Sodium picosulfate

Generic Medicine Info
Indications and Dosage
Adult: 5-10 mg once daily at bedtime.
Child: 1 month to <4 years 0.25 mg/kg. Max: 5 mg; 4-10 years 2.5-5 mg; >10 years 5-10 mg. All doses are given at bedtime. Dosage recommendations may vary among countries or individual products (refer to specific product guidelines).
May be taken with or without food.
Ileus or intestinal obstruction, acute painful and/or feverish acute abdominal conditions (e.g. appendicitis) associated with nausea and vomiting; acute inflammatory bowel diseases, severe dehydration.
Special Precautions
Patient with history of inflammatory bowel disease, recent gastrointestinal surgery. Avoid long-term everyday use. Children. Pregnancy and lactation.
Adverse Reactions
Significant: Intestinal loss of fluids leading to dehydration, fluid and electrolyte imbalance, hypokalaemia.
Gastrointestinal disorders: Diarrhoea, abdominal discomfort (e.g. abdominal pain, cramps).
Nervous system disorders: Dizziness, syncope.
Patient Counseling Information
Should not be taken on a continuous daily basis for long periods. This drug may cause vasovagal response, dizziness and syncope, if affected, do not drive or operate machinery.
Monitoring Parameters
Monitor serum electrolytes and bowel movement patterns.
Symptoms: Abdominal cramps, diarrhoea, fluid and electrolyte loss, colonic mucosal ischaemia. Chronic overdose: Chronic diarrhoea, abdominal pain, secondary hyperaldosteronism, renal calculi; renal tubular damage, metabolic alkalosis, and muscle weakness secondary to hypokalaemia. Management: May perform gastric lavage or induce emesis to minimise or prevent absorption. Fluid replacement and correction of electrolyte imbalance may be needed. Administer antispasmodic agents if necessary.
Drug Interactions
Increased risk of electrolyte imbalance with diuretics or adrenocorticosteroids. Increased sensitivity with cardiac glycosides caused by electrolyte imbalance. Decreased laxative action with antibiotics.
Mechanism of Action: Sodium picosulfate is a locally acting laxative which has a dual action of stimulating the mucosa of both the large intestine and the rectum, resulting in peristalsis, accumulation of water and electrolytes and stimulation of defaecation, softening of stool, and reduction of transit time.
Onset: Within 6-12 hours.
Absorption: Negligible (small amount).
Metabolism: Metabolised in the distal segment of the intestine via bacterial cleavage by colonic bacteria to the active form bis-(p-hydroxyphenyl)-pyridyl-2-methane (BHPM) followed by conjugation in the intestinal wall and liver to inactive BHPM glucuronide afterwards.
Excretion: Via urine (10.4% as BHPM glucuronide).
Chemical Structure

Chemical Structure Image
Sodium picosulfate

Source: National Center for Biotechnology Information. PubChem Compound Summary for CID 68654, Sodium picosulfate. Accessed Nov. 21, 2023.

Store below 30°C. Protect from light.
MIMS Class
Laxatives, Purgatives
ATC Classification
A06AB08 - sodium picosulfate ; Belongs to the class of contact laxatives.
Anon. Sodium Picosulfate. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. Accessed 12/07/2023.

Buckingham R (ed). Sodium Picosulfate. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. Accessed 12/07/2023.

Dulcolax Adult Pico Perles, 2.5 mg Soft Capsules (Opella Healthcare UK Limited). MHRA. Accessed 12/07/2023.

Dulcolax Twelve Plus Pico Liquid, 5 mg/5 mL, Oral Solution (Aventis Pharma Limited). MHRA. Accessed 12/07/2023.

Joint Formulary Committee. Sodium Picosulfate. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. Accessed 12/07/2023.

Skilax Drops 7.5 mg/mL (Milrin Pharmaceutical Co. [M] Sdn Bhd). National Pharmaceutical Regulatory Agency - Ministry of Health Malaysia. Accessed 12/07/2023.

Sodium Picosulfate 5 mg/5 mL Oral Solution (Crescent Pharma Limited). MHRA. Accessed 12/07/2023.

Disclaimer: This information is independently developed by MIMS based on Sodium picosulfate from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2024 MIMS. All rights reserved. Powered by
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