Preparing for a Colonoscopy - Miralax

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Miralax Colonoscopy Prep

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Colonoscopy Tips and Tricks

For tips and tricks to make your colonoscopy easier, watch our video.

Procedure Instructions

PLEASE REVIEW THESE INSTRUCTIONS CAREFULLY. QUESTIONS? CALL (608) 417-6389

  1. Arrange for someone to drive you to and from the procedure. 
    • Do not use a taxi or bus unless you have someone that can join you for the ride home. 
    • You cannot drive for the remainder of the day after your procedure because of the sedation medications. If you are not able to arrange for a driver, we will need to reschedule your appointment. 
    • Arrange for your driver to be with you after the procedure to talk with your doctor and nurses. Due to the medications, you may not remember important information.
  2. Please do not bring children with you if at all possible. The time spent waiting during the procedure, including prep and recovery time, can be stressful for children. 
  3. Jewelry. We highly recommend you remove all jewelry, including wedding rings, and leave them at home. Tongue piercings must be removed. 
  4. Pregnancy Testing. Female patients of child-bearing age may be asked to provide a urine sample if pregnancy status is unknown. If you are pregnant, risks and benefits should be discussed with your physician prior to continuing with the procedure. 
  5. Blood Thinning Medicine (Warfarin, Coumadin®, Plavix® or enoxaparin). If you are taking blood thinners, you must talk to your prescribing physician or primary care provider about safely stopping the drug. It is recommended these medications be stopped for 5 days prior to your procedure. Enoxaparin is to be held 12 hours prior to procedure. If you are unable to discontinue taking these medications temporarily, your procedure may be cancelled. 
  6. Diabetic Patients. Please contact your primary care provider for any special instructions regarding your diabetic medications.

Five Days Before Your Procedure

  1. After receiving approval from your prescribing doctor or primary doctor, the following medications should be stopped: 
    • Plavix® 
    • Warfarin, Coumadin®, Jantoven® 
    • Dabigatran, Pradaxa®  
  2. Discontinue iron pills and multi-vitamins that contain iron. Other common names for iron include: ferrous sulfate, ferrous gluconate, ferrous fumarate, Femiron®, Niferex®  
  3. Discontinue fiber supplements. Common fiber supplements include: Metamucil®, Fibercon®, Citrucel®, Konsyl®, Benefiber®, Fibersure, colon care capsules  
  4. Discontinue consuming the following foods: 
    • Nuts, seeds, popcorn 
    • Corn, beans, peas, raw salad, celery, tomatoes. 
    • All other vegetables must be cooked (carrots, broccoli, cauliflower, potatoes without skins). 
    •  Wheat germ, granola, cereal with visible grains and/or fruit.  
    • Bread with seeds or visible grains. 
    • You may eat fruit, but skin and seeds must be removed before eating.  
  5. It is safe to continue taking: 
    • Aspirin 
    • Anti-inflammatory pain relievers (Advil®, Nuprin®, Aleve®, naproxen sodium, ibuprofen)

USE YOUR BEST JUDGMENT. IF IN DOUBT, CALL THE DIGESTIVE HEALTH CENTER AT (608) 417-6389, OR DO NOT CONSUME IT. 

General Bowel Prep Instructions

Purchase the Following 

  1. A 238-gram bottle of Miralax® (or generic equivalent). Miralax can be purchased over-the-counter from any pharmacy or large retail store (e.g. Target, Walmart). 
  2. Four (4) Dulcolax® or Bisacodyl over-the-counter laxative tablets from any drug store or pharmacy. 
  3. 64oz. of clear liquid to mix with Miralax. The clear liquid of choice is Gatorade G2™ due to its low sugar content. However, other acceptable alternatives include Gatorade®, Powerade®, and other sports drinks, Crystal Light®, or diet soda with bubbles stirred out. Please avoid red liquids and plain water as a mixer. 

The Entire Day Before Your Colonoscopy 

  1. No solid food. 
  2. Drink a clear liquid diet the entire day. Anything you can see through and has no pulp is OK to drink: 
    • Broth/bouillon, coffee (sugar is OK, no cream), tea 
    • Carbonated beverages (Coke®, Pepsi®, Sprite®, etc.), clear fruit juices (no pulp), Jell-O®, Gatorade and popsicles. 
    • Hard candy is allowed. 
    • DO NOT drink anything red or purple. 
  3. No dairy. 
  4. Discontinue Lovenox (enoxaparin).  After receiving approval from your prescribing doctor, injections should be held 12 hours prior to your procedure. 

