What are the oral bowel preparation solutions alternative to GoLytely (Polyethylene Glycol)?

From the Guidelines

Oral bowel preparation solutions alternative to GoLytely (Polyethylene Glycol) include Sodium Picosulfate/Magnesium Citrate, Oral Sulfate Solution, and PEG-3350 powder.

Alternatives to GoLytely

• Sodium Picosulfate/Magnesium Citrate (Prepopik): a low-volume agent that is effective and well-tolerated by most patients, but not recommended in patients with renal insufficiency, pre-existing electrolyte disturbances, congestive heart failure, cirrhosis, or ascites 1.
• Oral Sulfate Solution (SUPREP): a low-volume agent that is effective and has been compared with Sodium Phosphate (NaP) and PEG-ELS in several trials 1.
• PEG-3350 powder: an OTC laxative that can be used for bowel preparation, with satisfactory colon cleansing rates comparable to 4 L PEG-ELS in some studies, and better tolerability based on taste and overall experience 1.

Important Considerations

• The choice of bowel preparation solution should take into consideration the patient’s medical history, medications, and prior colonoscopy results 1.
• Split-dose regimens, such as 2 L of PEG-ELS the day before and 2 L the day of the procedure, have been shown to increase bowel cleanliness and patient satisfaction 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

Alternative Oral Bowel Preparation Solutions

The following are alternative oral bowel preparation solutions to GoLytely (Polyethylene Glycol):

• Isosmotic solutions:
  • Low-volume PEG-ELS with ascorbic acid (e.g., MoviPrep, PLENVU) 2
  • Sulfate-free high-volume PEG-ELS formulations (SF-PEG-ELS) 2
• Hyperosmotic solutions:
  • Oral sulfate solution (OSS) (e.g., SUPREP) 2
  • Sodium phosphate tablets (NaP) (e.g., OsmoPrep) 2, 3, 4
  • Oral sulfate tablets (OST) (e.g., SUTAB) 2
  • Flavored PEG with sulfate salts (FPSS) (e.g., SUFLAVE) 2
  • Magnesium citrate 2, 3
• Hypoosmotic solutions:
  • PEG-sports drink (PEG-SD) 2
• Combination solutions:
  • Sodium picosulfate with magnesium citrate (SPMC) with laxatives (e.g., CLENPIQ) 2
  • OSS with SF-PEG-ELS (Suclear) 2

Comparison of Bowel Preparation Methods

Studies have compared the effectiveness of different bowel preparation methods, including:

• GoLytely vs. standard bowel cleansing preparation 5
• Polyethylene glycol-electrolyte lavage solution (PEG-ELS) vs. sodium phosphate 3, 4
• Oral sodium phosphate solution vs. polyethylene glycol-based solution in children 6