How should I manage my medications before a colonoscopy?

Medication Management Before Colonoscopy

Direct Recommendation

Continue most of your medications as prescribed, but hold Jardiance (SGLT-2 inhibitor) on the morning of your colonoscopy and resume it after the procedure once you're eating normally and kidney function is verified. 1

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Specific Medication Instructions

Medications to HOLD on Colonoscopy Day

• Jardiance (SGLT-2 inhibitor): Stop on the morning of the procedure to avoid dehydration and electrolyte imbalances during bowel preparation 1

  • Resume after the procedure only after normal eating has resumed and kidney function has been verified 1
  • Restarting without checking kidney function increases complication risk 1

• Glipizide (sulfonylurea): Hold on the day of the procedure to minimize hypoglycemia risk during fasting 1

Medications to CONTINUE

• Januvia (DPP-4 inhibitor): Can be safely continued through the colonoscopy preparation period 1

  • Unlike GLP-1 receptor agonists, DPP-4 inhibitors don't significantly delay gastric emptying and don't increase risk of inadequate bowel preparation 1

• Lantus (basal insulin): Should be reduced but NOT completely discontinued 1

  • Monitor blood glucose more frequently during the preparation period, especially during fasting 1

• Beta blocker (if applicable): Continue as prescribed 2

  • Patients on beta blockers can continue this treatment safely during the perioperative period 2

• Topical and nasal medications: Continue as prescribed (these don't interfere with bowel preparation)

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Bowel Preparation Timing

Use a split-dose bowel preparation regimen for optimal results. 3

• Begin the second portion of your bowel preparation 4-6 hours before colonoscopy 3, 1
• Complete the last dose at least 2 hours before the procedure 3
• Split-dose regimens are superior to day-before-only preparations and lead to higher adenoma detection rates 3

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Dietary Modifications

Limit dietary modifications to the day before colonoscopy only. 3

• Use low-residue and low-fiber foods or full liquids for early and midday meals on the day before colonoscopy 3
• This approach improves patient satisfaction without compromising bowel preparation quality 3

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Critical Monitoring Points

Blood Glucose Monitoring

• Check blood glucose more frequently during the preparation period 1
• Pay particular attention during the fasting phase when hypoglycemia risk is highest 1

Post-Procedure

• Verify kidney function before restarting Jardiance, especially if you have any kidney disease risk factors 1
• Resume normal medication schedule once eating has resumed 1

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Common Pitfalls to Avoid

• Don't completely stop basal insulin (Lantus) - reduction is appropriate, but complete discontinuation increases hyperglycemia risk 1
• Don't restart SGLT-2 inhibitors without checking kidney function - this can lead to serious complications 1
• Don't take the entire bowel preparation the day before - split-dosing provides superior cleansing and better adenoma detection 3