Suprep

Medically Reviewed by Dr. Harshi Dhingra, M.D.

Last Reviewed: Jan 26, 2024

Warnings

Suprep Risks, Warnings, and Complications

Suprep can cause severe health problems, especially in certain high-risk patients. Some of the risks of taking Suprep include:

FLUID AND ELECTROLYTE ABNORMALITIES: Suprep causes watery bowel movements to cleanse the colon. This can result in fluid and electrolyte imbalance and can cause serious complications such as renal impairment, seizures, and heart arrhythmias. Make sure you drink water and stay well hydrated in the days before your colonoscopy. Get immediate medical help if you develop dizziness, severe vomiting, or reduced urine output after taking Suprep.
CARDIAC ARRHYTHMIAS: There are rare reports of cardiac arrhythmias (abnormal heart rhythm) in people who used the Suprep Bowel Prep Kit. Tell your doctor if you have a history of heart problems such as prolonged QT interval, irregular heartbeat, recent heart attack, unstable angina, enlarged heart, or congestive heart failure. Your doctor may order an echocardiogram (ECG) before prescribing Suprep and monitor your heart after the colonoscopy exam if you are at an increased risk of cardiac arrhythmias.
SEIZURES: Use of Suprep can result in electrolyte abnormalities (low sodium, potassium, calcium, and magnesium), which can cause seizures, even in people with no prior history of seizures. These seizures usually resolve when the fluid and electrolyte abnormalities are corrected. Tell your doctor if you have a history of seizures, take medications such as tricyclic antidepressants that can lower the seizure threshold, are undergoing alcohol or benzodiazepine withdrawal, or have low sodium levels.
IMPAIRED RENAL FUNCTION: Suprep Bowel Prep Kit should be used with caution in people with impaired renal function (reduced kidney function). Risk factors for kidney injury include taking certain medications such as diuretics (water pills), nonsteroidal anti-inflammatory drugs, angiotensin-converting enzyme (ACE) inhibitors, and angiotensin receptor blockers (ARBs). Make sure you drink clear liquids and hydrate well with Suprep. Your doctor may order laboratory tests to check electrolyte levels after your colonoscopy.
GASTROINTESTINAL PROBLEMS: There are reports of osmotic laxatives causing serious problems in the gut, such as colonic mucosal ulceration and ischemic colitis. Risk factors include a history of inflammatory bowel disease and taking stimulant laxatives at the same time as Suprep. Tell your doctor if you have a history of gastrointestinal conditions such as active ulcerative colitis, gastrointestinal perforation (hole in the bowel), or obstruction (blockage). Suprep may not be safe for you. Do not take any other laxatives during your bowel preparation.

Precautions Before Starting Suprep

Tell your healthcare provider if you have ever had an allergic reaction to Suprep (magnesium sulfate, potassium sulfate, sodium sulfate), any of the active or inactive ingredients in the Suprep kit, or any other drugs. Your pharmacy can give you a list of ingredients.

Give your healthcare provider a complete medical history. Suprep may not be safe for people with certain medical conditions such as gastrointestinal blockage or perforation, toxic megacolon (a life-threatening expansion of the large intestine), or problems emptying the stomach and intestines. Also tell your doctor if you have heart problems (recent heart attack, unstable angina (chest pain), heart failure, an enlarged heart, heart rhythm abnormalities, prolonged QT interval), inflammatory bowel disease, ulcerative colitis, heartburn, swallowing difficulties, electrolyte abnormalities (such as low sodium, potassium, magnesium or calcium), gout, seizures, or kidney disease.

Give your doctor a complete list of all your medications, including prescription drugs, over-the-counter medications, vitamins, dietary supplements, and herbal products. This can help avoid serious interactions between Suprep and your regular medications.

Talk to your doctor if you take insulin or oral medications for diabetes or are on blood thinners. You may need to adjust the doses of your medications before your colonoscopy.

Tell your doctor if you are pregnant, could be pregnant, plan to get pregnant, or are breast-feeding.

Precautions During Use of Suprep

Do not take other laxatives while using Suprep.

If you are taking other medications by mouth, take them at least 1 hour before starting your bowel preparation with Suprep.

Take the following medications at least 2 hours before or 6 hours after your bowel prep:

Chlorpromazine
Antibiotics such as levofloxacin, moxifloxacin (Avelox), ofloxacin, delafloxacin (Baxdela), ciprofloxacin (Cipro), gemifloxacin (Factive), minocycline (Minolira, Minocin, Solodyn, others), tetracycline (Achromycin V, in Pylera), demeclocycline, doxycycline (Doryx, Acticlate, Oracea, Vibramycin, others), and penicillamine (Cupramine, Depen)
Digoxin (Lanoxin)
Iron supplements

Drink clear liquids in the days before your colonoscopy to stay well hydrated. Follow your doctor’s directions for a clear liquid diet on the day before your colonoscopy carefully.

Suprep Drug Interactions

Taking Suprep with certain medications can affect how the medications work. Interactions between medications can increase the risk of serious adverse reactions. Your doctor may change the dose, switch you to a different medication, or monitor you carefully for side effects if there are known drug interactions between Suprep and your other medications. Suprep can interact with the following medications:

Benzodiazepines such as alprazolam (Xanax), diazepam (Diastat, Valium), lorazepam (Ativan), estazolam, flurazepam, triazolam (Halcion), and midazolam (Versed)
Medications prescribed for abnormal heart rhythms such as amiodarone (Cordarone, Pacerone), disopyramide (Norpace), dofetilide (Tikosyn), quinidine (Quinidex, in Nuedexta), and sotalol (Betapace, Betapace AF, Sorine)
Tricyclic antidepressants such as amitriptyline and desipramine (Norpramin)
Blood pressure medications (angiotensin-converting enzyme (ACE) inhibitors) such as benazepril (Lotensin, in Lotrel), enalapril (Epanid, Vasotec, in Vaseretic), captopril, fosinopril, moexipril, lisinopril (Prinivil, Qbrelis, Zestril, in Zestoretic), perindopril (Aceon, in Prestalia), ramipril (Altace), quinapril (Accupril, in Accuretic, Quinaretic), and trandolapril (in Tarka)
Blood pressure medications (angiotensin II receptor antagonists) such as valsartan (Diovan, Diovan HCT, in Byvalson, Entresto, Exforge, Exforge HCT), eprosartan (Teveten), candesartan (Atacand, in Atacand HCT), irbesartan (Avapro, in Avalide), olmesartan (Benicar, in Azor and Tribenzor), losartan (Cozaar, in Hyzaar), and telmisartan (Micardis, in Micardis HCT and Twynsta)
Aspirin and other nonsteroidal anti-inflammatory medications such as ibuprofen (Motrin) and naproxen (Aleve, Naprosyn)
Diuretics or water pills
Antibiotics such as erythromycin (E.E.S., Erythrocin) and moxifloxacin (Avelox)
Anti-seizure medications
Psychiatric medications such as pimozide (Orap) and thioridazine

Give your healthcare professionals a complete list of your medications, including prescription drugs, over-the-counter medications, vitamins, dietary supplements, and herbal products. Also, tell your health care provider if you smoke, drink alcohol, or use illegal drugs because some of these substances can cause serious health complications when used with medications.

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