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MiraLAX Extended Preparation Instructions

These instructions are for patients WITHOUT severe kidney and heart disease. If you have severe kidney or heart disease, please call our office for alternative instructions: 303-604-5000

This bowel preparation requires a little organization but is an extremely important part of your colonoscopy to ensure you have the highest quality exam. Bowel preparation starts days prior to your procedure, as you need to stop taking certain medications or supplements and change your diet. If you do not follow these directions, your colonoscopy may be cancelled.

Key Information:

  • DO NOT EAT any solid food after 7pm two days before your colonoscopy. Drink only clear fluids.
  • Bring a list of all your MEDICATIONS (including over-the-counter medications), photo ID, insurance card, co-pay/co-insurance/deductible with you to your procedure.
  • DO NOT bring unnecessary belongings. We are not responsible for lost or misplaced items.
  • Stop all clear liquids two hours before your procedure arrival time.
  • Your colon must be COMPLETELY EMPTY so that your doctor can clearly view your colon.
    Follow all instructions in this handout EXACTLY as they are written. If you have completed your prep, and your stools are not clear or yellow, please contact our office at 303-604-5000, even if after hours.

Transportation on the day of your procedure:

  • A responsible adult MUST BE PRESENT (18 years or older) with you at check-in before your procedure and MUST BE ABLE to pick you up IMMEDIATELY when you are discharged. You are NOT ALLOWED to drive, take a taxi or bus, or leave the Endoscopy Center alone. If you do not have a responsible driver with you to take you home, your procedure WILL BE CANCELLED.
  • Because of the sedation, you are NOT ALLOWED to use a bus, taxi, Uber/Lyft, Access-a-Ride, walk home, etc. alone.

 

Medications:

  • Blood thinners: including Coumadin (warfarin), Plavix (clopidrogel), Ticlid (ticlopidine hydrochloride), Brilinta (ticagrelor), Aggrastat (tirofiban), Agrylin (anagrelide), Xarelto (rivaroxaban), Pradaxa (dabigatran), Eliquis (apixaban), Lovenox (low molecular weight heparin), Innohep (heparin) or Effient (Prasugrel), You must follow the instructions provided by our nurses.
  • Diabetes/Weight Loss medication: See instructions below.
  • ACE Inhibitor Blood Pressure medications: Do NOT take medications ending ‘pril’ the day of your procedure. Examples: lisinopril, benazepril, ramipril, captopril, enalapril, quinapril
  • ARB Blood Pressure medications: Do NOT take medications ending in ‘sartan’ the day of your procedure. Examples: losartan, irbesartan, candesartan, valsartan, telmisartan, olmesartan
  • Diuretics: Do NOT take “water” pills the day of your procedure. Examples: furosemide (Lasix), bumetanide (Bumex), torsemide, hydrochlorothiazide (HCTZ), spironolactone (Aldactone), indapamide, chlorothiazide, chlorthalidone, metolazone
  • All other medications: Including aspirin, should be taken the day of the exam with a sip of water

Weight Loss/Diabetes Medications:

  • GLP-1 Agonists (Injectable): including Mounjaro (tirzepatide), Zepbound (tirzepatide), Trulicity (dulaglutide), Victoza, Saxenda (liraglutide), Adlyxin (lixisenatide), Ozempic (semaglutide), Wegovy (semaglutide), Bydureon BCise (exenatide), Byetta (exenatide), Stop one week prior to your procedure.
  • GLP-1 Agonists (Oral): including Rybelsus (semaglutide tablet), Stop 24 hours prior to procedure.
  • Anorectics: including Adipex-P, Lomaira, Suprenza (phentermine hydrochloride), Qsymia (phentermine hydrochloride/topiramate), Stop 5 days prior to your procedure.

If you have diabetes, follow these instructions:

  • Long-Acting Insulins (ex. Lantus, Basaglar, Semglee, Toujeo, Insulin Glargine): Decrease basal rate by ½ the day before and the day of your procedure.
  • Rapid-Acting and Regular Short-Acting Insulin (ex. Lispro, Humalog, Admelog, Regular Insulin): If your blood sugar is high and you need to take a correction, take ½ or 50% of your usual correction.
    This applies to the day before and the day of your procedure.
  • Insulin Pump: Decrease basal rate by ½ the day before and the day of your procedure. Do not administer bolus doses.
  • SGLT2 Inhibitors: including Jardiance (empagliflozin), Brenzavvy (bexagliflozin), Glyxambi (empagliflozin/linagliptin), Invokamet (canagliflozin/metformin), Invokana (canagliflozin), Qtern (dapagliflozin/saxagliptin), Segluromet (ertugliflozin/metformin), Steglatro (ertugliflozin), Steglujan (ertugliflozin/sitagliptin), Synjardy (empagliflozin/metformin), Inpefa (sotagliflozin), Trijardy (empagliflozin/linagliptin/metformin), Xigduo (dapagliflozin/metformin), Farxiga (dapagliflozin), Stop these medications four days prior to your procedure.
  • Other Diabetic Oral & Injectable Medications: including Glucophage (metformin), Glucotrol/Glynase Pres Tab/Micronase (glipizide), Amaryl (glimepiride), DiaBeta (glyburide), Tradjenta (linagliptin), Januvia (sitagliptin), Nesina (alogliptin), Onglyza (saxagliptin), Zituvio (sitagliptin), Actos (pioglitazone), Avandia (rosiglitazone) or any combination of these medications, Stop these medications the day before your procedure.
  • Check your blood sugar at same intervals as usual, and additionally, if needed: If your blood sugar is less than 60, please take glucose tablets at any time before your procedure with a sip of water.

