TWO DAY MIRALAX PREP



TWO DAY MIRALAX PREP

Do not take iron pills within 7 days prior to procedure.

Purchase from pharmacy (4) four Dulcolax (Bisacodyl) 5mg oral tablets (no prescription needed)

Purchase from pharmacy (1) one 238 gram bottle of Miralax (no prescription needed)

Purchase (1) one 64 oz bottle of Gatorade (No Red Flavors)

A. DAY 1: ________________________________________. In a.m., mix the 238 gram bottle of Miralax powder into the 64 oz bottle of Gatorade and chill in the refrigerator until time to begin prep. (Shake the solution until Miralax is completely disolved).

Begin Clear Liquids Only. (Clear liquids allowed include water, soft drinks, coffee or tea without cream, Jello, non-pulpy juice (orange , apple, white grape, white cranberry), broth and bouillon. Do not drink any RED colored beverages or eat RED jello.)

12:00 Noon: Take (2) Dulcolax tablets

2:00 p.m.: Begin drinking Miralax Prep – 8 oz. every 10 minutes until one half (1/2) of the mixture is gone.

B. DAY 2: ___________________________________________. Continue clear liquid diet as above.

12:00 Noon: Take remaining (2) Dulcolax tablets with water.

2:00 p.m.: Begin drinking the remaining Miralax prep. Drink 8 oz. every 15-30 minutes until entire solution is gone. If you become nauseated during the ingestion of the Miralax prep, stop the prep for 45 minutes then resume. YOU MUST CONTINUE ON CLEAR LIQUIDS THE REMAINDER OF THE DAY TO PREVENT DEHYDRATION.

C. THE DAY OF YOUR EXAM ____________________________________________________.

---You may have clear liquids until 4 hrs prior to your procedure.

Please leave all jewelry and valuables at home. We do not provide a secure area for these items.

TRANSPORTATION: Due to sedation that you will be given, you MUST have someone to drive you to and from your appointment. If you do not have a driver, your procedure WILL NOT BE DONE. All drivers must report in with the patient and sign in and MUST remain until the patient is discharged.

PRESCRIPTION MEDICATIONS: Do not use anti-inflammatory medication 5 days prior to your procedure.

Use Tylenol. Call our office if you are taking Coumadin. Stop iron medicines 1 week before your procedure. If you have diabetes, take 1/2 of your insulin the morning of procedure. Do not take oral morning diabetic medicine. Take all oral medications, inhalers and nebulizers 4 hours prior to your procedure time. Do not skip any doses of blood pressure medicine.

______________________ __________________________ _____________________

APPOINTMENT DATE APPOINTMENT TIME ARRIVAL TIME

If you have any changes in your medical history between the day of scheduling and the appointment date, please contact our office and if you have any questions or should you need to reschedule this procedure, please call 336-760-4340, Option 4. WE REQUIRE A 48 HOUR (BUSINESS DAY) NOTICE IF THERE IS A NEED FOR CHANGE OR CANCELLATION OF YOUR PROCEDURE.

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