Suflave
Suflave bowel prep is a powder that you mix with water. You drink the mixture to help clean the bowels before a colonoscopy procedure. This medication works well, but it requires you to drink a lot of liquid. Suflave is only approved for use in adults, whereas other bowel preps can also be used in children. Suflave works by causing diarrhea, but other side effects can include nausea and vomiting.
What is Suflave?
What is Suflave used for?
- Cleansing the colon to prepare for colonoscopy
How Suflave works
Suflave is a combination medication that contains two components.
- Polyethylene glycol 3350 (PEG 3350) is an osmotic laxative. It cleanses out your bowels by pulling water into your colon, causing you to have very watery diarrhea to get rid of the stools.
- Electrolytes prevent you from losing too much of your body fluids and nutrients. Some electrolytes, such as sodium sulfate and magnesium sulfate, also help cleanse your bowels in a similar way as PEG 3350 does.
Drug facts
Side effects of Suflave
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 (7-13%)
- Vomiting (4-6%)
- Stomach distension (feeling full or bloated; 1-6%)
- Stomach pain (3%)
- Headache (2-3%)
Less Common Side Effects
- Abnormal electrolyte levels
Suflave 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, lack of energy
- Heartbeat problems: feeling anxious, a fluttering in the chest, chest pain, dizziness, feeling lightheaded
- Colon ulcers: severe stomach pain, bleeding from the rectum
- Severe allergic reaction: rash, swelling in the face or throat, trouble breathing
- Seizures
- Choking
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Pros and cons of Suflave
Pros
- Lemon-lime-flavored for better taste
- Few side effects
Cons
- Must drink a lot of liquid, which can be time-consuming
- Can cause dehydration if you don't drink enough liquids during treatment
Pharmacist tips for Suflave
- Make sure to tell your provider and pharmacist about all of the medications, herbals, and supplements you take because Suflave can affect how your other medications work. For this reason, avoid taking any medications by mouth within 1 hour of starting each Suflave dose unless otherwise instructed by your provider.
- Follow the instructions on the container to prepare and take Suflave. Don't skip any steps, especially the step about drinking an additional 16 fl oz (2 cups) of water after each liter bottle. Drinking the additional water will help make sure that you don't get dehydrated during the bowel prep process.
- If you feel nauseous or bloated or develop cramps while you're drinking Suflave, take a break or slow down how fast you're drinking the solution until your symptoms go away. Call your provider if your symptoms don't get better or if they get worse.
- You can keep unmixed Suflave powder at room temperature. Once you've mixed the powder with water, place the mixture in the refrigerator. Don't freeze the Suflave mixture.
- If it's been more than 24 hours since you mixed Suflave and you haven't finished drinking it, throw it away. Let your provider know if you didn't completely finish your bowel prep because they might need to reschedule your colonoscopy.
Common questions about Suflave
Yes, it's important to take and finish both doses (2 bottles total). Even if you feel that your bowel is cleansed out after finishing the first dose, there might still be some stool left in your colon that you can't feel. Finishing both doses completely helps make sure your colon is cleansed out as much as possible. Let your provider know if you feel that you can't finish all of your bowel prep solution. Your provider might need to reschedule your colonoscopy procedure.
Tell your provider right away if you throw up at any point during your bowel prep with Suflave. Your provider can let you know whether you need to repeat your dose, take a different medication, or reschedule your procedure for a different date. Your provider might also need to check your electrolyte levels in case you've lost too much fluid.
Avoid drinking milk or eating or drinking anything that's colored red or purple. These can make it harder for your provider to see inside your colon. You should also avoid drinking alcohol. Don't take any other laxatives while you're taking Suflave because they can make you dehydrated or raise your risk for colon injury. And unless told otherwise by your provider, avoid taking any other medications by mouth within 1 hour of starting each Suflave dose. Some medications need to be taken 2 hours before Suflave.
Talk to your provider about what you can eat and drink after starting your Suflave bowel prep because your provider might have specific instructions for you. Some providers might allow you to eat a low residue breakfast, but double check with your provider that would be a discussion with your provider. Some examples of low residue breakfast foods are eggs, white bread, yogurt, cottage cheese, grits, tea, and coffee (without creamer). Clear liquids are generally okay to have (but not red or purple drinks); make sure to confirm with your provider first.
