From the Guidelines
PEG-3350 powder is a suitable substitute for GoLytely (Polyethylene glycol (PEG)).
Alternatives to PEG
- Other options include oral sulfate solution (OSS), sodium picosulfate/magnesium citrate, and a combination of PEG-ELS and OSS.
- Sodium phosphate (NaP) solution is also available, but its use is limited due to concerns about phosphate-induced renal disease 1.
Efficacy of PEG-3350 powder
- Studies have shown that PEG-3350 powder is comparable to 4 L PEG-ELS in terms of bowel cleansing efficacy, with some studies suggesting improved tolerability 1.
- A split-dose regimen of PEG-3350 powder may be beneficial in reducing the risk of hyponatremia 1.
Considerations
- The choice of bowel cleansing agent should take into account the patient's medical history, medications, and prior colonoscopy results 1.
- PEG-ELS regimens are often preferred in patients with renal insufficiency, congestive heart failure, and advanced liver disease due to their iso-osmotic properties 1.
From the Research
Alternatives to GoLytely (Polyethylene glycol (PEG))
- MiraLAX is not as effective as GoLytely in bowel cleansing before screening colonoscopies, with an average Ottawa score of 6.9 compared to 5.1 for GoLytely 2
- Polyethylene glycol with Gatorade is as safe and efficacious as four liters of polyethylene glycol with balanced electrolytes, with no differences in preparation scores or serum electrolytes between the two agents 3
- The combination of polyethylene glycol (PEG) 3350 without electrolytes (MiraLAX) and 64 oz of Gatorade has gained popularity as a bowel preparation regimen, but its efficacy and tolerability have not been compared to standard bowel preparations in clinical trials 2
- Dulcolax (bisacodyl) can be used in combination with GoLYTELY to improve colonoscopy preparation, with a statistically significant improvement in overall quality of preparation and amount of liquid stool present during colonoscopy 4
Comparison of Bowel Preparation Methods
- GoLytely resulted in better scores of overall quality and bowel appearance compared to traditional mechanical preparation, reflecting a greater efficiency in removing air, fluid, and feces from the bowel 5
- MiraLAX was associated with a trend toward longer procedure duration, but no differences in polyp detection rates or adverse events were found 2
- Patients who received PEG + Gatorade gave higher overall satisfaction scores for the preparation experience and had fewer adverse effects compared to those who received PEG-ELS 3