Download Miralax Prep Instructions

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Unity Point Health-Trinity West
2701 17th Street
Rock Island, IL 61201
Miralax Prep Instructions
Main Entrance/ Registration
Appointment: Day___________________ Date_________________ Arrival Time_____________a.m./p.m.
Linda Tong, M.D. AGAF
Poonputt Chotiprasidhi, M.D.
Ahmad Cheema, M.D.
YOUR PREP IS THE KEY TO A SUCCESSFUL COLONOSCOPY
A Bowel prep is done to clear the bowel of all solid matter. Please follow these instructions. Begin the
bowel prep one day before your scheduled procedure.
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5 Days Before
Stop arthritis pills and anti-inflammatories such as: Ibuprofen, Advil, Motrin, Aleve.
Stop bulk fiber supplements such as: Metamucil, Citrucel, Benefiber.
Stop eating popcorn, berries, nuts and seeds.
Ask your doctor if you should take any of your medicines the morning of your test.
If so, take with sips of water only.
You will need these items from a pharmacy:
 Miralax (sm. bottle, 119 grams)
These
 Miralax (lg. bottle, 238 grams)
 Dulcolax /Bisacodyl tablets (4 tablets-5 mg)
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These are over the counter
There may be store brands of these products that cost less.
Ask the pharmacist to help you find what you need.
Buy 3 (32 ounce) bottles of sports drink such as Gatorade. (No Red or Purple)
If you have diabetes, buy a zero calorie or low calorie drink such as Crystal Light instead. This will
be used to mix your Miralax the day before your test. Do not use carbonated beverages.
If you have questions, need to cancel or reschedule, please call PHONE: 309-779-4800 
FAX: 309-779-4805
r-6/17/15, 12/2/15
On the day before your procedure
1. Do not eat any solid food or milk products until after the Colonoscopy.
Drink only clear liquids. Avoid all red or purple colored liquids.
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Water
Fruit Juices (no pulp)
Popsicles
Gatorade or other
sports drinks
Soft drinks
Jello
Kool Aid
Coffee or tea (no
milk or cream)
Clear broth or
bouillon
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2. Follow the schedule in the table below for your bowel prep. You may need to get
to the toilet right away. You will have many bowel movements after you start your
prep.
They will become very watery. The bowels are clear or clean when there is only
pale yellow fluid without flecks of stool.
1:00 PM
Take 4 Dulcolax tablets (Bisacodyl Tablets) with a drink of clear liquids.
6:00 PM
Mix the 238 gram bottle of Miralax with 64 ounces of Gatorade or clear
liquid. Drink one glass every 15-30 minutes until gone.
Mix 119 gram bottle of Miralax with 32 ounces of Gatorade or other clear
__________________ liquid. Drink one glass every 15 to 30 minutes until gone. Try to finish
A.M./PM
drinking in 2 hours.
Please refrain from drinking 6 hours prior to procedure time
________________________________. You may gargle but do not swallow
any liquid. Do not smoke after midnight.
On the day of the Colonoscopy
Take blood pressure, heart, lung and seizure medication with sips of water.
Arrange to have an adult bring you to your appointment and take you home after your test.
Medications to hold:
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If you have questions, need to cancel or reschedule, please call PHONE: 309-779-4800 
FAX: 309-779-4805
r-6/17/15, 12/2/15