Chemistry:Sodium picosulfate
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| Other names | Picosulfuric acid |
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| Routes of administration | By mouth |
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| Formula | C18H15NNa2O9S2 |
| Molar mass | 499.42 g·mol−1 |
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Sodium picosulfate (INN, also known as sodium picosulphate) is a contact stimulant laxative used as a treatment for constipation or to prepare the large bowel before colonoscopy or surgery.
It is available as a generic medication.[2]
Medical uses
Sodium picosulfate used in combination with magnesium oxide and anhydrous citric acid is indicated for cleansing of the colon as a preparation for colonoscopy.[1]
Effects
Orally administered sodium picosulfate is generally used for thorough evacuation of the bowel, usually for patients who are preparing to undergo a colonoscopy. It takes 12–24 hours to work, since it works in the colon.[3]
Abdominal cramps and diarrhea are normal effects of picosulfate and should be expected.
The use of sodium picosulfate has also been associated with certain electrolyte disturbances, such as hyponatremia and hypokalemia.[4] Patients are often required to drink large amounts of clear fluids, to compensate for dehydration and to reestablish normal electrolyte balance.
Mechanism of action
Sodium picosulfate is a prodrug.[5] It has no significant direct physiological effect on the intestine; however, it is metabolised by gut bacteria into the active compound 4,4'-dihydroxydiphenyl-(2-pyridyl)methane (DPM, BHPM).[5][6] This compound is a stimulant laxative and increases peristalsis in the gut.[5][7]
Sodium picosulfate is typically prescribed in a combined formulation with magnesium citrate, an osmotic laxative. This combination is a highly effective laxative, often prescribed to patients for bowel cleansing prior to colonoscopies.[5][8]
Society and culture
Brand names
It is sold under the brand names Sodipic Picofast, Laxoberal, Laxoberon,[9] Purg-Odan, Picolax, Guttalax, Namilax, Pico-Salax,[10] PicoPrep,[11] and Prepopik,[3] among others.
Clenpiq is a combination of sodium picosulfate, magnesium oxide, and citric acid.[1]
References
- ↑ 1.0 1.1 1.2 "Clenpiq- sodium picosulfate, magnesium oxide, and anhydrous citric acid liquid". 5 September 2023. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=e95fff66-4ec0-4001-a727-33e66a5ec7d5.
- ↑ "2022 First Generic Drug Approvals". 3 March 2023. https://www.fda.gov/drugs/drug-and-biologic-approval-and-ind-activity-reports/2022-first-generic-drug-approvals.
- ↑ 3.0 3.1 "FDA News Release – FDA approves new colon-cleansing drug for colonoscopy prep". Food and Drug Administration. 17 July 2012. https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm312315.htm.
- ↑ ADRAC (February 2002). "Electrolyte disturbances with sodium picosulfate bowel cleansing products". Aust Adv Drug React Bull 21 (1). Free full text from the Australia n Therapeutic Goods Administration
- ↑ 5.0 5.1 5.2 5.3 "Mechanism of action and toxicities of purgatives used for colonoscopy preparation". Expert Opinion on Drug Metabolism & Toxicology 7 (1): 89–101. January 2011. doi:10.1517/17425255.2011.542411. PMID 21162694.
- ↑ "The hydragogue and laxative effect of the sulfuric acid ester and the free diphenol of 4,4'-dihydroxydiphenyl-(pyridyl-2)-methane". Naunyn-Schmiedeberg's Archives of Pharmacology 274 (1): 46–53. 1 March 1972. doi:10.1007/BF00501005. PMID 4262724.
- ↑ "Bis-(p-hydroxyphenyl)-pyridyl-2-methane: The common laxative principle of Bisacodyl and sodium picosulfate". Arzneimittel-Forschung 25 (11): 1796–1800. November 1975. PMID 1243088.
- ↑ "Comparison of two bowel preparations for colonoscopy: sodium picosulphate with magnesium citrate versus sulphate-free polyethylene glycol lavage solution". The American Journal of Gastroenterology 93 (9): 1478–82. September 1998. doi:10.1111/j.1572-0241.1998.00467.x. PMID 9732929.
- ↑ Website of Merck Pakistan
- ↑ PICO SALAX Product Information
- ↑ "Oral sodium phosphate (Fleet) is a superior colonoscopy preparation to Picopre (sodium picosulfate-based preparation)". Diseases of the Colon and Rectum 49 (5): 616–20. May 2006. doi:10.1007/s10350-005-0323-2. PMID 16525746.
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