Picosulfate sodium

C1H03S 7790-94-5) see Actinoquinol Azosemide Bendroflumethiazide Clopamide Diclofenamide Diethylstilbestrol disulfate Dorzolamide Furosemide Glibenclamide Glimepiride Hydroflumethiazide Lomoxicam Mafenide Meticrane Metolazone Saccharin Sildenafil Sodium picosulfate Sulfanilamide Tiotixene Tripamide Xipamide... 

Diphenolmethane derivatives (p. 177) were developed from phenolphthalein, an accidentally discovered laxative, use of which had been noted to result in rare but severe allergic reactions. Bisac-odyl and sodium picosulfate are converted by gut bacteria into the active colon-irritant principle. Given by the enteral route, bisacodyl is subject to hydrolysis of acetyl residues, absorption, conjugation in liver to glucuronic acid (or also to sulfate, p. 38), and biliary secretion into the duodenum. Oral administration is followed after approx. 6 to 8 h by discharge of soft formed stooL When given by suppository, bisacodyl produces its effect within 1 h. 

Selegiline hydrochloride Semduramycin sodium Serenda repcus, serenovarepens Sertraline hydrochloride Sevoflurene inhalation Sibutramine hydrochloride Sildenafil citrate Silymarin Simvastatin Sodium enoxaparin Sodium picosulfate Solution/nasal spray/injection... 

Oral sodium picosulfate and oral sodium phosphate have been compared for bowel preparation before elective colorectal surgery and colonoscopy in randomized studies in 256 patients (32). Oral sodium phosphate was superior to sodium picosulfate on surgical assessment of bowel preparation, fecal residue in the resected specimen, and endoscopic score. However, there was no significant difference with regard to abdominal pain, nausea, vomiting, embarrassment, fear, and fatigue between the two groups. 

Oral sodium picosulfate plus magnesium citrate (Picolax) has been compared with a self-administered... 

Two cases of generalized urticarial skin reactions occurred after a first dose of sodium picosulfate (34). This may have represented an interaction with aminosalicylate derivatives, which were being administered at the same time, or a simple adverse effect to one of the agents. 

In 194 patients randomized to receive either sodium picosulfate or fleet phosphate soda before barium enema, there was no difference in the quality of bowel preparation, but picosulfate was easier to take and better tasting and it provoked less nausea and vomiting (2). 

Sodium picosulfate Electrolyte disturbance, convulsions, syncope, metabolic alkalosis (40)... 

Anonymous. Sodium picosulfate. Reports of severe electrolyte disturbances. WHO Pharmaceuticals Newslett 2002 2 9. 

Sodium picosulfate becomes active following metabolism by colonic bacteria so it has a relatively slow onset of action, usually within 10-14 hours. It can be used in young children. 

Phenolphthalein, once among the most popular components of laxatives, has been withdrawn from the market in the United States because of potential carcinogenicity. Oxyphenisatin, another older drug, was withdrawn due to hepatotoxicity. Sodium picosulfate (Lubrilax, SUR-LAX) is a diphenylmethane derivative widely available outside of the United States. It is hydrolyzed by colonic bacteria to its active form, and hence acts locally only in the colon. Effective doses of the diphenylmethane derivatives vary as much as four- to eightfold in individual patients. Consequently, recommended doses may be ineffective in some patients but may produce cramps and excessive fluid secretion in others. 

Paralytic ileum was reported in an 85-year-old man who had been taking a tea with senna leaf and fruit (with licorice, mallow, fennel, "balum," and caraway) every other day for 2 months. At the time the condition was diagnosed, the man was being hospitalized for transitory ischemic stroke. He had a history of high blood pressure, chronic obstructive bronchopneumopathy, and cholelithiasis, and a 5-year history of constipation, for which lactulose, bisacodyl, and sodium picosulfate were taken, with enemas used every 15 to 30 days (Sossai et al. 2007). 

Placebo-controlled studies In a double-blind, randomized, placebo-controlled trial for 4 weeks in 367 patients with functional constipation, sodium picosulfate 10 mg/day as oral drops was more efficacious in controlling both bowel movements and symptoms associated with constipation [90. The most frequent adverse event was diarrhea, which occurred in 4.5% of the placebo group and 32% of those who took sodium picosulfate. Abdominal pain was reported by 2.2% of patients on placebo and by 5.6% of patients on sodium picosulfate. 

Muelier-Lissner S, Kamm MA, Wald A, Hinkel U, Koehler U, Richter E, Bubeck J. Multicenter, 4-week, doubleblind, randomized, placebo-controlled trial of sodium picosulfate in patients with chronic constipation. Am J Gastroenterol 2010 105 897-903. 

Comparative studies In a randomized study, patients took Pico-Salax (a small-volume, osmotically active laxative containing sodium picosulfate lOmg -I- magnesium... 

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