Checklist to Ensure Proper Bowel Preparation

To ensure the proper completion of your colonoscopy preparation, we strongly suggest that you PRINT OUT this document and check off each of the instructions as you complete them. This will greatly help you in following the detailed instructions and help ensure you receive a proper colonoscopy.

GROCERY STORE LIST: Purchase the items below at least five days before your procedure:

☐ 4 – Dulcolax laxative tablets containing 5 mg of bisacodyl each (NOT Dulcolax stool softener). ☐ 2 – 8.3 oz bottle of MiraLAX (238 grams) or generic equivalent.
☐ 2 – 8.3 oz bottle of MiraLAX (238 grams) or generic equivalent (polyethylene glycol).
☐ 2 – 28 oz or 32 oz bottles of Gatorade (NOT Red or Purple). Patients with diabetes should use Gatorade G2 (low sugar version-not red or purple). See clear liquid list below.
☐ 4 – Gas-X tablets (simethicone)
☐ 1 – Easily measurable 8-ounce glass/cup: You will be drinking multiple quantities of 8 oz liquids.
☐ 1 – 16-gram packet of magnesium citrate OR 10 oz bottle of magnesium citrate

5 days before your colonoscopy:

☐ Make sure you have purchased your bowel preparation items! (listed above!)
☐ DO NOT take medications that stop diarrhea such as Imodium (loperamide), Pepto-Bismol (bismuth subsalicylate) or Lomotil (diphenoxylate/atropine).
☐ DO NOT take fiber supplements such as Metamucil, Citrucel, Psyllium or Benefiber.
☐ DO NOT take products that contain iron such as multi-vitamins or iron supplements.
☐ Take one heaping teaspoon of MiraLAX® mixed with 8 oz. of a beverage twice daily until the day before your procedure when you will follow your general prep instructions. MiraLAX® can be mixed into any beverage, hot or cold. Some examples include coffee, tea, water, orange juice, iced coffee, ice water, coconut water, smoothie, iced tea and seltzer.

3 days before your colonoscopy:

☐ Discontinue high-fiber foods – Please see Low Fiber Diet tips attached.

​

Checklist: Two Days Before Your Colonoscopy

☐ DO NOT eat solid food after 7 pm until after your procedure.
☐ Follow a clear liquid diet using the charts below:

CLEAR LIQUIDS – YOU CAN DRINK:

  • Gatorade, Pedialyte, Powerade, Kool-Aid
  • Gatorade G2, Propel, Crystal Light
  • Popsicles
  • Jell-o, Juice without Pulp (ex. Apple Juice)
  • Black Coffee
  • Tea, Water
  • Clear Sodas (ex. Sprite, Ginger Ale)
  • Sparkling water

DO NOT DRINK:

  • NO Red or Purple Liquids
  • NO Milk or Non-dairy Creamers
  • NO Alcohol
  • NO Broth or soup
  • NO Juice with Pulp (ex. pineapple juice)
  • NO Liquid you cannot see through
  • NO Apple Sauce
  • NO Smoothies

Checklist: The Day Before Your Colonoscopy

☐ If you have diabetes, please see diabetes instructions above.
☐ Only drink clear liquids the ENTIRE DAY before your procedure. NO solid foods.
☐ Drink at least 8-ounces of clear liquids EVERY HOUR after waking up. See charts above.

The charts below will show you examples of what you can and cannot drink:

4:00 pm – the evening before your procedure, prepare the MiraLAX bowel preparation solution:

☐ Mix ½ of MiraLAX bottle (4.2 oz) into each of the two 28 oz or 32 oz Gatorade bottles, until dissolved.
You may have to drink a little or pour some of the Gatorade out, to make room for the MiraLAX.
Keep both Gatorade bottles cool in the refrigerator. DO NOT add ice.

