|AHFS/Drugs.com||International Drug Names|
|Chemical and physical data|
|Molar mass||481.409 g/mol|
|3D model (Jmol)|
|(what is this?)|
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 sold under the trade names Sodipic Picofast, Laxoberal, Laxoberon, Purg-Odan, Picolax, Guttalax, Namilax, Pico-Salax, PicoPrep, and Prepopik, among others.
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.
The most common side effects of picosulfate are abdominal cramps and diarrhea.
The use of sodium picosulfate has also been associated with certain electrolyte disturbances, such as hyponatremia and hypokalemia. Patients are often required to drink large amounts of clear fluids as well as rehydrate to reestablish the electrolyte balance.
Mechanism of action
Sodium picosulfate is a prodrug. 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-pyridiyl)methane (DPM, BPHM). This compound is a stimulant laxative and increases peristalsis in the gut.
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.
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- PICO SALAX Product Information
- Tjandra, Joe J.; Chan, Miranda; Tagkalidis, Peter P. (2006). "Oral sodium phosphate (Fleet(R)) is a superior colonoscopy preparation to Picoprep(R) (sodium picosulfate-based preparation)". Diseases of the Colon & Rectum. 49 (5): 616–620. doi:10.1007/s10350-005-0323-2. PMID 16525746.
- "FDA News Release – FDA approves new colon-cleansing drug for colonoscopy prep". Food and Drug Administration. July 17, 2012. Retrieved December 1, 2016.
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- Adamcewicz, Margaret; Bearelly, Dilip; Porat, Gail; Friedenberg, Frank K. (2011-01-01). "Mechanism of action and toxicities of purgatives used for colonoscopy preparation". Expert Opinion on Drug Metabolism & Toxicology. 7 (1): 89–101. doi:10.1517/17425255.2011.542411. ISSN 1742-5255. PMC . PMID 21162694.
- Forth, W.; Nell, G.; Rummel, W.; Andres, H. (1972-03-01). "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. doi:10.1007/BF00501005. ISSN 0028-1298.
- Jauch, R; Hankwitz, R; Beschke, K; Pelzer, H (November 1975). "Bis-(p-hydroxyphenyl)-pyridyl-2-methane: The common laxative principle of Bisacodyl and sodium picosulfate.". Arzneimittel-Forschung. 25 (11): 1796–1800. PMID 1243088.
- Regev, Arie; Fraser, Gerald; Delpre, George; Leiser, Alfredo; Neeman, Ami; Maoz, Eran; Anikin, Victor; Niv, Yaron. "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): 1478–1482. doi:10.1111/j.1572-0241.1998.00467.x.