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PATIENT PREPARATION FOR BARIUM ENEMA Ask the pharmacist for the following: (They can be purchased at any pharmacy) 1 BOX DULCOLAX® (Only need 2 tablets) 1 BOX PICO-SALAX® (2 sachets) 3 DAY PREPARATION IS REQUIRED: DAY 1 Eat and drink normally. Take two (2) Dulcolax tablets (5 mg) at 6 pm. DAY 2 Low fiber diet. DO NOT EAT fruits, vegetables, cereals or breads. You may eat fish, chicken (no red meat), eggs, white rice, potatoes or pasta with red sauce only. Starting at 6 pm: Your diet will be CLEAR FLUIDS ONLY. Do not eat solid foods. Clear Fluid Guideline: You may drink water, tea or coffee (without milk), clear chicken or beef broth/bouillon or consommé, any kind of soft drink, any juice that you can see through (i.e. apple or cranberry juice, Jello and Popsicles. DAY 3 Your diet will continue to be CLEAR FLUIDS ONLY. DO NOT EAT SOLID FOODS. See Clear Fluid Guideline above. Before 8 am: Mix one packet of PICO-SALAX with 150mL (5 oz.) of cold water and allow cooling. Drink this before 8:00 am. 8 am to 4 pm: If possible, drink 250mL (8 oz) of water or other clear fluid every hour. 4 pm to 6 pm: Take second packet of PICO-SALAX mixed with 150mL of cold water (5 oz.) between 4 and 6 pm and continue on clear fluids until bedtime. DO NOT DRINK AFTER MIDNIGHT READ ALL OF THIS INFORMATION CAREFULLY BEFORE YOU START USING THIS MEDICINE If you have further questions, please ask your doctor or pharmacist. This medicine is for your use only and you should not give it to others. Your medicine is called PICO-SALAX. Each sachet contains 16.1 g of powder which has 3 active ingredients: sodium picosulfate 10 mg and magnesium oxide 3.5 g and citric acid 12 g which together form magnesium citrate in solution. Each sachet also contains the inactive ingredients: orange flavour, potassium bicarbonate and sodium saccharin. What is PICO-SALAX and what is it used for? PICO-SALAX is a white powder. It is a very strong purgative (ie to empty bowels). PICO-SALAX is used to cleanse the bowel of faecal matter and secretions prior to x-ray examination, endoscopy or surgery.This product is not intended to use as a regular laxative. Warnings and Precautions for Use: Do not take PICO-SALAX: (Golytely/Colyte/Peglyte are recommended substitutes) If you are allergic to any of the ingredients (see above). If you have any of the following; gastric retention (reduced ability of the stomach to empty), gastric ulcers, appendicitis, gastrointestinal blockage or perforation. If you have ileus (intestinal blockage or failure of normal movements), toxic colitis (damage to intestinal wall) or toxic mega colon (acute dilatation of the large bowel). In these conditions, transit of the contents of the bowel may be impaired or prevented. Symptoms include nausea, vomiting, diarrhea, abdominal pain, tenderness or swelling, colicky pain and fever. If you have congestive cardiac failure (the heart is unable to pump blood efficiently around the body). If you have severely reduced kidney function. Please consult your doctor before taking PICO-SALAX: If you have recently had gastrointestinal surgery. If you have a medical condition affecting the heart or kidneys. If you have inflammatory bowel disease such as ulcerative colitis or Crohn’s disease, If you are using bulk forming laxatives e.g. bran Pregnancy or Breast Feeding: If you are pregnant or are breast feeding, ask your doctor or pharmacist for advice before taking PICO-SALAX. Taking Other Medicines: Please inform your doctor or pharmacist if you are taking or have recently taken or used any other medicines – even those that are available without a prescription.If you are taking antiepileptics, contraceptives, antibiotics, diabetes medications and cardiac glycosides as they may be affected during treatment with PICO-SALAX. If you are taking diuretics, corticosteroids and lithium as these drugs may affect electrolyte balance. If you are taking nonsteroidal anti-inflammatory drugs (NSAIDs), tricyclic antidepressants, antipsychoticdrugs, carbamazapine as these drugs may add to the electrolyte imbalance. If you are taking oral iron preparations (including multivitamins) stop them for a week before the colonoscopy. If you are taking constipating drugs some prescription pain and sleep medications-please check with your pharmacist, they should be suspended for few days before the procedure. Possible Side Effects Like all medicines, PICO-SALAX can have side effects. However, adverse reactions to PICO-SALAX are very rare. Hyponatraemia (low level of sodium in the blood) and other electrolyte disturbances have been reported, with or without associated convulsions. Seizures have occasionally been reported in epileptic patients. Symptoms related to electrolyte disturbances include tingling skin, numbness, spasms, palpitations (rapid heart beat) muscle weakness and tremors. Other reactions reported include skin reactions such as rash, urticaria (hives) and pruritus (itching). Gastrointestinal effects reported include vomiting, diarrhoea, abdominal pain, nausea and proctalgia (anal pain). Vomiting and severe diarrhoea can lead to dehydration with headache and confusion without proper fluid and salt replacement. If you experience one or more of these side effects or any other undesirable effects, please inform your doctor or pharmacist. Keep PICO-SALAX out of reach of children. Store the package between 15° - 25°C. Instructions for use referenced from: Ferring Inc. Toronto, Ontario M2J 5C1 1-800-263-4057 ® registered trademark of Ferring B.V. Toronto, Ontario M2J 5C1 ®PICO-SALAX is a registered trademark of Ferring BV. ®Dulcolax is a registered trademark of Boehringer Ingelheim Consumer Healthcare 1 866 384 1314