Colonoscopy prep pills are used to clean out your bowels before a colonoscopy. Some people prefer the pills over the liquid solutions that are often prescribed for this purpose.

A doctor inserts a tube into your rectum that has a video camera in it. This allows your doctor to check for colon cancer and other conditions.

Your doctor can see the inside of your large intestine with a clear view of your bowels.

You can learn more about colonoscopy prep pills, liquid solutions for colonoscopy prep, and how to take them, by reading this.

Colonoscopy prep pills are laxatives. They work by stimulating the muscles in the walls of the intestines to move stool through the bowels.

Liquid solutions are used in most colonoscopy preparations. There are a few colonoscopy preparation medications that are available in tablets.

Oral sodium phosphate medications include the brand name OsmoPrep. This medication was once available over the counter in the United States. But due to safety concerns associated with dosing, it’s now only available with a prescription from a doctor.

In 2020, the Food and Drug Administration (FDA) approved another colonoscopy prep pill sold under the brand name Sutab. Sutab contains a combination of the following active ingredients:

  • The sulfate is called sodium sulfate.
  • The sulfate of magnesium.
  • The compound is called potassium chloride.

“It is only available with a doctor’s prescription.”

If you’re scheduled for a colonoscopy, your doctor can offer detailed instructions about which medication to take before your procedure. If you’d prefer to take oral tablets instead of a liquid solution for your colonoscopy prep, ask your doctor whether oral tablets are a suitable option for you.

Clinical data shows that colonoscopy prep tablets are effective. Sutab is more effective than OsmoPrep. They differ in terms of safety.

One of the biggest issues with liquid prep solutions is they require drinking a large volume of fluids. One of the advantages of liquid prep solutions, though, is that they typically result in a minimal loss of electrolytes. Miralax-based preps tend to be the safest. But these generally involve drinking more fluid than other types of bowel preps.

Not all health insurance companies will cover the cost of newer brand-name preps, such as Sutab. Always check with your insurance provider if you have insurance. They can let you know what types of preps will be covered and which will require out-of-pocket expenses.

Effectiveness of Sutab

A few recent clinical trials compared the safety and effectiveness of The sulfate is called sodium sulfate. (Sutab) with other FDA-approved colonoscopy preparations.

In particular, a 2021 study looked at 515 adult participants undergoing colonoscopies. The authors reported that Sutab was likely to provide successful bowel cleansing in 92 percent of participants. Other bowel prep solutions provided successful bowel cleansing in 89 percent of participants.

A 2021 letter published in the Journal of the American Medical Association reported that Sutab is as effective as MoviPrep and Clenpiq, which are both liquid prep solutions. But Sutab may cause additional gastrointestinal side effects.

Also, more research is needed to evaluate the safety of Sutab among people who have heart failure, kidney problems, or electrolyte imbalances.

Effectiveness of OsmoPrep

A 2019 prospective clinical trial of 4,339 colonoscopies compared the effectiveness of 7 bowel prep prescriptions, including OsmoPrep but not Sutab.

The authors reported that all seven types were effective, but that the OsmoPrep was less effective than other preparations. For comparison:

  • 81% of individuals received adequate bowel cleansing from OsmoPrep.
  • In 91% of individuals, MoviPrep provided adequate bowel cleansing.
  • In 94.5% of individuals, Miralax provided adequate bowel cleansing.

Concerns about the safety of OsmoPrep were not addressed in the study. Acutephosphate nephropathy is a type of kidney problem.

According to the FDA label, OsmoPrep may not be safe for people who:

  • Are they younger?
  • Have a heart problem.
  • Have any problems with the kidneys.
  • Have end stage disease.
  • Have electrolyte imbalances.
  • Take certain drugs.

Both Sutab and OsmoPrep are used for different purposes. You have to take two different doses of the same drug in the evening before your procedure and the next morning.

Dosing information for Sutab

  • First dose. Take 12 tablets with 48 ounces of water the evening before your colonoscopy.
  • Second dose. Take 12 tablets with 48 ounces of water 5 to 8 hours before your colonoscopy.

Dosing information for OsmoPrep

  • First dose. Take 20 tablets with 40 ounces of clear liquid the evening before your colonoscopy.
  • Second dose. Take 12 tablets with 24 ounces of clear liquid 3 to 5 hours before your colonoscopy.

“It is important to read your doctor’s instructions carefully, as the evening and morning doses might not be the same.”

Your physician will provide you with detailed instructions on how to prepare for your colonoscopy. It’s extremely important to follow these instructions and ask for clarification when necessary.

Here is how to prepare your bowels for a colonoscopy.

  • Limit your fiber intake. Your doctor will probably ask you to follow a low residue diet in the days leading up to your colonoscopy to limit the amount of fiber in your bowels.
  • Follow a clear liquid diet. On the day before the procedure, you’ll typically need to consume only transparent liquids, such as water, fat-free broth, sports drinks, and pulpless fruit juice.
  • Take your colonoscopy prep pills exactly as prescribed. You’ll need to take your prep pills in one dose the night before your procedure and again the following morning. These two doses may be slightly different. Make sure you follow your doctor’s instructions carefully.
  • Drink water. Your prescription will include instructions on how much water to drink with your prep pills.
  • Stay close to the bathroom. The prep pills will cause diarrhea, so it’s best to stay close to the bathroom after taking them. In addition, you might experience other gastrointestinal symptoms such as bloating and abdominal cramps.
  • Avoid eating before your colonoscopy. Although you’ll likely be hungry, it’s important to avoid all food and drink in the hours leading up to your procedure.
  • Ask your doctor about prescription medication. If you need to take prescription medication, ask your doctor when you should do so before your colonoscopy.

“Your physician may have to change your procedure if your bowel isn’t cleaned out.”

“The prep pills are used to clean the bowels before a colonoscopy. They are available with a doctor’s prescription.”

Most of the time, prep pills are just as effective as liquid solutions. There are some concerns with OsmoPrep.

“Your doctor will look at your age, health, and any medications you take to decide which bowel prep is best for you. It is important to follow your doctor’s instructions when doing a colonoscopy prep. The effectiveness of the procedure can be compromised if a prep is not done correctly.”