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Risks and warnings for Suflave
Suflave 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 have electrolyte problems
Because Suflave works by causing diarrhea, you can lose a lot of fluids (get dehydrated) while you use this bowel prep. This medication 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 well-hydrated and that any electrolyte problems are fixed before you start Suflave. It’s also important that you stay hydrated during and after taking Suflave. Let your provider know right away if you vomit a lot or notice that you're dehydrated (e.g., dizzy, headache, very dark urine) after you drink Suflave. Your provider might order blood tests to check your electrolyte levels or how well your kidneys are working.
Heartbeat problems
- Risk factors: Heartbeat or heart problems | Recent heart attack | Heart failure | Taking medications that can cause heartbeat problems
Although rare, some people who took osmotic laxatives like Suflave for bowel prep reported serious changes in heartbeat (arrhythmias). Changes in heartbeat with Suflave use happen mainly in people with a history of heart conditions, heartbeat problems, or electrolyte problems. It's important to tell your provider about your medical history so they can assess the need to check your heart before and after you use Suflave.
You might not always feel any symptoms when you have changes in your heartbeat. But some people might experience a fluttering in the chest, difficulty breathing, or chest pain. Let your provider know if you have any of these symptoms as you take Suflave.
Seizures
- Risk factors: Electrolyte problems | History of seizures | Taking medications that raise your risk for seizures | Withdrawal from alcohol or benzodiazepines
Some people who took Suflave have passed out or have had a seizure. Some of these people have never had seizures before. Seizures might happen with Suflave use because the medication can cause your body fluids and electrolyte levels to be out of balance. To lower your risk for seizures, make sure you stay hydrated while you're using Suflave. Get medical help right away if you feel fearful, anxious, or nauseous or feel like you're spinning, as these might be warning signs of seizures.
Use with caution in people at risk for kidney damage
- Risk factors: People age 65 and older | Low body fluids | History of kidney problems | Taking medications that can affect your kidneys (e.g., diuretics, NSAIDS)
Different brands of bowel preps can differ in the types of electrolyte they contain. If you have kidney problems, ask your provider whether Suflave 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), ACE inhibitors, ARBs, and nonsteroidal anti-inflammatory drugs (NSAIDs). Make sure to drink enough water before, during, and after taking Suflave to avoid getting dehydrated and kidney damage.
Damage to your colon
- Risk factors: Inflammatory bowel disease (IBD) | Ulcerative colitis (UC) | Taking stimulant laxatives
Osmotic laxatives, such as Suflave, 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 because they might raise your risk for colon ulcers. Let your provider know if you have stomach ulcers, blockage, or an inflammatory bowel disease (IBD) before taking Suflave because you might need to take a different medication.
Choking or difficulty breathing
- Risk factors: Problems with gag reflex | Swallowing problems
You have to drink a lot of liquid when you're using Suflave 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 Suflave 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. Let your provider know as soon as possible if you're having trouble taking Suflave. Your provider can discuss whether there are better options for you.
Allergic reactions
Suflave contains ingredients that have rarely caused serious allergic reactions, including anaphylaxis. Get medical help right away if you experience a rash, shortness of breath, choking sensation, or swelling in your face or throat.
Suflave dosage
Kit| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 2 bottles of 178.7g/7.3g | 1 kit | $101.81 | $101.81 |
Typical dosage for Suflave
Suflave is a 2-day regimen. You'll need to take a total of 2 bottles for a complete bowel prep (1 bottle per day). Follow the directions on the container and the directions that your provider gave you to prepare and take each dose.
- Mix the powder well with the instructed amount of lukewarm water in the provided bottle.
- Drink 8 fl oz (1 cup) of the mixture every 15 minutes until gone.
- Once the bottle is empty, drink an additional 16 fl oz (2 cups) of water the evening before your procedure.
- On the morning of your colonoscopy (5 to 8 hours before your procedure and no sooner than 4 hours from starting the first bottle), prepare and drink another bottle of mixture just like the day before. Drink an additional 16 fl oz (2 cups) of water once the bottle is empty.
How much does Suflave cost?
$101.81
Suflave 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 Suflave will not be safe for you to take.
- Gastrointestinal obstruction (stomach block)
- Bowel perforation (opening in the wall of your intestine)
- Toxic colitis or megacolon (very inflamed colon)
- Gastric retention (problem with food and fluid emptying from the stomach)
