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Carolina digestive diseases, pa

Miralax and Dulcolax Colonoscopy Prep
To help determine your medical treatment, you have been scheduled for a colonoscopy, which is an examination of your large
intestine using a flexible tube while you are given intravenous sedation.
To obtain the best possible exam, your colon must be free of stool. You will need to buy Miralax in large
bottle (8.3 ounces or 238 grams) and four (4) Dulcolax pills
(laxative), both of which are available over the
counter, along with a large 64 ounce bottle of sports drink such as Gatorade. (If you have diabetes, buy a no or
low calorie drink such as Crystal Light instead). This will be used to mix your Miralax in the day before your
procedure. Do not use carbonated beverages.
On the day BEFORE your procedure:
1. Start clear liquids at breakfast: Nothing red or orange in color is allowed!
Please drink plenty of fluids in addition to the prep.
2. At 1 pm, take all 4 of the Dulcolax pills
3. At 2 pm, Mix the Miralax in a 64 ounce bottle of Gatorade or other clear liquid of choice. Cap the
bottle and shake the bottle to dissolve the powder. Most people prefer to drink the liquid chilled so you
may want to place it in the refrigerator.
4. At 4pm, Start to drink the Miralax. Drink one glass every 10-15 minutes. Drink it quickly rather
than sipping small amounts. Finish drinking all the liquid within 2 hours.
NOTHING BY MOUTH AFTER MIDNIGHT PRIOR TO YOUR PROCEDURE
It generally takes about 15-30 min for the actual procedure and 30 min for recovery afterwards. Due to the
sedation you receive, YOU WILL NEED SOMEONE TO DRIVE YOU HOME! Your driver is required to
bring you to the endoscopy center, and to drive you home after your procedure. Please DO NOT use a cab
service, unless prior approval has been received.
 Please notify our office promptly if you are currently taking any blood thinners, aspirin products! NSAIDS (ibuprofen, naprosyn, arthritis medications) will have to be stopped 3-5 days prior to your procedure.  If you take insulin, you will need to either take ½ your usual dose or hold it completely the morning of your procedure. Please consult your primary physician if you have questions!  On the morning of your procedure, you may take any medications absolutely necessary or that would be unsafe for you to miss a dose, such as heart meds, blood pressure meds, anti-convulsant/seizure meds. Please hold other medications until you return home from your procedure. On the day of your appointment, please wear 2 piece, comfortable, loose clothing and refrain from wearing
excessive make-up, jewelry, and nail polish.
APPOINTMENT DATE:__________________
Arrive at our office at ________________________
Your procedure is scheduled to begin between ____________________________ www.carolinadigestivediseases.com
Stefan P. Marcuard, MD, FACP ● Phillip J. Goldstein, MD
704 W.H. Smith Blvd ● Greenville NC 27834 ● tel (252) 758-8181 ● fax (252) 758-8182

Source: http://cddgastro.com/wp-content/uploads/2013/04/Miralax-and-Dulcolax-Prep-for-Office.pdf

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Medical History Name: _______________________________________ Date of Birth: _____-_____-_____ Today’s Date: _____-_____-_____ Who referred you? ___________________________________ Family Doctor: ____________________________________ What type of work do you do? (if retired, what did you do?) ______________________________________________________ Please list any medications you take or

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