Sodium picosulfate

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Sodium picosulfate
Sodium picosulfate.svg
Ball-and-stick model of the component ions of sodium picosulfate
Clinical data
AHFS/ International Drug Names
Routes of
ATC code
CAS Number
PubChem CID
ECHA InfoCard 100.030.097
Chemical and physical data
Formula C18H13NNa2O8S2
Molar mass 481.409 g/mol
3D model (Jmol)
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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 sold under the trade names Sodipic Picofast, Laxoberal, Laxoberon,[1] Purg-Odan, Picolax, Guttalax, Namilax, Pico-Salax,[2] PicoPrep,[3] and Prepopik,[4] 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.[4]

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.[5] Patients are often required to drink large amounts of clear fluids as well as rehydrate to reestablish the electrolyte balance.

Mechanism of action[edit]

Sodium picosulfate is a prodrug.[6] 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).[6][7] This compound is a stimulant laxative and increases peristalsis in the gut.[6][8]

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.[6][9]


  1. ^ Website of Merck Pakistan
  2. ^ PICO SALAX Product Information
  3. ^ 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. 
  4. ^ a b "FDA News Release – FDA approves new colon-cleansing drug for colonoscopy prep". Food and Drug Administration. July 17, 2012. Retrieved December 1, 2016. 
  5. ^ ADRAC (February 2002). "Electrolyte disturbances with sodium picosulfate bowel cleansing products". Aust Adv Drug React Bull. 21 (1).  Free full text from the Australian Therapeutic Goods Administration
  6. ^ a b c d 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 3030244Freely accessible. PMID 21162694. 
  7. ^ 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. 
  8. ^ 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. 
  9. ^ 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.