2 Day Bowel Prep with Miralax and Dulcolax

2 Day Bowel Prep with Miralax and Dulcolax

 

To prepare for your test or procedure, you will need to clean out your bowels or large intestines. Review all of the information you are given as soon as you can, so you are prepared and know what to expect during and after your test.

  • You may need to make changes to your diet or medicines.
  • You will need to adjust your diet 5 days before the test and begin this bowel prep at 6:00 PM, 2 days before your test.

 

You need to have an adult come with you to your test

You will be given medicine to help you relax during the test that will affect your judgement and reflexes much of the day. For your safety, you will need a responsible adult to drive you home after the test. If you take a cab, bus, or medical transportation service, an adult, other than the driver needs to come with you for your safety.

Your driver, or adult coming with you, needs to check in with you for the test.

  • If your driver doesn’t check in with you, we will need to speak to your driver before we can start your test. Your test will be delayed or cancelled if we cannot speak to your driver.
  • If your driver leaves the facility during the test, he or she needs to give the staff a phone number where he or she can be reached. Your driver needs to be within 30 minutes of the endoscopy unit.

You should have an adult with you to help you after the test at home for at least 6 hours.

 

You may need to make changes to your medicines

If you take aspirin or NSAIDs, such as ibuprofen, naproxen, or Celebrex for pain, you do NOT need to stop taking these medicines before this test.

If you take medicines for diabetes, ask the doctor who ordered your diabetes medicine how to adjust your medicines for this test.

If you take any of the blood thinner medicines listed below:

  • Ask the doctor who ordered this medicine if it is safe for you to stop taking this medicine before the test. If you have a stent or certain other health problems, do NOT stop taking these medicines.
  • If your doctor has advised you to NOT stop taking these medicines before the test, please call 614-293-6255 and ask to talk to a nurse.
  • If your doctor agrees you should stop taking any of the medicines listed below, stop for the listed number of days before your test or as your doctor recommends:
  • Brilinta (Ticagretor) – 5 days
  • Coumadin (Warfarin) – 5 days
  • Effient (Prasugrel) – 7 days
  • Eliquis (Apixaban) – 2 days
  • Lovenox (Enoxaparin) – 1 day
  • Plavix (Clopidogrel) – 5 days
  • Pletal (Cilostazol)– 5 days
  • Pradaxa (Dabigatran) – 2 days
  • Savaysa (Edoxaban) – 2 days
  • Xarelto (Rivaroxaban) – 1 day

 

The week before your test

You will need to buy 2 medicines from a pharmacy. They can be found in the “laxative” section. Store brands often cost less. You do not need a prescription. Ask the pharmacist to help you find what you need.

  • Miralax (Polyethelene Glycol 3350) -A large bottle (8.3 ounces or 238 grams) and a small bottle (4.1 ounces or 119 grams)
  • 4 Dulcolax Laxative Tablets (bisacodyl USP 5 mg) - sold in boxes of 10 tablets or more

Also buy one large 64-ounce bottle and one 32 ounce bottle of Gatorade, Powerade, or other sports drink that is not red in color. Use Crystal Light or sugar-free sports drinks if you have diabetes. The liquid will be used to mix your Miralax the day before your test.

You will need clear liquids from the list to drink during the day before your test.

5 days before your test:

  • Do not eat any nuts, seeds, popcorn, corn, or green leafy vegetables.
  • Stop any iron tablets or vitamins with iron.
  • Stop using fiber supplements, like Metamucil, Citrucel, or Fiberall.

 

About the prep

For this prep, you will drink a medicine mixture and take some pills to clear your bowels of all solid matter. You will need to go to the bathroom often, and your stool will get very watery. The prep may cause you to have cramps or feel bloated.

Your bowels are clear when you are passing pale yellow liquid without any stool.

The prep medicine may not taste good. You need to take all of it, so your bowels are clear for the test. If your bowels are not cleared, you may have to have the test rescheduled and do another prep.

 

Clear liquids for prep

These clear liquids are allowed, but avoid all red colored liquids:

  • Water
  • Fruit juices that you can see through such as apple, white cranberry, or white grape
  • Popsicles or ice chips
  • Ginger ale or lemon-lime soda
  • Gatorade, other sports drinks or other drink mixes like Kool-Aid
  • Clear broth or bouillon
  • Jell-O
  • Coffee or tea with no milk or cream added

 

2 days before your test

Do not eat any solid food or eat or drink any milk products until after your test is done. Drink only clear liquids.

