Peg 3350 and Electrolytes
PEG 3350/electrolytes bowel prep is mixed into a solution and taken by mouth to clean the bowels for procedures called colonoscopy and barium enema x-ray examination. This medication works well, but requires you to drink a lot of liquid. There are many brands of PEG 3350/electrolytes bowel preps and they can differ from one another in things such as the amount of solution you need to drink, the type of electrolytes or ingredients they contain, and when you need to start the bowel prep. Most bowel preps can only be used in adults, but some can be used in children as young as 6 months of age.
What is PEG 3350/electrolytes bowel prep?
What is PEG 3350/electrolytes bowel prep used for?
- Cleansing the colon to prepare for colonoscopy
- Cleansing the colon to prepare for barium enema x-ray examination (Golytely, Colyte, Gavilyte-C, and certain generic preps only)
How PEG 3350/electrolytes bowel prep works
PEG 3350/electrolytes bowel prep is a combination medication that contains:
- Polyethylene glycol 3350 (PEG), an osmotic laxative that cleanses out your bowels by pulling water into your colon and causing you to have very watery diarrhea to get rid of the stools.
- Electrolytes, to prevent you from losing too much body fluids and electrolytes.
Drug facts
Side effects of PEG 3350/electrolytes bowel prep
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Nausea
- Vomiting
- Feeling very full in your stomach
- Bloating
- Stomach cramps
- Anal irritation
- Shivering (Moviprep)
- Trouble sleeping (Moviprep)
- More hungry and thirsty (Moviprep)
- Tiredness (Moviprep)
Less Common Side Effects
- Upper stomach bleeding
- Choking (aspiration)
- Changes in electrolytes
- Headache (Moviprep, Plenvu)
PEG 3350/electrolytes bowel prep serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Kidney problems: weakness, drowsiness, urinating less than normal, swelling of ankles, feet, and legs
- Electrolyte imbalance (changes in body fluid and blood salts): vomiting, stomach cramps, dizziness, urinating less than normal, fast heart rate, fast breathing, headache, fainting, or lack of energy
- Colon ulcers: severe stomach pain, rectal bleeding
- Heartbeat problems: Feeling anxious, a fluttering in the chest, chest pain, dizziness, feeling light-headed
- Seizures
- Choking
The following PEG 3350/electrolytes bowel prep side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
Less common
Bloody or black, tarry stools
severe stomach pain
swelling of the neck
trouble breathing
vomiting
vomiting of blood or material that looks like coffee grounds
Incidence not known
Bloody urine
blue lips and fingernails
blurred vision
chest tightness
coughing that sometimes produces a pink frothy sputum
decreased frequency or amount of urine
difficulty swallowing
dizziness
fainting
fast, noisy breathing
fast, slow, or irregular heartbeat
increased sweating
increased thirst
large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or genitals
loss of appetite
lower back or side pain
nervousness
pale skin
pounding in the ears
rapid weight gain
rectal bleeding
seizures
stomach tenderness
tingling of the hands or feet
unusual tiredness or weakness
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Stomach fullness
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
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Pros and cons of PEG 3350/electrolytes bowel prep
Pros
- Comes in many brands that differ in factors, such as how much solution you need to drink or the type of electrolytes in the solution, which gives you options to choose a bowel prep that fits your needs
- Some bowel prep solutions have flavor packets to improve taste
- Nulytely, Gavilyte N, and certain generics can be taken by children as young as 6 months old
- Many of the bowel preps can also be taken through a nasogastric tube (NG tube) for people who can't swallow
Cons
- Requires you to drink a lot of liquid, so can be time-consuming
- Can cause your electrolytes to be out of balance, which might raise your risk of side effects, such as kidney damage or seizures
- Can cause nausea; some people have a hard time finishing
- Can cause dehydration (loss of body fluids) if you don't drink enough liquids during the treatment
Pharmacist tips for PEG 3350/electrolytes bowel prep
- Each PEG 3350/electrolytes bowel prep product will differ slightly in directions. Make sure you read the instructions for your product before you use it.
- Make sure you drink enough fluids and take in enough electrolytes before starting PEG 3350/electrolytes bowel prep. Don't start the bowel prep if you've lost a lot of body fluids (dehydrated) or feel very thirsty because doing so can raise your risk of side effects, such as kidney problems or seizures. Signs of dehydration (low body fluid) and electrolyte (body salts) levels that are out of balance include headaches, feeling confused, and having dark urine.
- Don’t take other oral medications within 1 hour of starting PEG 3350/electrolytes bowel prep because doing so can flush out your medications before your body has had a chance to absorb them.
