ascorbic acid + macrogol 3350 + potassium chloride + sodium ascorbate + sodium chloride + sodium sulfate, anhydrous: clinical use

Prescribing considerations

• Confirm the indication, procedure timing, hydration plan and management of regular oral medicines.
• Correct dehydration and assess renal, cardiac, swallowing, seizure and electrolyte risks.
• Use particular caution with frailty, severe renal impairment, advanced heart failure, arrhythmia risk or severe acute inflammatory bowel disease.
• Consider sodium and potassium content in patients with dietary restrictions or impaired renal function.
• Aspartame and ascorbate make the selected product unsuitable in phenylketonuria and glucose-6-phosphate dehydrogenase deficiency respectively.

Contraindications and cautions

• Hypersensitivity to an ingredient
• Known or suspected gastrointestinal obstruction or perforation
• Ileus
• Impaired gastric emptying
• Phenylketonuria
• Glucose-6-phosphate dehydrogenase deficiency
• Toxic megacolon

Monitoring

• Consider electrolytes and renal function before and after preparation in clinically vulnerable patients.
• Consider ECG monitoring when arrhythmia or clinically significant electrolyte disturbance is a concern.
• Assess sudden abdominal pain or rectal bleeding for possible ischaemic colitis.
• Investigate neurological symptoms for fluid or electrolyte disturbance.

Clinical pharmacology

Macrogol 3350, sulfate and high-dose ascorbate act osmotically within the intestinal lumen. Macrogol increases stool volume and promotes propulsive colonic motility; most macrogol and ascorbate remain unabsorbed and are eliminated in faeces.

Formulation and product differences

• The labelled preparations are compositionally different and must not be substituted for one another or combined except as labelled.
• The selected Plenvu formulation contains aspartame, sucralose, and mango and fruit-punch flavourings.