The following weight loss / diabetic drugs should be held as instructed prior to procedure:

• Liraglutide: Victoza (weekly) and Saxenda (daily)
• Dulaglutide: Trulicity (weekly)
• Exenatide: Bydureon (weekly) and Byetta (daily)
• Semaglutide: Ozempic (weekly), Wegovy (weekly) and Rybelsus (daily)
• Tirzepatide: Mounjaro (weekly) and Zepbound (weekly)
• Lixisenatide: Adlyxin (daily)

The medication will need to be stopped seven (7) days prior to your procedure if you are on a weekly dose or the day of your procedure if you are on a daily dose.

If you routinely have less than 2 bowel movements per week then you will also need to purchase an 8.3 oz bottle of Miralax. Begin taking a dose of Miralax twice a day 5 days prior to your procedure. Take the last dose of Miralax in the morning the day before your procedure.

You may only have clear liquids the entire day such as water, coffee, tea, broth, sodas, apple juice, Gatorade, Kool-aid, Jell-O, popsicles and hard candy. You may not have any solid food. It is important to drink extra clear liquids before your prep to maintain adequate hydration. Do not drink liquids that are not clear such as milk. Do not drink liquids that are red or purple in color.

• MORNING:
  • Mix the prep according to instructions. Shake until the powder is mixed and chill in the refrigerator.

  BETWEEN 3 AND 6 PM – START YOUR PREP:
  • Shake the container. Begin drinking the solution. Drink an 8 ounce glass of the solution every 10 – 15 minutes. It is recommended that you drink the whole glass rapidly rather than sip small amounts. A straw may help.
  • Keep drinking the solution every 10-15 minutes until you drink 3 liters (bottle is 3/4 empty). Shake the container before pouring each dose. Refrigerate the unused portion.
  • Make a conscious effort to drink as much clear liquids as you can before, during and after the preparation.

  NOTE:
  • If you experience nausea – slow down your prep intake and walk around until nausea is relieved.
  • Use baby wipes and/or Balneol cleansing cream or lotion during the prep to reduce irritation.

• STEP 1:
  • Begin drinking the remainder of the solution (1 liter). Drink an 8 oz. glass of the solution every 10 -15 minutes as directed above. Do not rush. If you need to wait longer between glasses, do so.
  • Keep drinking the solution until the bottle is empty. This solution must be completed at least 3 hours prior to your appointment arrival time.

  STEP 2:
  • You may drink clear liquids until 3 hours before your appointment time.
  • You may take your prescription medications (except those listed in the booklet) with water up to 3 hours before your appointment arrival time.
  • Do not use smokeless tobacco on the day of your procedure.
  • Starting 3 hours before your appointment arrival time absolutely nothing by mouth including gum, hard candy, breath mints.

Please call us at (346) 340 4414 if you have any questions or if you are having difficulty with the preparation. We are available 24 hours a day, 7 days a week.

• If you take oral medications for your diabetes, do NOT take your diabetes pills on the day prior to your procedure (prep day) or on the day of your procedure (until your procedure is complete and you resume a normal diet).
• If you take non-insulin injectable medications (Byetta, Bydureon, Victoza, Trulicity, Tanzeum, Symlin), do not take the medication if your injection day is the day prior to your procedure (prep day). You can resume it after the procedure is complete.
• If you take insulin, reduce your dose by 50% (half) of your normal dose on the day prior to your procedure and the day of your procedure. You can resume your normal dose after the procedure when you resume normal diet.
• If you use an insulin pump, contact your diabetes doctor for instruction. Generally, most patients will need to reduce their basal rate to 80% of the normal rate.

• You should aim for 45-60 grams of carbs with each meal. Although you may ordinarily avoid sugars, they are ok to take when you are prepping for your colonoscopy as these will be the main source of calories when you are on a clear liquid diet.
• For snacks, try to include other fluids that contain electrolytes such as broth.
• Examples of clear liquids with carb amounts are listed below. Note, if you experience low blood sugar (<60) during the 2 hours before your procedure, you can take 3 teaspoons of soda or clear juice to raise your sugar. Do NOT take solid foods or non-clear liquids, as your procedure will be cancelled.

Please call us at (346) 340 4414 if you have any questions or if you are having difficulty with the preparation. We are available 24 hours a day, 7 days a week.