Active ingredients
In terms of composition and mechanism, these are different drugs. Moviprep uses the high-molecular substance Macrogol 3350. Macrogol 3350 is a second-generation drug with a reduced molecular weight that causes minor irritation to the mucous membrane of the distal parts of the colon (sigmoid and rectum). This substance retains water in the intestinal lumen, preventing it from being absorbed through the mucous membrane, and, like a piston, squeezes everything out of the intestine and washes it out in one go. Contains sodium sulfate enhances intestinal motility.
Picoprep contains 2 saline laxatives - sodium picosulfate (the same as sodium sulfate) and magnesium oxide. These two substances enhance each other in terms of laxative effect, but are quite irritating to the intestinal mucosa, which often explains nausea, vomiting and abdominal pain.
Pharmacological properties
Oral administration of macrogol-based electrolyte solutions causes mild diarrhea and leads to rapid emptying of the large intestine.
Macrogol 3350, sodium sulfate and ascorbic acid
in high doses they act on the intestines osmotically, causing a laxative result.
Macrogol 3350 helps to increase the volume of feces, which affects the mobility of the colon through the neuromuscular pathways. As a result, accelerated passage of softened feces through the colon is achieved. The electrolytes contained in the drug and the additional intake of clear liquid prevent water and electrolyte imbalance, reducing the risk of dehydration.
Macrogol 3350 remains unchanged in the intestine. It is practically not absorbed in the gastrointestinal tract. Macrogol 3350, which is absorbed, is excreted in the urine.
Ascorbic acid is absorbed primarily in the small intestine via an active transport mechanism that is sodium dependent and is considered saturable. There is an inverse relationship between the dose taken and the percentage of the dose absorbed. When oral doses of 30–180 mg are administered, the amount of dosage absorbed is 70–85%. After oral administration of up to 12 g of ascorbic acid, only 2 g are absorbed.
After oral administration of high doses of ascorbic acid and when plasma ascorbic acid levels exceed 14 mg/l, ascorbic acid is excreted unchanged in the urine.
Scope of application
In practice, the volume of liquid needed to cleanse the intestines that you need to drink is approximately the same - 3-4 liters. It differs from the volumes recommended in the annotations. For Picoprep in the annotation we find 2.6 liters. This leads to incomplete cleansing of the intestines. Therefore, it is better to add another 1.4 liters of clear liquid to these 2.6 liters. In addition, it was noticed that Picoprep acts more slowly, after taking it after 3-4 hours. For Moviprep, the manufacturer recommends a total volume of 3.0 liters. Which is also not enough in practice. And you need to bring it to 4.0 liters.
The use of both drugs involves first diluting and drinking the active laxative in sachets, and then drinking any clear liquid, for example, chicken broth, tea without milk, juice without pulp, plain water. Alcoholic and carbonated drinks are not allowed.
Instructions for use before colonoscopy
Colonoscopy is a study that allows, using a thin hose with a video camera at the end, to penetrate the intestines through the anus and examine the condition of the organ from the inside. The procedure will be faster and will give more information to the doctor if the intestines are empty and their walls will not be covered with food fragments. Oncological diseases are more treatable in the early stages, so it is important to allow the doctor to examine the intestinal walls in as much detail as possible in order to pay attention to the most minor changes in the structure of the tissue.
In addition to taking the drug directly, it is important to follow the recommended diet before the study. Depending on what time the procedure will be performed, you should choose one of three dosage regimens:
- One-stage, evening.
- Two-stage.
- One-stage morning.
If the doctor deems it necessary, he can add his recommendations to the drug regimen. This is most often done when the patient needs a long period of time to get to the test site.
All three schemes involve the preparation of two types of solutions for oral administration. The volume of each is 1 liter. The only difference is the time interval between taking the first and second liter.
To prepare the first liter, you need to take half a glass of water at room temperature and dissolve 1 sachet A and one sachet B in it. After the powder has completely dissolved, the volume of liquid must be brought to 1 liter. The temperature of the liquid should be close to body temperature. The prepared mixture must be consumed within two hours. For comfortable use, it is suggested to drink 1 glass every quarter of an hour or half an hour.
The second liter is prepared in the same way as the first. However, the time of its administration is determined by the time of the prescribed procedure. If a study or surgical intervention is scheduled for the morning, before 10:00, Moviprep should be taken the day before, in the evening. As a rule, the first liter is drunk between 19:00 and 20:00. And the second liter is prepared and consumed between 21:00 and 22:00.
If the procedure is scheduled for the first half of the day, but after 10:00, then the dosage regimen is as follows: the first liter is drunk the day before from 20:00 to 21:00, and the second in the morning of the next day from 06:00 to 07:00.
