Monograph Details
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Gastrointestinal Tract
> Constipation and bowel cleansers
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VISICOL |
| Manufacturer |
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Salix Pharmaceuticals, Inc. |
| Legal Classification |
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Rx
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| Pharmacological Class |
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Osmotic bowel cleanser. |
| Generic Name |
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Sodium phosphate (as monobasic monohydrate and dibasic anhydrous) 1.5g; tabs. |
| Indications |
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Bowel cleansing prior to colonoscopy. |
| Children |
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<18yrs: not recommended. |
| Adults |
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≥18yrs: Clear liqs only for at least 12 hours before starting. Evening before colonoscopy: 3 tabs with 8oz of clear liq every 15 mins (last dose is 2 tabs) for a total of 20 tabs; repeat on day of colonoscopy 3–5 hrs before procedure. Wait 7 days before retreating. |
| Contraindications |
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Biopsy-proven acute phosphate nephropathy. |
| Precautions |
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Severe renal insufficiency (CrCl<30mL/min). Impaired renal function. CHF. Unstable angina. Arrhythmias (consider pre-dose and post-colonoscopy ECGs). History of cardiomyopathy. Prolonged QT. Recent MI. CABG. Ascites. Gastric retention. Ileus or acute obstruction or pseudo-obstruction. Gastric bypass or stapling surgery. Severe chronic constipation. Bowel perforation. Acute colitis. Toxic megacolon. Hypomotility syndrome. Inflammatory bowel disease. Swallowing difficulties. Correct electrolyte abnormalities before use. Consider doing baseline and post-colonoscopy labs in patients at increased risk. Seizure disorder or risk. Maintain adequate fluid intake. Elderly. Pregnancy (Cat.C). |
| Interactions |
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Avoid concomitant purgative agents (esp. sodium phosphate). Caution with drugs that prolong QT interval, affect electrolytes or renal function (eg, diuretics, ACEIs, ARBs, NSAIDs), or lower seizure threshold. May reduce drug absorption. |
| Adverse Reactions |
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Nausea, vomiting, abdominal bloating/pain, dizziness, headache, mucosal bleeding or ulceration, electrolyte imbalances, seizures; rare: renal failure, acute phosphate nephropathy. |
| How Supplied |
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Tabs—40, 100 |
| Additional Resources |
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• Related Prescribing Note |
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