From the Guidelines
To prepare for your procedure, a split-dose regimen of 4 L PEG-ELS, such as MoviPrep, is recommended, with the first dose taken the evening before and the second dose taken the morning of the procedure, and Dulcolax (bisacodyl) can be taken as an adjunct to enhance bowel cleansing, as supported by the US Multi-Society Task Force on Colorectal Cancer 1. When administering MoviPrep and Dulcolax, consider the patient's medical history, medications, and prior colonoscopy results, as recommended by the US Multi-Society Task Force on Colorectal Cancer 1.
- The MoviPrep solution should be mixed with water according to the manufacturer's instructions and consumed over a specified period.
- The Dulcolax tablet can be taken immediately after finishing the MoviPrep solution to provide additional stimulation for bowel movements.
- It is essential to follow the recommended split-dose regimen and drink all of the solution within the specified timeframe to achieve optimal bowel cleansing.
- Patients should be advised to stay near a bathroom, as frequent bowel movements may occur shortly after starting the preparation.
- Healthcare providers should provide additional instructions regarding dietary restrictions before the procedure, taking into consideration the patient's individual needs and medical history, as recommended by the US Multi-Society Task Force on Colorectal Cancer 1. The use of a split-dose regimen of 4 L PEG-ELS, such as MoviPrep, has been shown to provide high-quality bowel cleansing, as supported by the US Multi-Society Task Force on Colorectal Cancer 1.
- The addition of Dulcolax (bisacodyl) can enhance bowel cleansing, particularly in patients with constipation or inadequate bowel preparation.
- However, the specific protocol for administering MoviPrep and Dulcolax may vary depending on the patient's individual needs and medical history, and should be determined by a healthcare provider, as recommended by the US Multi-Society Task Force on Colorectal Cancer 1.
From the FDA Drug Label
Directions - tear off one suppository from the strip - peel apart the wrapper - continue peeling apart to almost the full length of the suppository - gently remove the suppository from the wrapper - lie on your side and push suppository, with pointed end first, high into the rectum so it will not slip out - retain it for 15 to 20 minutes The protocol for administering Dulcolax (bisacodyl) is to insert one suppository into the rectum once daily for adults and children 12 years and over.
- For children 6 to under 12 years, the dose is 1/2 suppository once daily.
- For children under 6 years, a doctor should be consulted. The FDA drug label does not answer the question regarding the protocol for administering MoviPrep (polyethylene glycol) 2.
From the Research
Protocol for Administering MoviPrep (Polyethylene Glycol) and Dulcolax (Bisacodyl)
- The protocol for administering MoviPrep (polyethylene glycol) and Dulcolax (bisacodyl) involves taking bisacodyl 10 mg plus 1 L of polyethylene glycol the night before and 1 L on the day of the exam, as shown in a study comparing the tolerability, acceptability, safety, and efficacy of two solutions used for intestinal preparation for a colonoscopy 3.
- Another study found that a combination of bisacodyl suppository and 1 L polyethylene glycol plus ascorbic acid is a non-inferior and comfortable regimen compared to 2 L polyethylene glycol plus ascorbic acid 4.
- The quality of bowel cleansing with polyethylene glycol and bisacodyl has been compared to other preparations, such as polyethylene glycol-ascorbate, and found to be equivalent or superior in terms of tolerability and efficacy 5, 6.
- A meta-analysis of low-volume polyethylene glycol and bisacodyl for bowel preparation prior to colonoscopy found that this regimen demonstrates less nausea, vomiting, and bloating without adversely affecting the bowel preparation 7.
Key Findings
- Polyethylene glycol and bisacodyl can be administered in a low-volume regimen (1-2 L) with similar efficacy to higher volume regimens.
- The addition of bisacodyl to polyethylene glycol can improve tolerability and reduce adverse events such as nausea, vomiting, and bloating.
- The quality of bowel cleansing with polyethylene glycol and bisacodyl is equivalent or superior to other preparations, such as polyethylene glycol-ascorbate.
Administration Guidelines
- Take bisacodyl 10 mg plus 1 L of polyethylene glycol the night before and 1 L on the day of the exam.
- Alternatively, take a combination of bisacodyl suppository and 1 L polyethylene glycol plus ascorbic acid.
- Follow the specific instructions provided by the healthcare provider or manufacturer for the administration of MoviPrep and Dulcolax.