What are the directions for using MiraLAX (polyethylene glycol) and Dulcolax (bisacodyl) the day before a colonoscopy?

MiraLAX and Dulcolax Directions for Colonoscopy Preparation

For optimal colonoscopy preparation, use a split-dose regimen with MiraLAX (polyethylene glycol) and Dulcolax (bisacodyl) taken the day before and morning of the procedure, with the second dose completed at least 2 hours before the colonoscopy. 1, 2

Preparation Timeline

Day Before Colonoscopy:

• Diet Modifications:

  • Follow a low-residue/low-fiber diet for breakfast and lunch 1, 2
  • Switch to clear liquids after lunch for the remainder of the day 2
  • Avoid red or purple liquids that could be mistaken for blood

• Evening Dose (First Half of Preparation):

  1. Take 2-4 Dulcolax (bisacodyl) tablets as prescribed by your doctor
  2. Mix 238g (approximately half a bottle) of MiraLAX powder with 64 ounces (2 liters) of clear liquid (water, Gatorade, etc.)
  3. Ensure the powder is fully dissolved before drinking 3
  4. Drink an 8-ounce glass every 15 minutes until half the solution is consumed

Day of Colonoscopy:

• Morning Dose (Second Half of Preparation):
  1. Begin the second half of the MiraLAX solution 4-6 hours before the procedure
  2. Drink an 8-ounce glass every 15 minutes until the solution is finished
  3. Complete the last dose at least 2 hours before the procedure time 1, 2

Key Considerations

• Split-dose regimen is strongly recommended over taking the entire preparation the day before, as it leads to better cleansing quality and higher polyp detection rates 1, 2
• For afternoon colonoscopies, a same-day regimen (taking the entire preparation on the day of the procedure) is an acceptable alternative 1
• For morning colonoscopies, the split-dose regimen is superior, even if it means waking up early 1
• Hydration is crucial - drink additional clear liquids before, during, and after the preparation to prevent dehydration 2

Important Precautions

• Do not combine MiraLAX with starch-based thickeners used for difficult swallowing 3
• Ensure the MiraLAX powder is fully dissolved before drinking 3
• Patients over 75 years of age should be monitored more closely as they have a higher risk of complications 4
• Patients with constipation may require a stronger preparation regimen 4
• If you have kidney disease, heart failure, or electrolyte disturbances, consult your doctor as alternative preparations may be needed 2

Expected Results

• Bowel movements will become increasingly liquid
• By the end of the preparation, bowel movements should be clear or light yellow liquid with no solid matter
• Adequate preparation is crucial for detecting colorectal lesions and preventing colorectal cancer 5, 6

The quality of bowel preparation directly impacts the effectiveness of the colonoscopy in detecting polyps and preventing colorectal cancer. Following these instructions precisely will help ensure optimal results and potentially avoid the need for a repeat procedure.