- Don’t add PEG 3350/electrolytes bowel prep to any liquids that you've already thickened with starch-based thickeners. One of the ingredients in the bowel preps (PEG) will cause the starch-thickened liquid to thin out. This can cause you to choke.
- Make sure you add the correct amount of water PEG 3350/electrolytes bowel prep. Double check the medication label or directions from the manufacturer before you mix the solution. Don't pour the powder directly into your mouth because doing so can cause problems such as nausea, vomiting, and loss of body fluids and electrolytes.
- Most of the PEG 3350/electrolytes bowel preps that come in 4 L containers need to be mixed with lukewarm drinking water. Before mixing your bowel prep, please double check the package insert so that you're dissolving the medication in water with the right temperature.
- To improve taste, many of the PEG 3350/electrolytes bowel preps come with flavor packets you can mix into the solution. Don't use flavorings that aren't already included with your bowel prep. Many of the bowel preps also taste better when they're cold, so you can put the solution in the refrigerator to chill it after it’s been mixed. If you have questions about how to improve the taste of your bowel prep, talk with your provider or pharmacist.
- For many of the 2-dose PEG 3350/electrolytes bowel preps, after you finish a dose of the solution, you need to fill the empty container with water and drink to complete your dose. The amount of water you drink will differ depending on the brand of bowel prep, so please double check the medication label for instructions.
- Don’t take stimulant laxatives, such as senna (Senokot) or bisacodyl (Dulcolax), while taking PEG 3350/electrolytes bowel prep. Doing so can damage your bowels.
- If you feel too bloated or have stomach pain from drinking PEG 3350/electrolytes bowel prep, you can wait longer to drink each portion or stop drinking it temporarily until your symptoms ease. If you have questions, please contact your provider.
Common questions about PEG 3350/electrolytes bowel prep
You can store all unmixed bowel preps at room temperature. After they've been mixed, almost all PEG 3350/electrolytes bowel preps have to be refrigerated. Only Plenvu solution can be kept either at room temperature or in the refrigerator after it's been mixed. All bowel preps have to be taken within 1 to 2 days after they've been mixed. Specific storage directions and expiration dates will differ depending on which PEG 3350/electrolytes bowel prep you use, so make sure to read the manufacturer's label carefully. Ask your provider or pharmacist if you've any questions.
It’s important to take your PEG 3350/electrolytes bowel prep as directed by your provider. The purpose of this prep is to clean out your colon. You can tell your bowel prep is complete if you start to have watery stool that's clear in color and without any solids. With the 1-dose prep solutions, such as Golytely, Nulytely, or Gavilyte, this typically happens after you drink 3 L to 4 L of solution. With the 2-dose bowel prep solutions, such as Moviprep and Plenvu, this will require you to drink both doses. Even if you feel that your bowel is cleaned out after the first dose, it's important to drink the second dose because there might still be some stools left behind that you can't feel. If you're not clear about how you can tell whether your bowel prep is complete, please talk with your provider.
Ask your provider what you can eat or drink when you use PEG 3350/electrolytes bowel prep. Instructions for what you can eat or drink and when you need to stop eating or drinking might differ slightly for different bowel preps. But typically, your diet needs to change starting the morning before your procedure. You're probably allowed to eat a light breakfast. You can only drink clear liquids, such as water, fruit juices without pulp, clear broth, coffee, or tea. Don't eat or drink anything that's red or purple in color, such as popsicles or soft drinks, because the dye can be mistaken for blood during your procedure. Most likely, you'll need to stop drinking all liquids 2 hours before your procedure starts.
Tell your provider immediately if you threw up after taking PEG 3350/electrolytes bowel prep. They can let you know if you need to repeat your dose, take an alternative medication, or reschedule your procedure for a different date.
Typically, your provider's office will write a prescription for the PEG 3350/electrolytes bowel prep that's part of their clinic's protocols. But sometimes, you might need to choose one type of bowel prep over another because of a medical need or personal preference. One major difference between the bowel preps is the amount of solution you need to drink. For example, you need to drink about 4 L of solution with Golytely and Nulytely, but you only have to drink 1 L total with Plenvu. A second difference is how long before your procedure you need to start the bowel prep. For example, Plenvu gives you the option to start the morning of your procedure. But you have to start many of the other PEG 3350/electrolytes bowel preps the evening before your procedure. A third difference is that not all bowel preps contain the same or same amount of electrolytes. Because of certain medical conditions, such as kidney problems, some people might need to avoid certain electrolytes. For more information about differences between the bowel preps, read the guidelines from the American Society for Gastrointestinal Endoscopy. If you're not sure which PEG 3350/electrolytes bowel prep is best for you, please talk with your provider.
