Preparing for a colonoscopy

Pick up your preparation materials (laxative products) as instructed. For most patients, this will be:

• MiraLAX®: 1 bottle, 238 grams (if your doctor has advised you to use a different prep than MiraLAX, you will need a prescription).
• Dulcolax® (Bisacodyl): 4 pills, 5 mgs each.
• Gatorade or Crystal Light Lemonade: 64 ounces (two 32-ounce bottles). Use yellow, green, or clear colors only.

Please review all of your prep instructions during this time.

You are required to arrange transportation to take you home after the procedure. Arrange for a responsible person to pick you up after your colonoscopy. Tell them that your estimated exam completion time will be two to three hours after your arrival time. You are not allowed to drive or leave the endoscopy center alone.

You may need to stop certain medications prior to your procedure. Check the following medications and supplements section to understand which medications you must stop and when. Contact your physician if needed to determine the timeline.

Eat a low-fiber diet for one week before your exam. Avoid seeds, nuts, popcorn, or other high-fiber foods. 2-3 days before the procedure, also avoid oatmeal, whole grains, beans, peas, corn, and peels of fruits of vegetables. Review the following low-fiber diet section for guidance on how to eat to make your preparation more successful.

Food

• Do not eat any solid food for breakfast, lunch, or dinner.
• You may have clear broth or bouillon, Jell-O®, and ice pops (yellow, green, or clear).

Drink

• Drink plenty of clear fluids, including water (still, sparkling, seltzer), broth, apple juice, white grape juice, or diet or regular ginger ale or Sprite®.
• Do not have any red, blue, or purple foods and drinks.
• Do not drink alcohol.
• You can drink coffee and tea, but no milk or cream.

Smoking

• Avoid smoking tobacco, cigars, cannabis, or vaping products for at least 24 hours before your scheduled procedure to reduce the risk for reactive airway complications.

4:00 pm on the day before your colonoscopy:

• Take 4 Dulcolax® pills.
• Mix the entire MiraLAX® bottle with 64 ounces of Gatorade or Crystal Light lemonade in a large pitcher. Stir and place in the refrigerator.

5:00 to 6:00 pm on the day before your colonoscopy:

• Drink the first half (32 ounces) of MiraLAX solution during this hour. You may not enjoy the taste; try drinking it cold, using a straw, or taking small sips. Use a measuring cup or large drinking glass to measure eight ounces.
• At 5:00 pm: Drink 8 ounces of the MiraLAX solution.
• At 5:15 pm: Drink 8 ounces of the MiraLAX solution.
• At 5:30 pm: Drink 8 ounces of the MiraLAX solution.
• At 5:45 pm: Drink 8 ounces of the MiraLAX solution.

If you take aspirin, do not stop taking your aspirin. If you take NSAIDs, such as Advil®, Motrin®, Celebrex®, or ibuprofen, you may continue to take them as usual.

If you take prescription medications to thin your blood, such as to treat blood clots or to prevent a heart attack or stroke, ask the doctor who prescribes it for you when to stop taking it.

Do not stop these medications without the consent of your physician. Some endoscopic procedures may be performed while on these medications, while others may not.

Some examples of blood thinners are:

• Coumadin® (warfarin)
• Plavix® (clopidogrel)
• Ticlid® (ticlopidine hydrochloride)
• Agrylin® (anagrelide)
• Xarelto® (Rivaroxaban)
• Pradaxa® (Dabigatran)
• Eliquis® (Apixaban)
• Effient® (Prasugrel)

You’ll need to stop taking GLP-1 agonists (ex: Ozempic) or SGLT-2 inhibitors (ex: Jardiance) before your procedure or there is a small risk you could experience a serious reaction. These medications should be held per the duration of the dosing schedule. For example, if you take the medication weekly, the dose should be stopped for a week. Be sure to check the medications listed in the following sections for further guidance on which medications must be stopped and when. If you do not stop these medications far enough in advance, your colonoscopy may need to be canceled or rescheduled.

Stop seven days before your procedure:

• Dulaglutide (Trulicity®)
• Exenatide (Byetta, Bydureon®)
• Liraglutide (Saxenda®, Victoza®)
• Lixisenatide (Adlyxin®)
• Semaglutide (Ozempic®, Wegovy®)
• Tirzepatide (Mounjaro®, Zepbound®)
• Iron supplements (Ferrous sulfate, gluconate)

Stop four days before your procedure:

• Ertugliflozin (Steglatro™)
• Ertugliflozin/metformin (Segluromet™)
• Ertugliflozin/sitagliptin (Steglujan™)

Stop three days before your procedure:

• Bexagliflozin (Brenzavvy®)
• Canagliflozin (Invokana®)
• Canagliflozin/metformin (Invokamet®)
• Canagliflozin/metformin XR (Invokamet® XR)
• Dapagliflozin (Farxiga®)
• Dapagliflozin/metformin XR (Xigduo®)
• Dapagliflozin/metformin XR (Xigduo® XR)
• Dapagliflozin/saxaglipitin (Qtern®)
• Dapagliflozin/saxaglipitin/metformin (Qternmet® XR)
• Empagliflozin (Jardiance®)
• Empagliflozin/metformin (Synjardy®)
• Empagliflozin/metformin XR (Synjardy® XR)
• Empagliflozin/linagliptin (Glyxambi®)
• Empagliflozin/linagliptin/metformin XR (Trijardy® XR)

• Do not eat or drink anything the morning of the procedure.
• You can take medications with small sips of water.
• Do NOT drink any liquids later than three hours before your arrival time.
• You can brush your teeth.
• Pack lightly and wear loose, comfortable clothing. Leave your money and all other valuables, including jewelry, at home.

Drink the remaining half (32 ounces) of the MiraLAX solution starting six hours before your arrival time. It’s important to finish drinking all the solution. You may need to set an alarm to meet this time requirement.

• Six hours before arrival: Drink 8 ounces of the MiraLAX solution.
• Five hours and 45 minutes before arrival: Drink 8 ounces of the MiraLAX solution.
• Five hours and 30 minutes before arrival: Drink 8 ounces of the MiraLAX solution.
• Five hours and 15 minutes before arrival: Drink 8 ounces of the MiraLAX solution.

The exact times can be found using the following table, based on your arrival time: