Picolax for Morning Appointments

Patient Information Factsheet

Bowel preparation instructions for colonoscopy

What is Picolax?

• Picolax is a medicine that helps clean your bowel (or colon) before an endoscopy.
• It works by making you empty your bowel a lot (going for a poo), causing watery bowel movements to clean it out.
• It is important to have an empty, clean bowel so that the Endoscopist can see it clearly.

Before you take Picolax

• Do not take Picolax if you have ever had an allergic reaction to it.
• Please tell your Doctor or call us on the number below if you have this or any other allergies.
• If you have serious heart or kidney problems, please contact us before you start taking Picolax, as it might not be safe for you.
• Please tell us if you are pregnant or trying to get pregnant.
• This medicine contains lactose as part of the flavouring.
• If you have galactose intolerance, Lapp lactase deficiency or glucose- galactose malabsorption, do not take this medicine.
• If you are not sure about taking Picolax or do not understand the instructions, please contact the endoscopy department on 020 7288 3811/3819 or email whh-tr.endoscopypreassessment@nhs.net.
• Your test will only work well if your bowel is very clean. If it is not clear enough, your test may need to be delayed, and you might have to take the medicine again.
• Please read the leaflet inside the Picolax box carefully to make sure you are not allergic to any of the ingredients.
• Once you start taking Picolax, stay close to a toilet, as you will need to go often.

Medication

• Do not take any iron tablets 7 days before your test.
• Stop taking fibre supplements (like Fybogel, Regulan, or Isphagula Husk) 3 days before your test.
• Stop taking medicines for diarrhoea (like loperamide, Imodium or Lomotil) 3 days before your test.

Other medication

• If you take any medication regularly, do not take them within one hour before or after drinking Picolax.
• If you use the contraceptive pill, you must use extra protection (like condoms). Picolax can cause diarrhoea and make the pill less effective.
• Picolax might stop other medicines from working properly until the diarrhoea goes away. If you are worried about any of your medicines, please talk to the endoscopy team.
• You should keep taking your regular medicines, including steroids, but you may need to wait until after the procedure to take them on the day of your test.
• If you take blood thinners or medications for diabetes, please speak to the endoscopy Nurses before starting Picolax. You may need special instructions for your medicines.

Diet

• You must start eating a low fibre diet 3 days before your procedure.
• You can eat:
  • Fats: butter or margarine
  • Eggs: boiled, poached or scrambled eggs
  • Cereal: Rice Krispies or Corn Flakes
  • Cheese: Cheese, cream cheese, cottage cheese or cheese sauce
  • Dairy: milk, plain yogurt (no fruit bits), custard
  • Pasta: plain macaroni, spaghetti or noodles (not whole-wheat)
  • Rice: plain boiled white rice
  • Meat/Fish: well-cooked beef, lamb, ham, pork, chicken, fish (without skin) or shellfish
  • Bread: white bread or toast
  • Soya/Tofu
  • Sugar: white or brown sugar and sweeteners
  • Spreads: shred less marmalade or jam
  • Potatoes
• Do not eat:
  • Wholegrain or seeded bread
  • Bran cereals, porridge, muesli
  • Raw fruit or vegetables, skins, seeds
  • Nuts, lentils, peas, beans
  • Red or purple drinks or jelly
  • Pies or pastries

Taking Picolax for morning appointment

• It is important that you take both doses of Picolax exactly as shown below.
• Please note that the times may be a little different from those in the leaflet inside the box.
• Make sure you also follow the food and drink advice given above.

The day before your test

• You can eat a light low fibre breakfast and lunch before 12 noon. - After 12pm: drink only clear fluids. No solid food from this point.
• Do not eat even if you feel hungry. You can have clear soup or any of the clear drinks listed below. Try to drink plenty of fluids every hour.
• Clear fluids (no alcohol beverages):
  • Water
  • Soft drinks, energy drinks (try to avoid fizzy ones)
  • Fruit squash, Cordials (no blackcurrant or dark colours)
  • Tea or coffee (black only- no milk)
  • Herbal or fruit teas (no bits)
  • Clear soups such as consommé, strained chicken soup or Bovril
  • Drinks made from stock or meat extract cubes
• At 3PM: Dissolve the first sachet of Picolax by mixing the contents of one sachet in 200 ml of water (large glass of water).
• Stir well for 2-3 minutes and drink it slowly, in small sips, over 30 minutes. If the mixture becomes hot, allow it to cool, then drink.
• Drinking it slowly helps with side effects such as feeling sick.
• After finishing the medicine, drink at least another 500 ml of water or clear fluid to keep yourself well hydrated.
• At *7PM: Dissolve the second sachet of Picolax, by mixing the contents of one sachet in 200 ml of water (large glass of water).
• Stir well for 2-3 minutes and drink it slowly, in small sips, over 30 minutes. If the mixture becomes hot, allow it to cool, then drink.
• Drinking it slowly helps prevent side effects such as feeling sick.
• After finishing the medicine, drink at least another 500 ml of water or clear fluid to keep yourself well hydrated.
• Continue drinking clear liquids and then stop drinking 2 hours before your test.

Possible side effects

• Common side effects (you may notice):
  • Feeling tired or having trouble sleeping
  • Headache or feeling sick (nausea)
  • Stomach pain or bloating
  • Soreness around your bottom (anal discomfort)
  • Feeling thirsty or hungry
  • Being sick (vomiting)
  • Indigestion or feeling generally unwell
• Uncommon side effects (sometimes people may experience):
  • Dehydration
  • Skin rash or allergic reaction (very rare cases of severe allergy or anaphylaxis)
  • Fits or seizures (very rare)
• Stop taking Picolax and seek medical help immediately if you have:
  • Rash, itching, or swelling of your face, ankles or other parts of your body
  • Heart palpitations (fast or irregular heartbeat)
  • Extreme fatigue
  • Shortness of breath
  • Severe or ongoing vomiting
  • Severe stomach pain
• If you have any severe side effects or you are worried about how you feel contact the Endoscopy Unit on 020 7288 3811/3819. If it is out of hours, please go to your nearest Emergency Department.
• If you do not have a bowel movement within 6 hours of taking the second dose of Picolax, stop taking it and go to your nearest Emergency Department.

Contact our service

Endoscopy department

Tel.:020 7288 3811/3819

Email: whh-tr.endoscopypreassessment@nhs.net