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Risks and warnings for PEG 3350/electrolytes bowel prep
PEG 3350/electrolytes bowel prep can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Low body fluids and electrolyte problems
- Risk factors: Kidney problems | Heart failure | Taking other medications that cause you to lose body fluids and electrolyte problems
PEG 3350/electrolytes bowel prep can cause you to lose a lot of fluids (dehydration). It can also cause your body salt (electrolyte) levels to be out of balance. These issues can lead to other serious health conditions, including heartbeat problems, seizures, and kidney problems. Make sure you're hydrated and that any electrolyte problems are fixed before you start PEG 3350/electrolytes bowel prep. It’s also important that you stay hydrated during and after taking PEG 3350/electrolytes bowel prep. If you vomit a lot or notice that you're dehydrated (e.g., feel dizzy, have a headache, or your urine is very dark) after you drink PEG 3350/electrolytes bowel prep, let your provider know immediately. They might order labs to check your electrolyte levels or how well your kidneys are working.
Heart beat problems
- Risk factors: Heart beat or heart problems | Recent heart attack | Heart failure | Taking medications that can cause heart beat problems
Although rare, PEG 3350/electrolytes bowel prep can cause changes in your heartbeat (arrythmias), which can be very serious. You might not always feel any symptoms with this condition, but some people might experience a fluttering in the chest, difficulty breathing, or chest pain. If you have a history of heart beat problems or heart conditions, tell your provider. They might need to check your heart before and after you use PEG 3350/electrolytes bowel prep.
Seizures
- Risk factors: Electrolyte problems | History of seizures | Taking medications that raise your risk for seizures | Withdrawal from alcohol or benzodiazepines
Taking PEG 3350/electrolytes bowel prep can cause you to pass out or have a seizure, even if you've never had seizures before. This is because it can cause your body fluids and electrolyte levels to be out of balance. To lower your risk for seizures, make sure you stay hydrated. Get medical help immediately if you feel faint or feel confused for no reasons, these might be early signs of seizures.
Kidney damage
- Risk factors: People age 65 and older | Low body fluids | History of kidney problems | Taking medications that can affect your kidneys (diuretics, blood pressure, NSAIDS)
Different brands of bowel preps can differ in the types of electrolyte they contain. If you have kidney problems, ask your provider which brand of PEG 3350/electrolytes bowel prep is best for you to avoid further damage to your kidneys. Your risk for kidney damage is higher if you're also taking other medications that can affect your kidney, such as diuretics (water pills), angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers, and nonsteroidal anti-inflammatory drugs (NSAIDs). Drink enough water before, during, and after taking PEG 3350/electrolytes bowel prep to avoid getting dehydration and kidney damage.
Damage to your colon
- Risk factors: Inflammatory bowel disease (IBD) | Ulcerative colitis | Stimulant laxatives
Osmotic laxatives, such as PEG 3350/electrolytes bowel prep, can cause damage in your colon (ulcers). In serious cases, you'll have to go to the hospital. Don’t take stimulant laxatives, such as senna (Senokot) or bisacodyl (Dulcolax), at the same time. Let your provider know if you have stomach ulcers, blockage, or inflammation before taking PEG 3350/electrolytes bowel prep because you might need to take a different medication.
Choking or difficulty breathing
- Risk factors: Problems with gag reflex
You have to drink a lot of liquid with PEG 3350/electrolytes bowel prep. If you already have trouble swallowing or problems with your gag reflex, be very careful when taking this medication to avoid accidentally inhaling it into your lungs. Don’t add PEG 3350 and electrolytes bowel prep to any liquids that you've already thickened with starch-based thickeners. One of the ingredients in the bowel preps (PEG) will cause the starch-thickened liquid to thin out. This can cause you to choke. If you are having trouble taking PEG 3350/electrolytes bowel prep, let your provider know as soon as possible to see if there are better options for you.
Use with caution in low glucose-6-phosphate dehydrogenase (G6PD) and phenylketonuria (PKU) - Moviprep and Plenvu only
Moviprep and Plenvu contain sodium ascorbate and ascorbic acid. These bowel preps must be used with caution in people with low G6PD because these ingredients can destroy your red blood cells.
MoviPrep and Plenvu also contain phenylalanine, which is found in the aspartame part of the mixture. This ingredient can be harmful to people with phenylketonuria (PKU).
If you have low G6PD or PKU, ask your provider what precautions you need to take if you choose to take Moviprep and Plenvu. Also, ask if there are safer alternatives for you.
