sodium sulfate / potassium sulfate / magnesium sulfate
Suprep is a combination bowel prep kit used to clean out your colon before a colonoscopy. It works by causing diarrhea, which helps clear your intestines so that your gastroenterologist can see inside your colon more clearly. The medication is a berry-flavored liquid taken in two doses that must be prepared according to the instructions. You take the first dose on the night before your procedure and the second dose on the morning of your procedure. Common side effects include bloating, stomach pain, and nausea.
What is Suprep?
What is Suprep used for?
- Colon cleansing before a colonoscopy
How Suprep works
Suprep is an osmotic laxative that contains sodium sulfate, potassium sulfate, and magnesium sulfate. These salts aren't easily absorbed by your body, so they pull water into your intestines, causing bowel movements that help empty your colon before a procedure.
Drug facts
Side effects of Suprep
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
Adults:
- Overall discomfort (54%)
- Bloating (40%)
- Stomach pain (36%)
- Nausea (36%)
- Vomiting (8%)
Children: (more than 10%)
- Nausea
- Stomach pain
- Bloating
- Vomiting
Less Common Side Effects
- Electrolyte imbalances
Suprep serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Severe dehydration: vomiting, dizziness, tiredness, headache, urinating less, dry mouth
- Heart rhythm problems: weakness, dizziness, fainting, chest pain, trouble breathing
- Kidney problems: urinating less, swelling, tiredness, nausea, vomiting
- Seizures
The following Suprep side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Dehydration—increased thirst, dry mouth, feeling faint or lightheaded, headache, dark yellow or brown urine
- Fast or irregular heartbeat
- Kidney injury—decrease in the amount of urine, swelling of the ankles, hands, or feet
- Seizures
- Sudden or severe stomach pain, bloody diarrhea, fever, nausea, vomiting
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
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Pros and cons of Suprep
Pros
- Works quickly, within an hour or so
- Requires less liquid to drink compared to other bowel prep products
- Berry-flavored for taste
- Brand-name medication is approved for adults and children 12 years and older
Cons
- Commonly causes nausea and vomiting
- Might not be safe for people with kidney problems
- Raises the risk of a gout attack in people with gout
- Can interact with medications taken by mouth if taken close to your prep time
Pharmacist tips for Suprep
- Follow all instructions carefully about what to eat or drink in the days before taking Suprep. If you're unsure, ask your care team.
- The day before your colonoscopy, drink only clear liquids. Avoid alcohol, milk, or anything that's red or purple. Safe options include water, apple or orange juice (no pulp), coffee or tea (without creamer), chicken broth, and gelatin desserts without fruit or toppings.
- Drink both doses of Suprep for a complete bowel prep. If you skip the second dose, your colon might not be fully cleaned, which could affect your colonoscopy results.
- Stay near a restroom after taking Suprep since it will cause frequent bowel movements.
- Call your prescriber right away if you have severe vomiting or signs of dehydration like dizziness, tiredness, or headaches after taking Suprep. Dehydration can cause electrolyte imbalances, which can lead to serious side effects like heart rhythm problems or seizures.
- Tell your prescriber about any medications you take. In general, take other medications at least 1 hour before taking Suprep. But some medications like tetracycline antibiotics, fluoroquinolone antibiotics, and iron supplements should be taken at least 2 hours before or 6 hours after taking Suprep.
Tips on how to prepare your Suprep dose
- Each Suprep kit contains two doses, each in a separate bottle. You'll need to add cool water to each dose before drinking. Don't drink the medication directly from the bottle.
- Taking the first dose: On the evening before your procedure, pour one bottle of Suprep into the provided mixing container. Add cool water to the 16-oz line (or 12-oz line for children) and mix. Drink the entire mixture. Then, refill the container with water to the 16-oz line and drink twice more over the next hour.
- Taking the second dose: On the morning of your procedure, repeat the same steps as dose 1. Make sure you drink the final container of water at least 2 hours before your procedure.
Common questions about Suprep
Possibly. Suprep reaches its highest level in your body about 17 hours after the first dose and about 5 hours after the second dose. Be sure to finish all of the solution and additional water at least two hours before your colonoscopy for the best results.
Bowel movements can start within an hour or so after taking Suprep. But for some people, it might take a few hours to work. Make sure to follow all instructions from your gastroenterologist and call the office if you have any questions.
Talk to your prescriber before using castor oil with Suprep. While castor oil has been studied for bowel cleansing, you should check with your care team before taking any medications or fluids within 2 hours of Suprep. In general, it's best to avoid taking other laxatives with Suprep.
Follow your prescriber’s timing instructions for taking Suprep. In most cases, the second dose should be taken 10 to 12 hours after the first dose. Avoid taking the doses too far apart or too close together because this can affect how well Suprep cleans your colon before your colonoscopy.
No. Only mix Suprep with cool drinking water. You might, however, drink clear liquids, like orange juice without pulp, the day before your colonoscopy if your prescriber says it's okay. On the day of the colonoscopy, drink only clear liquids until two hours before the procedure.
