Stimulant Laxative·Gastrointestinal - Laxatives

Sodium picosulfate

Short-term relief of constipation, bowel clearance prior to procedures

STIMULANTDulcolax SP Drops, Picoprep (combo with magnesium citrate)UNSCHEDULEDTGA

No source link confirmed for this record yet. Its own source notes are under Additional.

At a glance

Max Dose

15 mg/day

Onset

6-12 h

Caution: Dehydration

HIGH RISK

Renal Adj.

NOT REQ.

Cautions

Avoid / Cautions

Bowel obstruction, severe inflammatory bowel disease, toxic megacolon.

Where it stands

Rapid Summary

Overview

Potent prodrug stimulant laxative. Activated by colonic bacteria. Widely used as oral drops for titration on the ward, or in massive doses for colonoscopy bowel prep.

Clinical Focus

Highly titratable via liquid drops. Essential to maintain oral hydration during use.

Bottom Line

Sodium picosulfate is a stimulant laxative primarily used for bowel preparation before procedures, but causes significant electrolyte disturbances and dehydration requiring adequate fluid intake.

Formulation & Access

Brand Names

Dulcolax SP Drops, Picoprep (combo with magnesium citrate)

Oral Routes

Oral liquid drops (7.5 mg/mL). Oral powder sachets (bowel prep).

Prescribing & PBS

Over The Counter (OTC).

Indications & Use

Primary

TGA

Short-term relief of constipation, bowel clearance prior to procedures.

Clinical Place

Liquid drops allow for very fine titration in the elderly compared to fixed-dose Senna tablets.

Quick reference

Class & Role

Stimulant Laxative — Potent prodrug stimulant laxative.

Route / Formulation

Oral liquid drops (7.5 mg/mL). Oral powder sachets (bowel prep). (Dulcolax SP Drops, Picoprep (combo with magnesium citrate))

Usual Dose & Max

PO 5-15 mg (10-30 drops) NOCTE. Max 15 mg/day (as standard drops). Bowel prep doses are much higher.

Key Indication Doses

Constipation (Drops): PO 5-15 mg (10-30 drops) NOCTE. Bowel Preparation (Picoprep): PO Dissolve sachets (10 mg) in water, taken exactly as per endoscopy protocol (often split dosing).

Best Uses

Sodium picosulfate is a stimulant laxative primarily used for bowel preparation before procedures, but causes significant electrolyte disturbances and dehydration requiring adequate fluid intake.

Key Risks

Gastrointestinal: Abdominal cramps, diarrhea, nausea. Metabolic: Water and electrolyte depletion (hypokalemia, hyponatremia) especially with bowel prep doses.

Key Interactions

Broad-spectrum antibiotics may theoretically reduce the colonic bacteria needed to activate the drug, but rarely clinically significant.

Monitoring

Monitor fluid input/output strictly if using for bowel prep. High risk of orthostatic hypotension due to fluid loss. Check U&E if patient becomes confused or lethargic post-bowel prep (hyponatremia).

Clinical Pearl

If 10 drops do nothing, and 20 drops cause explosive diarrhea, you can instruct the patient to use exactly 15 drops. This granularity makes it an excellent choice for tricky chronic constipation.

Access

Dulcolax SP Drops, Picoprep (combo with magnesium citrate)

Brand: Dulcolax SP Drops, Picoprep (combo with magnesium citrate)
Formulation: Oral liquid drops (7.5 mg/mL). Oral powder sachets (bowel prep).

From this page

No calculator, monitoring schedule or factsheet is linked to this medicine page yet.

Stimulant Laxative·Gastrointestinal - Laxatives

Sodium picosulfate

Short-term relief of constipation, bowel clearance prior to procedures

STIMULANTDulcolax SP Drops, Picoprep (combo with magnesium citrate)UNSCHEDULEDTGA

No source link confirmed for this record yet. Its own source notes are under Additional.

At a glance

Max Dose

15 mg/day

Onset

6-12 h

Caution: Dehydration

HIGH RISK

Renal Adj.

NOT REQ.

Cautions

Avoid / Cautions

Bowel obstruction, severe inflammatory bowel disease, toxic megacolon.

Where it stands

Rapid Summary

Overview

Potent prodrug stimulant laxative. Activated by colonic bacteria. Widely used as oral drops for titration on the ward, or in massive doses for colonoscopy bowel prep.

Clinical Focus

Highly titratable via liquid drops. Essential to maintain oral hydration during use.

Bottom Line

Sodium picosulfate is a stimulant laxative primarily used for bowel preparation before procedures, but causes significant electrolyte disturbances and dehydration requiring adequate fluid intake.

Formulation & Access

Brand Names

Dulcolax SP Drops, Picoprep (combo with magnesium citrate)

Oral Routes

Oral liquid drops (7.5 mg/mL). Oral powder sachets (bowel prep).

Prescribing & PBS

Over The Counter (OTC).

Indications & Use

Primary

TGA

Short-term relief of constipation, bowel clearance prior to procedures.

Clinical Place

Liquid drops allow for very fine titration in the elderly compared to fixed-dose Senna tablets.

Quick reference

Class & Role

Stimulant Laxative — Potent prodrug stimulant laxative.

Route / Formulation

Oral liquid drops (7.5 mg/mL). Oral powder sachets (bowel prep). (Dulcolax SP Drops, Picoprep (combo with magnesium citrate))

Usual Dose & Max

PO 5-15 mg (10-30 drops) NOCTE. Max 15 mg/day (as standard drops). Bowel prep doses are much higher.

Key Indication Doses

Constipation (Drops): PO 5-15 mg (10-30 drops) NOCTE. Bowel Preparation (Picoprep): PO Dissolve sachets (10 mg) in water, taken exactly as per endoscopy protocol (often split dosing).

Best Uses

Sodium picosulfate is a stimulant laxative primarily used for bowel preparation before procedures, but causes significant electrolyte disturbances and dehydration requiring adequate fluid intake.

Key Risks

Gastrointestinal: Abdominal cramps, diarrhea, nausea. Metabolic: Water and electrolyte depletion (hypokalemia, hyponatremia) especially with bowel prep doses.

Key Interactions

Broad-spectrum antibiotics may theoretically reduce the colonic bacteria needed to activate the drug, but rarely clinically significant.

Monitoring

Monitor fluid input/output strictly if using for bowel prep. High risk of orthostatic hypotension due to fluid loss. Check U&E if patient becomes confused or lethargic post-bowel prep (hyponatremia).

Clinical Pearl

If 10 drops do nothing, and 20 drops cause explosive diarrhea, you can instruct the patient to use exactly 15 drops. This granularity makes it an excellent choice for tricky chronic constipation.

Access

Dulcolax SP Drops, Picoprep (combo with magnesium citrate)

Brand: Dulcolax SP Drops, Picoprep (combo with magnesium citrate)
Formulation: Oral liquid drops (7.5 mg/mL). Oral powder sachets (bowel prep).

From this page

No calculator, monitoring schedule or factsheet is linked to this medicine page yet.