Morning

  • Start in the morning drinking only clear liquids.
  • Drink at least four (8-ounce) glasses of water through the day as well as other clear liquids.
  • Mix the small bottle of Miralax powder with the 32 ounce sports drink, so the mixture can chill in the refrigerator. Most people find it easier to drink the prep medicine if the mixture is cold.
  1. To make room for the Miralax in the sports drink bottle, pour out a cup of the sports drink first and drink it.
  2. Pour the Miralax powder into the sports drink bottle. Put the cap on the bottle and shake it to dissolve the powder.
  3. Place the mixture into the refrigerator to cool.

6:00 PM and through the evening

  • Start to drink the prep medicine mixture. Drink one, 8-ounce cup of the mixture every 10 to 15 minutes until you finish the mixture. It is better to drink each cup quickly rather than taking small sips.
  • Continue to drink other clear liquids through the evening.

 

1 day before your test

Do not eat any solid food or eat or drink any milk products until after your test is done. Drink only clear liquids.

3:00 PM

  • Take 4 Dulcolax tablets with a drink of clear liquids.

  • Mix the large bottle of Miralax powder with the 64 ounce bottle of sports drink as you did before.

  • Place the mixture in the refrigerator to cool.

6:00 PM through evening

  • Start to drink half of the prep medicine mixture. Drink one 8-ounce cup of the mixture every 10 to 15 minutes until you finish half of the mixture. You will need to drink the other half of the mixture in the morning, 6 hours before your test.
  • Continue to drink other clear liquids through the evening.

 

Morning of your test

  1. Six (6) hours before your test is scheduled, drink the rest of the Miralax mixture as before. You may need to set your alarm to get up to finish your prep medicine.
  2. Drink two, 8-ounce cups of clear liquids after you finish the prep medicine.
  3. You can drink clear liquids up to 4 hours before your test. You can take a small sip of water to take blood pressure, heart, seizure, or pain medicine within 2 hours of your test. Your test will be delayed or cancelled if you drink anything other than a sip of water with medicines.
  4. Please leave all valuables and jewelry including piercings at home.
  5. Female patients should come prepared to give a urine sample in case a pregnancy test is needed.
  6. Bring these with you to your test:
  • A list of all medicines, including prescription and over the counter medicines and any vitamin or herbal products you are taking
  • A list of your allergies
  • List of medical conditions and previous surgeries
  • A copy of advanced directive such as a living will or power of attorney
  • Your photo identification, insurance card and co-payment, if needed

Plan to arrive at the arrival time on your letter, so the staff can get you ready. Expect to be here 2 to 4 hours for your test and recovery time.

 

Frequently asked questions about prep problems

I’ve drank the first half of my prep, but I still haven’t had a bowel movement. What do I do?

If you are able, have someone go to your local pharmacy and buy:

  • A large bottle (8.3 ounces or 238 grams) of Miralax (Polyethelene Glycol 3350)
  • 64 ounce bottle of Gatorade or sports drink that is not red in color 

Mix the entire bottle of Miralax in with the bottle of Gatorade or sports drink.

Drink the remaining half of your first prep.

If you still have not had any bowel movement, drink ½ of the added Miralax prep.

If you still are not moving your bowels, consider rescheduling your procedure. Also talk with your doctor who ordered the test about an extended bowel prep when the test is rescheduled.

I forgot to take the laxative pills in the afternoon, and now it’s time to start my prep. Can I take them now?

Yes, go ahead and take them now.

I’m feeling nauseous and I’ve thrown up. What do I do?

Take a break and start again when your symptoms are improved.

If the nausea keeps returning and if you do NOT have known heart or kidney problems, you can try 1 bottle of magnesium citrate (available in 10oz bottles) available at the drug store. If this does not work or you’re not having bowel movements, call the schedulers first thing in the morning at 614-293-6255 and reschedule. Request to have an anti-nausea medicine prescribed next time.

Do I need an adult with me at all times during the procedure?

Yes. You must have a responsible adult with you and to drive you home. Using a ride-share service, such as Uber or Lyft, medical transport service, or a taxi service is acceptable as long as you have another adult beside the driver with you.

My stools are clear, but I have not finished my prep. Do I need to continue?

Yes. Although your stools are clear now, contents from the small intestine will continue to enter into the large intestine from now until your procedure. This may build up stool in the colon and make doing your procedure difficult. Finishing the prep reduces the chance of this happening.


If you have other questions, are still vomiting up your prep medicine, have not had any bowel movements, or your bowels are not clear, please call 614-293-6255.

 

© 2014 – August 13, 2019. The Ohio State University Wexner Medical Center.

This handout is for informational purposes only. Talk with your doctor or healthcare team if you have any questions about your care. For more health information call the Library for Health Information at 614-293-3707 or email: health-info@osu.edu.