Suprep is only available as a prescription from a healthcare professional. You'll be able to pick up the medication at your local pharmacy.
Suprep has a berry flavor due to added flavoring. If you don’t like the taste or are having trouble finishing your dose, call your gastroenterologist. They might recommend a different bowel prep medication that might be easier for you to take.
No, you shouldn't mix Suprep with Gatorade or any other flavored drinks. Suprep should only be mixed with cool water as directed. Mixing it with other liquids can affect how well it works or cause unwanted side effects. If you’re unsure, check with your prescriber.
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Risks and warnings for Suprep
Suprep 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.
Severe dehydration and electrolyte imbalance
- Risk factors: Severe vomiting | Taking other medications that can lead to dehydration or electrolyte imbalance | Gout
Drink plenty of fluids before, during, and after taking Suprep to stay hydrated. If you experience severe vomiting or signs of dehydration after taking it, your prescriber might check your lab tests to monitor your electrolytes, kidney function, and hydration levels. Electrolyte imbalances can cause serious problems, including irregular heartbeats, seizures, and kidney issues.
Suprep can also temporarily raise uric acid levels, which might trigger a gout flare-up. If you have gout or other uric acid-related conditions, talk to your prescriber before using this medication.
Heart rhythm problems
- Risk factors: History of heart rhythm problems | Recent heart attack | Unstable chest pain | Congestive heart failure | Cardiomyopathy
There have been rare cases of serious heart rhythm problems (arrhythmias) linked to osmotic laxatives like Suprep used for bowel prep. Your prescriber might check your heart with an electrocardiogram (ECG) before and after your colonoscopy if you are at higher risk for heart problems.
Seizures
- Risk factors: History of seizures | Benzodiazepine withdrawal | Alcohol withdrawal | Low sodium levels | Taking other medications that raise your risk for seizures
Some people have had seizures or fainted after taking Suprep, even if they never had seizures before. These cases were linked to electrolyte imbalances, like low sodium, potassium, calcium, or magnesium levels.
If you have a history of seizures or are at higher risk, your prescriber might need to monitor you closely. This includes people taking certain antidepressants, those withdrawing from alcohol or benzodiazepines, or those with low sodium levels. Let your prescriber know about any seizure history or medications you take before using Suprep.
Kidney problems
- Risk factors: History of kidney problems | Taking other medications that can harm the kidneys
If you have kidney problems or take medications that can harm the kidneys — such as diuretics, ACE inhibitors, angiotensin receptor blockers, or NSAIDs — talk to your prescriber before taking Suprep. These medications raise your risk for kidney injury. It’s important to drink plenty of fluids while taking Suprep to stay hydrated. Your prescriber might check your kidney function with lab tests before and after your colonoscopy to make sure your kidneys are working properly.
Colon problems
- Risk factors: Inflammatory bowel disease (IBD) | Taking stimulant laxatives at the same time | Severe ulcerative colitis
Suprep and other osmotic laxatives might cause small ulcers in the colon. In rare cases, some people have developed a serious condition called ischemic colitis, which reduces blood flow to the colon and might require hospital treatment. Taking Suprep with stimulant laxatives can raise these risks, so talk to your prescriber before using any additional laxatives.
Serious choking
- Risk factors: Trouble swallowing | Poor gag reflex
If you have trouble swallowing or a poor gag reflex, you might be at risk of choking or inhaling (aspirating) Suprep. Let your prescriber know if you have any of these problems before starting this medication.
Suprep dosage
Kit| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 2 bottles of oral solution | 1 kit | $34.85 | $34.85 |
Typical dosage for Suprep
Adults: Take two 6-oz doses of Suprep for a complete two-day regimen.
- Dose 1 - Evening before your colonoscopy
- Drink a mixture of one 6-oz bottle of Suprep and cool water added up to the 16-oz line in the provided mixing container.
- Over the next hour, drink two more 16-oz containers of water.
- Dose 2 - Morning of your colonoscopy
- Drink a mixture of one 6-oz bottle of Suprep and cool water added up to the 16-oz line in the provided mixing container.
- Over the next hour, drink two more 16-oz containers of water. Children 12 years and older: Take two 4.5-oz doses of Suprep for a complete two-day regimen.
- Dose 1 - Evening before your colonoscopy
- Drink a mixture of one 4.5-oz bottle of Suprep and cool water added up to the 16-oz line in the provided mixing container.
- Over the next hour, drink two more 12-oz containers of water.
- Dose 2 - Morning of your colonoscopy
- Drink a mixture of one 4.5-oz bottle of Suprep and cool water added up to the 16-oz line in the provided mixing container.
- Over the next hour, drink two more 12-oz containers of water.
How much does Suprep cost?
Suprep 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 Suprep will not be safe for you to take.
- Blockage in the gut (obstruction)
- Hole in the bowel (perforation)
- Severe colon swelling (toxic megacolon)
- Stomach not emptying properly (gastric retention)
What are alternatives to Suprep?
Suprep images
