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As a purgative, Sodium picosulfate + Magnesium oxide + Citric acid (PICOPREP) increases the gastrointestinal transit rate. The absorption of other orally administered medicines (e.g. anti-epileptics, contraceptives, anti-diabetics, antibiotics) may therefore be modified during the treatment period. Tetracycline and fluoroquinolone antibiotics, iron, digoxin, chlorpromazine and penicillamine, should be taken at least 2 hours before and not less than 6 hours after administration of Sodium picosulfate + Magnesium oxide + Citric acid (PICOPREP) to avoid chelation with magnesium.
The efficacy of Sodium picosulfate + Magnesium oxide + Citric acid (PICOPREP) is lowered by bulk-forming laxatives.
Care should be taken with patients already receiving drugs which may be associated with hypokalaemia (such as diuretics or corticosteroids, or drugs where hypokalaemia is a particular risk i.e. cardiac glycosides). Caution is also advised when Sodium picosulfate + Magnesium oxide + Citric acid (PICOPREP) is used in patients on NSAIDs or drugs known to induce SIADH e.g. tricyclic antidepressants, selective serotonin re-uptake inhibitors, antipsychotic drugs and carbamazepine as these drugs may increase the risk of water retention and/or electrolyte imbalance.
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