Do I need to hold my medication prior to a colonoscopy?

Medication Management for Mojarro Prior to Colonoscopy

Mojarro does not need to be specifically held prior to a colonoscopy, as it is not mentioned in any bowel preparation guidelines as a medication requiring discontinuation. 1, 2

General Medication Management for Colonoscopy

The US Multi-Society Task Force on Colorectal Cancer guidelines focus on specific medications that require special consideration before colonoscopy, but do not list Mojarro as a medication requiring discontinuation. The guidelines emphasize:

• Medications that affect renal function (ACE inhibitors, NSAIDs, diuretics) may need adjustment when using certain bowel preparations 2
• Metformin should be reviewed and potentially adjusted in patients with borderline GFR 2
• Antihypertensive medication management should be individualized with assistance from the prescribing clinician 2

Key Considerations for Bowel Preparation

Dietary Modifications

• Limit dietary modifications to the day before colonoscopy for low-risk patients 1
• Use low-residue and low-fiber foods or full liquids for early and midday meals on the day before colonoscopy 1
• Clear liquids are allowed up to 2 hours before the procedure 2

Bowel Preparation Regimens

• Split-dose regimens are strongly recommended for all colonoscopies 2
  • First half taken the evening before
  • Second half taken 4-6 hours before colonoscopy, completed at least 2 hours before the procedure

Special Patient Populations

• Patients with renal insufficiency, congestive heart failure, or advanced liver disease should use 4L PEG-ELS preparations 2
• Patients at high risk for inadequate preparation include those with:
  • Prior inadequate preparation
  • History of constipation
  • Use of opioids or other constipating medications
  • Prior colon resection
  • Diabetes mellitus
  • Spinal cord injury 2

Common Pitfalls to Avoid

1. Misconception about medication discontinuation: Not all medications need to be held before colonoscopy. Focus on those that affect renal function or interact with bowel preparations.

2. Anesthesia concerns: Some anesthesia providers oppose split-dosing due to aspiration risk concerns. However, evidence shows that clear liquids (including bowel preparations) up to 2 hours before sedation do not increase residual gastric volume or aspiration risk 1.

3. Patient compliance issues: Ensure patients receive both verbal and written instructions about their bowel preparation regimen to improve compliance 1, 2.

4. Inadequate hydration: Patients should be monitored for signs of dehydration during preparation and ensure adequate hydration before, during, and after preparation 2.

In conclusion, there is no specific recommendation to hold Mojarro prior to colonoscopy in the current guidelines. The focus should be on following the standard bowel preparation protocols with appropriate dietary modifications and split-dosing regimens.