctor for more details.

If you are unable to drink all of this product and clear liquids as directed, call your doctor right away. Your procedure may need to be rescheduled.

Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.