Sodium Sulfate-Magnesium Sulfate-Potassium Chloride

Sodium Sulfate, Magnesium Sulfate, And Potassium Chloride is a prescription medication used for cleansing the bowel before a colonoscopy.

• Sodium Sulfate, Magnesium Sulfate, And Potassium Chloride is available under the following different brand names: Sutab

Adult dosage

Tablet

• 1.479g/0.225g/0.188g

Each carton contains

• 2 bottles; each bottle contains 12 tablets.
• 1 container with a 16-ounce fill line

Bowel Preparation

Adult dosage

Administer as a split dose (2-dose) regimen

The split-dose regimen consists of 2 doses: The first dose during the evening before colonoscopy and the second dose the next day, during the morning of the colonoscopy

Dose 1 (the evening before colonoscopy)

• A low-residue breakfast (e.g., eggs, white bread, cottage cheese, yogurt, coffee, tea) may be consumed
• After breakfast, consume only clear liquids until after the colonoscopy
• Early in the evening before colonoscopy, open one bottle of 12 tablets
• Fill the provided container with 16 ounces of water (up to the fill line); swallow each tablet with a sip of water and drink the entire amount over 15-20 min
• Approximately 1 hr after the last tablet is ingested, drink 16 ounces of water over 30 minutes
• Wait for 30 min after finishing the second container of water; drink another 16 ounces of water over 30 minutes
• If patients experience preparation-related symptoms (e.g., nausea, bloating, cramping), pause or slow the rate of drinking the additional water until symptoms diminish

Dose 2 (morning of colonoscopy)

• Continue to consume only clear liquids until after the colonoscopy
• Morning of colonoscopy (5-8 hr before colonoscopy and no sooner than 4 hr from starting Dose 1), open second bottle of 12 tablets
• Approximately 1 hr after the last tablet is ingested, drink 16 ounces of water over 30 minutes
• Wait for 30 min after finishing the second container of water; drink another 16 ounces of water over 30 minutes
• If patients experience preparation-related symptoms (e.g., nausea, bloating, cramping), pause or slow the rate of drinking the additional water until symptoms diminish
• Complete all tablets and water at least 2 hr before colonoscopy

Dosage Considerations – Should be Given as Follows: 

• See “Dosages”

Common side effects of Sodium Sulfate, Magnesium Sulfate, And Potassium Chloride include:

• nausea
• stomach-area swelling (abdominal distention)
• vomiting
• upper abdominal pain.

Serious side effects of Sodium Sulfate, Magnesium Sulfate, And Potassium Chloride include:

• changes in certain blood tests,
• abnormal heartbeats,
• seizures,
• abdominal pain,
• rectal bleeding,
• vomiting,
• dizziness,
• urinate less than usual,
• trouble drinking clear liquid,
• nausea,
• stomach (abdominal) cramping,
• bloating, and
• headache.

Rare side effects of Sodium Sulfate, Magnesium Sulfate, And Potassium Chloride include:

• none 

This is not a complete list of side effects and other serious side effects or health problems that may occur as a result of the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to FDA at 1-800-FDA-1088.

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first.

• Sodium Sulfate, Magnesium Sulfate, And Potassium Chloride has severe interactions with no other drugs.
• Sodium Sulfate, Magnesium Sulfate, And Potassium Chloride has serious interactions with the following drugs:
  • baloxavir marboxil
  • bisacodyl
  • bisacodyl rectal
  • demeclocycline
  • doxycycline
  • eravacycline
  • minocycline
  • omadacycline
  • polyethylene glycol/electrolytes and bisacodyl
  • raltegravir
  • sarecycline
  • senna
  • tetracycline
• Sodium Sulfate, Magnesium Sulfate, And Potassium Chloride has moderate interactions with at least 251 other drugs.
• Sodium Sulfate, Magnesium Sulfate, And Potassium Chloride has minor interactions with no other drugs. 

This information does not contain all possible interactions or adverse effects. Visit the RxList Drug Interaction Checker for any drug interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you and share this information with your doctor and pharmacist. Check with your health care professional or doctor for additional medical advice, or if you have health questions, concerns.

Contraindications

• Hypersensitivity to any ingredient
• Gastrointestinal obstruction or ileus
• Bowel perforation
• Toxic colitis or toxic megacolon
• Gastric retention

Effects of drug abuse

• None

Short-Term Effects

• See “What Are Side Effects Associated with Using Sodium Sulfate, Magnesium Sulfate, And Potassium Chloride?”

Long-Term Effects

• See “What Are Side Effects Associated with Using Sodium Sulfate, Magnesium Sulfate, And Potassium Chloride?”

Cautions

• Encourage adequate hydration, assess concurrent medications, and consider laboratory assessments (electrolytes, creatinine, BUN) before and after each use
• There have been rare reports of serious arrhythmias associated with the use of ionic osmotic laxative products for bowel preparation; use with caution in patients at increased risk of arrhythmias (e.g., patients with a history of prolonged QT, uncontrolled arrhythmias, recent myocardial infarction, unstable angina, congestive heart failure, cardiomyopathy); consider predose and post colonoscopy ECGs in patients at increased risk of serious cardiac arrhythmias
• Use with caution in patients with impaired renal function or patients taking concomitant medications that may affect renal function (e.g., diuretics, ACE inhibitors, angiotensin receptor blockers, NSAIDs); advise these patients of the importance of adequate hydration and consider performing baseline and post colonoscopy laboratory testing
• Rare reports of serious arrhythmias associated with ionic osmotic laxative products
• Osmotic laxative products may produce colonic mucosal aphthous ulcerations; reports of serious cases of ischemic colitis requiring hospitalization; coadministration with stimulant laxatives may increase risk
• If gastrointestinal obstruction or perforation is suspected, perform appropriate diagnostic studies to rule out these conditions before administering; caution with severe active ulcerative colitis
• Seizures
  • Reports of generalized tonic-clonic seizures and/or loss of consciousness have been associated with the use of bowel preparation products in patients with no prior history of seizures
  • Use caution in patients with a history of seizures and patients at increased risk of seizure, such as patients taking medications that lower the seizure threshold (e.g., tricyclic antidepressants), patients withdrawing from alcohol or benzodiazepines, or patients with known or suspected hyponatremia
• Drug interaction overview
  • Caution with coadministration of drugs that increase risk of fluid and electrolyte disturbances or that may increase risk of seizure, arrhythmias, or prolonged QT
  • Avoid coadministration with stimulant laxatives owing to increased risk of mucosal ulceration or ischemic colitis
  • Caution if coadministered with medications that may affect renal function (e.g., diuretics, ACE inhibitors, angiotensin receptor blockers, NSAIDs)
  • Potential for reduced drug absorption
  • Oral medication administered within 1 hr before bowel preparation may not be absorbed properly
  • Administer tetracycline or fluoroquinolone antibiotics, iron, digoxin, chlorpromazine, or penicillamine at least 2 hours before and not less than 6 hours after administration of bowel preparation to avoid chelation

Pregnancy and Lactation

• No data available data on use in pregnant females to evaluate for a drug-associated risk of major birth defects, miscarriage, or adverse maternal or fetal outcomes
• No reproduction or developmental studies in animals have been conducted with sodium sulfate, magnesium sulfate, and potassium chloride.
• Lactation
  • There are no available data on drug presence in human or animal milk, effects on the breastfed child, or effects on milk production.