5:00 pm – the evening before your procedure:

☐ Take four Dulcolax (bisacodyl) tablets and two tablets of simethicone/Gas X

6:00 pm – the evening before your procedure:

You will need to drink one of the 28 oz or 32 oz Gatorade bottles:
☐ 6:00 pm: Drink 8-ounces of the MiraLAX Gatorade bottle.
☐ 6:20 pm: Drink 8-ounces of the MiraLAX Gatorade bottle.
☐ 6:40 pm: Drink 8-ounces of the MiraLAX Gatorade bottle.
☐ 7:00 pm: Drink the rest of the MiraLAX Gatorade bottle.
☐ 7:20 pm: Drink an 8-ounce glass of a clear liquid. (see chart above)
☐ 7:40 pm: Drink an 8-ounce glass of a clear liquid.
☐ Before going to sleep: Take two additional simethicone tablets.
☐ Set your alarm! Make sure to wake up at least 4 hours before your procedure check-in time.

9:00 pm – the evening before your procedure:

☐ If you have not had any bowel movements, drink either the 10 oz bottle of magnesium citrate or a 16-gram packet of magnesium citrate (mixed with 8 oz of clear liquid of your choice).

Checklist: The Day of Your Colonoscopy

☐ If you have diabetes, please see diabetes instructions above.
☐ No marijuana.
☐ No mints, gum, hard candy or chewing tobacco.
☐ You may drink clear liquids up to 3 hours before your procedure check-in time. NO solid foods.

5 hours – before your procedure check-in time – this may be in the middle of the night or early AM:

You will need to drink the remaining 28 oz or 32 oz Gatorade bottle:

☐ 5 hours before procedure check-in: Drink 8-ounces of the MiraLAX Gatorade bottle.
☐ 4 hours & 40 min before check-in: Drink 8-ounces of the MiraLAX Gatorade bottle.
☐ 4 hours & 20 min before check-in: Drink 8-ounces of the MiraLAX Gatorade bottle.
☐ 4 hours before check-in: Drink the rest of the MiraLAX Gatorade bottle.
You should have finished the entire bottle.
☐ 3 hours & 40 min before check-in: Drink an 8-ounce glass of a clear liquid. (see chart above)
☐ 3 hours & 20 min before check-in: Drink an 8-ounce glass of a clear liquid.

3 hours – before your procedure check-in time

☐ 3 hours before check-in: STOP DRINKING ALL LIQUIDS!

Please note, all patients of childbearing age with a uterus will be asked to submit a urine sample prior to the procedure to test for pregnancy.

Congratulations, you have completed your prep! Please bring your medication list (including over-the-counter medications), photo ID, insurance card, co-pay/co-insurance/deductible with you to your procedure.

If you have any questions throughout your prep, please see our procedure FAQ’s: https://www.gastrorockies.com/procedure-faqs/

Procedure Cancellation Notice Requirements:

– Procedure cancellations must be made three (3) business days prior to your appointment.

– Failure to provide the required advance notice will result in a $150 Total Cancellation Fee.

($50 Physician cancellation fee from Gastroenterology of the Rockies + $100 Facility cancellation fee from the endoscopy center).

Download Prep Instructions

Colonoscopy Billing Information

Looking for billing information about colonoscopies? Download the PDF below for more information.

Download Billing Information

Low Fiber Diet

A low fiber diet limits the amount of food waste that must move through the large intestine.

Approved Foods

Bread, cereal, rice, and pasta

  • White bread, rolls, biscuits, croissants, melba toast
  • Waffles, French toast, pancakes
  • White rice, noodles, pasta, and macaroni
  • Peeled cooked potatoes
  • Plain crackers, saltines
  • Farina, cream of rice
  • Puffed rice, Rice Krispies, corn flakes, Special K

Meat

  • Ground (beef, chicken, turkey)
  • Lamb
  • Pork
  • Veal
  • Fish
  • Poultry

Vegetables

  • Cooked carrots
  • Asparagus tips
  • Green or wax beans
  • Pumpkin
  • Lima Beans

Fruits

  • Bananas, Honeydew, cantaloupe

Milk/Dairy

  • Milk-plain or flavored, eggs
  • ​Yogurt, custard, ice cream, cheese, cottage cheese

Fats, snacks, sweets, condiments, and beverages

  • Margarine, butter, oils
  • Mayonnaise
  • Sour cream
  • Dressing
  • Plain gravy
  • Sugar
  • Clear jelly
  • Honey
  • Syrup
  • Spices/cooked herbs
  • Bouillon, broth
  • Coffee, tea, carbonated drinks
  • Plain cake, cookies
  • Gelatin, plain pudding, popsicles
  • Hard candy or pretzels
  • Mustard, ketchup

Foods to Avoid

  • Breads or rolls with nuts, seeds or fruit: whole wheat, pumpernickel, rye, corn bread, chia seeds
  • Brown or wild rice, buckwheat, quinoa
  • Vegetables (raw or steamed, with seeds) – winter squash, peas, broccoli, Brussels sprouts
  • Cabbage, onions, cauliflower, sprouts, baked beans, peas, corn, potatoes with skin
  • Sauerkraut
  • Fruits (raw or dried) – all berries, figs, dates/raisins, prunes, prune juice
  • Yogurt with nuts or seeds
  • Processed meat – hotdogs, sausage, cold cuts, tough meat with gristle

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