Prepare the Prep 

Note: The instructions for taking the bowel prep are different than the instructions on the Miralax bottle. Please follow the instructions given below. 

To prepare the Miralax prep, there are two options: 

  1. Mix the entire bottle of Miralax (either 238 or 255 grams) in 64oz. of Gatorade or other clear liquid, except water. You may add the Miralax powder to the bottle directly, but you must first pour out one glass to make room for the powder. You can add the glass of liquid back into the bottle after you start drinking.  
  2. You may mix the Miralax with your liquid of choice in a pitcher or other container. Mix as directed.

Begin Bowel Prep 

The prep is designed to clean out your colon. It will usually cause you to have bowel movements within a few hours. Your bowels are clean when your stools become watery and you can see through them. They may be tinted depending on the color of liquids you have been drinking.

IF YOUR PROCEDURE IS BEFORE NOON:

  • Take four Dulcolax or Bisacodyl tablets, all at once, between 1:00-3:00 p.m. 
  • Two hours later, start drinking the Miralax prep. Drink one glass every 20-30 minutes. 
  • You will drink a total of eight 8-ounce glasses of the Miralax prep. 
  • This will take approximately 2-4 hours to drink. You may drink it faster if you prefer. 
  • If you become nauseated or feel full, stop drinking for at least 30 minutes then resume the prep. 
  • You must drink the entire 64 oz. of the prep. 
  • Continue drinking clear liquids even after you've finished the prep, as tolerated. Extra fluids will continue to clean out your colon and keep you hydrated. 
  • Your prep is adequate if you're passing clear, yellow fluid without sediment.

IF YOUR PROCEDURE IS AFTER NOON:

  • Take four Dulcolax or Bisacodyl tablets, all at once, between 1:00-3:00 p.m. 
  • Two hours later, start drinking the Miralax prep. Drink a total of four 8-ounce glasses of the Miralax prep. 
  • Drink one glass every 20-30 minutes. This will take approximately 1-2 hours to drink. 
  • Refrigerate the remaining Miralax prep. You will be drinking the rest of the prep starting at 6 a.m. the day of your procedure. 
  • If you become nauseated or feel full, stop drinking for at least 30 minutes. Then resume the Miralax prep. 
  • Continue drinking clear liquids, as tolerated, even after you have finished the prep. Extra fluids will continue to clean out your colon and will keep you hydrated.

If you are unable to tolerate your prep or have questions, please call: Digestive Health Center (608) 417-6389 or Nurse on Call (608) 417-5755.

Day of Your Procedure 

Afternoon Procedures 

Only Start drinking the second ½ (half) of the refrigerated Miralax® prep at 6 a.m. Drink one glass every 20-30 minutes until the rest of the prep is gone. 

All Patients (regardless of procedure time) 

  • Continue drinking clear liquids after you have finished the Miralax® prep up until 3 hours prior to your arrival time. 
  • Take your routine prescription medications (with exception to the medications noted earlier). 
  • Do not take Aspirin, NSAIDs, vitamins or supplements. 
  • Plan to be at the Digestive Health Center fora total of 2-3 hours. This includes registration, procedure and recovery time. 

Things to Bring With You

  1.  A current list of medications and dosages. 
  2. If you have sleep apnea and use a CPAP machine, please bring the machine, mask and tubing with you. 
  3. If you have a current living will and/or durable power of attorney for health care, please bring a copy of it to your procedure so we can update your health file. 

Moderate Sedation: What You Can Expect 

Moderate sedation is a mixture of medicines given during a procedure to help relieve pain and anxiety. While under moderate sedation, you are able to answer questions, speak to your health care professionals and breathe on your own. The medications may cause you to have brief memory loss during your procedure and for a short time afterward. 

After Your Procedure 

You will be monitored after your treatment. During this time, a nurse will check your blood pressure, heart rate, breathing and alertness. You will be sent home with your responsible adult driver and written instructions. You may feel sleepy and light-headed, but this feeling will fade. 

  • Do not drive a car, operate machinery or power tools. 
  • Do not drink any alcoholic drinks. 
  • Do not make important legal decisions. 
  • Do not smoke for the first 8 hours without supervision. 
  • Do not cook on a stove or use a microwave without supervision.


Download a printable version of these Colonoscopy Prep Instructions - Miralax