PEG 3350/electrolytes bowel prep dosage
Typical dosage for PEG 3350/electrolytes bowel prep
The dosing for PEG 3350/electrolytes bowel prep varies depending on the brand of medication that your provider prescribes. Please read the directions on the label carefully before using.
Golytely, Colyte, Nulytely, Gavilyte-C, Gavilyte-G, Gavilyte-N, and generic PEG 3350 with electrolytes:
One dose is needed for a complete bowel prep. Prepare the dose by following the directions on the container. After it's mixed, a full dose should contain about 4 L of solution. It's typically taken the evening before the procedure.
- Adults: After mixing the solution, drink 8 fl oz by mouth every 10 minutes until gone, or until you start to have watery stool that's clear in color and without any solids.
- Children 6 months or older (Nulytely, Gavilyte N, and certain generics only): After mixing the solution, your child should drink at the rate of 25 mL/kg per hour by mouth until they start to have watery stool that's clear in color and without any solids.
Moviprep and generic PEG 3350 with electrolytes:
Two doses of Moviprep (or generic PEG 3350 with electrolytes) are needed for a complete bowel prep. Prepare each dose by following the directions on the container. After it's mixed, each dose should contain about 1 L of solution. Drink 8 fl oz of the Moviprep mixture (or generic PEG 3350 with electrolytes mixture) by mouth every 15 minutes until gone. This should take about 1 hour.
- Two-day dosing (preferred): Drink dose 1 the evening before colonoscopy. To complete your dose, fill the empty container half way with clear liquid and drink until gone. Drink dose 2 the morning of colonoscopy (about 12 hours after starting dose 1 and at least 3.5 hours before your procedure). Again, to complete your dose, fill the empty container half way with clear liquid and drink until gone.
- One-day dosing: Drink dose 1 at least 3.5 hours before bedtime on the evening before colonoscopy. Drink dose 2 at least 1.5 hours after starting dose 1. After dose 2, fill the empty container to the fill line with clear liquid and drink until gone before going to bed.
Two doses of Plenvu are needed for a complete bowel prep. Prepare each dose by following the directions on the container. After it's mixed, each dose of Plenvu should contain about a half liter of solution. Drink the Plenvu mixture by mouth, over 30 minutes, until gone. To complete your dose, fill the empty container to the fill line with clear liquid and drink over 30 minutes, until gone.
- Two-day dosing (preferred): Drink dose 1 on the evening before colonoscopy (between 4pm and 8pm). Drink dose 2 on the morning of colonoscopy (about 12 hours after dose 1).
- One-day dosing: Drink dose 1 on the morning of colonoscopy (between 3am and 7am). Drink dose 2 at least 2 hours after starting dose 1.
Interactions between PEG 3350/electrolytes bowel prep and other drugs
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
- Amantadine
- Atropine
- Belladonna
- Belladonna Alkaloids
- Benztropine
- Biperiden
- Clidinium
- Darifenacin
- Dicyclomine
- Eplerenone
- Fesoterodine
- Glycopyrrolate
- Hyoscyamine
- Methscopolamine
- Oxybutynin
- Procyclidine
- Scopolamine
- Solifenacin
- Tolterodine
- Trihexyphenidyl
- Trospium
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Acalabrutinib
- Alacepril
- Amiloride
- Amphetamine
- Benazepril
- Benzphetamine
- Bisacodyl
- Cabotegravir
- Canrenoate
- Captopril
- Cilazapril
- Delapril
- Dextroamphetamine
- Digoxin
- Erdafitinib
- Fosinopril
- Gefitinib
- Imidapril
- Indomethacin
- Ketoconazole
- Ledipasvir
- Licorice
- Lisdexamfetamine
- Lisinopril
- Mefenamic Acid
- Memantine
- Methamphetamine
- Moexipril
- Neratinib
- Octreotide
- Pazopanib
- Pentopril
- Perindopril
- Quinapril
- Ramipril
- Rilpivirine
- Selpercatinib
- Senna
- Sodium Picosulfate
- Spirapril
- Spironolactone
- Temocapril
- Trandolapril
- Triamterene
- Zofenopril
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Chloroquine
- Licorice
How much does PEG 3350/electrolytes bowel prep cost?
PEG 3350/electrolytes bowel prep contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because PEG 3350/electrolytes bowel prep will not be safe for you to take.
- Gastrointestinal (GI) obstruction (stomach block)
- Bowel perforation (opening in the wall of your intestine)
- Toxic colitis (very inflamed colon)
- Toxic megacolon (very swollen intestine)
- Gastric retention (problem with food and fluid emptying from the stomach)
- Ileus (bowel can’t push waste out of your body)
What are alternatives to PEG 3350/electrolytes bowel prep?
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