Your appointment is scheduled for:
__________________ _________________
Date _____________
Time
_____________________________________
Pharmacy
Extended Colonoscopy Preparation
It is important that you follow the directions below exactly as they are
stated. It is very important that your colon (large intestine) is completely clean
and empty. This is so your exam will be comfortable, accurate and safe.
6 days
5 days
4 days
3 days
2 days
1 day
Day
before exam
before exam
before exam
before exam
before exam
before exam
of exam
Drink at least 8 glasses of
water during the day.
Drink at least 8 glasses of
water during the day.
Drink at least 8 glasses
of water during the day.
The preparation (prep) kit will be
available at the pharmacy of your
choice. The prep kit includes:
• 2 tablets bisacodyl (Dulcolax).
Do not use stool softeners
• 1 bottle of MiraLAX,
8.3 ounces
• 8 liters of GoLYTELY (you
will only be using 6 liters)
• 3 tablets Zofran
Start a low-fiber diet.
Continue the low-fiber
diet.
Twice during the day, mix 17
grams (1 capful) of MiraLAX
with 8 oz. of water, juice or
liquid of your choice.
Arrange for your ride home
after your exam:
• No cab, bus or medical
transport without someone
riding with you
• Must be a licensed driver
Drink at least 8
glasses of water
during the day.
Drink at least 8 glasses of
water during the day.
Drink at least 8 glasses of
water during the day.
Begin a clear liquid diet.
Continue the clear liquid
Continue the lowdiet.
You can have water, clear
fiber diet.
• No raw fruits or
broth or bouillon, coffee or
Twice during the day,
At noon (12 p.m.): Take the
vegetables
Twice during the
mix 17 grams (1 capful)
tea (without milk or
two bisacodyl tablets by
• No whole wheat or high
of MiraLAX with 8 oz. of day, mix 17 grams creamer), Gatorade,
mouth. You may or may not
fiber
(1
capful)
of
water,
juice
or
liquid
of
Powerade,
Pedialyte,
have a bowel movement
• No nuts or popcorn
MiraLAX with 8
carbonated and nonafter taking these tablets.
• No Metamucil, Fibercon, your choice.
oz. of water, juice carbonated soft drinks,
bran or bulking agents
or liquid of your
Kool-Aid or other fruit
Between 4-6 p.m., begin
• Stop any iron supplements
choice.
flavored drinks, strained
drinking 4 liters of
fruit
juices
(no
pulp),
Jell-O,
GoLYTELY. Drink one
Twice during the day, mix
popsicles and hard candy.
8 oz. glass every 15-20
17 grams (1 capful) of
NO RED OR PURPLE
minutes until the 4 liters are
MiraLAX with 8 oz. of
LIQUIDS.
gone. Put remaining 4 liters
water, juice or liquid of your
in the refrigerator.
choice.
Twice during the day, mix
17 grams (1 capful) of
You may take Zofran for
MiraLAX with 8 oz. of
nausea according to
water, juice or liquid of your instructions on the package.
If you need to cancel or
For questions after
choice.
reschedule your exam,
hours, call
please call 651-254-8680 at HealthPartners®
least 48 hours before your CareLine service at
You must have someone drive
appointment.
612-339-3663 or
you home after your exam.
800-551-0859.
• 5 hours before your
appointment time: Drink
2 liters of GoLYTELY.
• Continue clear liquid
diet, including water.
• 3 hours before your
appointment time: Stop
drinking liquids. (You
may take your morning
medicines with 4 ounces
of water.)
• Please do not wear
fragrant perfumes or
lotions today.
• Your stool should be clear
yellow to be ready for the
exam.
Things to bring to the
exam:
• Someone to drive you
home
• Insurance card
• Health history form
• Picture ID