Sodium picosulfate
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| AHFS/Drugs.com | International Drug Names |
| Routes of administration | Oral |
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| ECHA InfoCard | 100.030.097 |
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| Formula | C18H13NNa2O8S2 |
| Molar mass | 481.409 g/mol 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 sold under the trade names Sodipic Picofast, Laxoberal, Laxoberon,[1] Purg-Odan, Picolax, Guttalax, Namilax, Pico-Salax[2] and Prepopik [3] among others. PicoPrep[4] is based on Sodium picosulphate.
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.[5]
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.[6] 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.[7] 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).[7][8] This compound is a stimulant laxative and increases peristalsis in the gut.[7][9]
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.[7][10]
References
- ^ Website of Merck Pakistan
- ^ PICO SALAX Product Information
- ^ FDA approves new colon-cleansing drug for colonoscopy prep
- ^ Picoprep study at ingentaconnect 'Picoprep-3 Is a Superior Colonoscopy Preparation to Fleet: A Randomized, Controlled Trial Comparing the Two Bowel Preparations' study at St George Hospital, Sydney, NSW, Australia
- ^ FDA approves new colon-cleansing drug for colonoscopy prep
- ^ 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
- ^ 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 3030244. 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.