Provided that the colonoscopy is scheduled for the second half of the day, after 14:00, Moviprep is taken on the day of the study, in the morning. The first liter is from 8:00 to 9:00, and the second is from 10:00 to 11:00.
It is important to drink at least half a liter of another liquid (non-alcoholic and dairy-free) between doses of the drug in order to maintain the water-salt balance in the body.
Side effects
Both drugs most often cause sleep disturbances, dizziness, and headaches.
The use of both drugs in elderly and debilitated patients must be under medical supervision. Picoprep is approved for use in children from 1 year of age. Moviprep only from 18 years old.
During pregnancy, both drugs are prescribed according to strict indications and their use is limited. But when breastfeeding, Picoprep is allowed, since it does not pass into milk.
No effect on the control of machinery and vehicles has been identified when using Moviprep, and when using Picoprep it is recommended to refrain from driving, especially if sedation with propofol is used.
How does Moviprep work?
The product is used immediately before endoscopic examinations of the intestines, as well as before x-rays. In addition, the drug is prescribed before intestinal surgery so that remaining stool fragments do not interfere with surgeons’ ability to detect and remove tumors, polyps and tumors.
Taking Moviprep does not imply the treatment of diseases of the colon. The product does not relieve inflammation, does not relieve pain, and is not aimed at combating pathogens. It acts as a laxative, gently removing food debris from the body. Unlike conventional laxatives, Moviprep acts within clearly defined time intervals and does not cause intestinal spasms, which is very important for patients with severe painful symptoms that accompany the course of the disease.
Gentle cleansing is provided by Macrogol, which, thanks to long polymer bonds, can capture and retain water molecules, thereby increasing the volume of feces. They, in turn, increase pressure on the intestinal walls, triggering reflex cleansing mechanisms through the activation of peristalsis.
How to take Moviprep correctly
The freshly prepared solution is intended for oral administration. The doctor can determine an individual dosage regimen based on the patient’s body weight. But usually it is used in accordance with the annotation. The solution is prepared by diluting the contents of two different sachets in a small amount of water and then bringing the volume to one liter. Using the same algorithm, another liter of solution is prepared. You can take it in one of two ways:
- Drink two liters of the sour-sweet-bitter dilution in the evening before the examination or early in the morning.
- Drink a liter of solution in the evening, the rest in the morning.
If surgery is to be performed, two liters of the solution are taken in the evening to avoid any residual urge to bowel movement during the operation. When preparing for an endoscopic or radiographic examination, in addition to Moviprep, you should drink at least a liter of other liquids. You can use plain or still mineral water, juices, compotes, berry fruit drinks. About an hour before the upcoming medical procedure, you should not drink drinks. And also take any food.
Contraindications
The drug is not used if the following conditions are present or suspected:
- hypersensitivity to any component of the drug;
- obstruction or perforation of the digestive tract;
- impaired gastric emptying (in particular gastric paresis);
- ileus;
- phenylketonuria (since the drug contains aspartame);
- deficiency of glucose-6-phosphate dehydrogenase (since the drug contains ascorbate);
- toxic megacolon,
- acute inflammatory bowel diseases, including Crohn's disease, ulcerative colitis.
The use of the drug in unconscious patients is contraindicated.
Are there any side effects?
The instructions for Moviprep contain a warning about the possibility of local allergic manifestations with swelling and redness of the skin, rash, itching, and pain. Despite the fact that the active substance of the drug does not penetrate into the blood, systemic negative reactions of the body are observed. They appear this way:
- anaphylactic shock;
- sleep disorders;
- headache, dizziness, convulsions caused by acute sodium deficiency;
- short-term surges in blood pressure;
- bloating and abdominal pain, nausea, irritation in the anorectal area, vomiting, digestive disorders, difficulty swallowing, flatulence;
- malaise, chills, thirst, hunger.
Laboratory tests may reveal potassium and sodium levels that are insufficient compared to normal. If this happens, you should stop using the laxative and consult a doctor. He will cancel Moviprep and recommend a product with a similar effect, but with a different active ingredient.
Release form and composition
Moviprep has recently appeared in pharmacies. It is produced by the UK pharmaceutical company Norgine. The drug is produced in one dosage form - in the form of a fine-crystalline powder, highly soluble in water. A special feature of Moviprep is the presence of two different sachets in the primary packaging, which is a large box with instructions for use included inside. The composition of the first sachet is represented by the following ingredients:
- macrogol;
- sodium sulfate;
- sodium chloride;
- potassium chloride;
- aspartame;
- acesulfame potassium;
- flavoring.
White powder with a slight yellowish tint intended for dilution in water. The result is a drink with a pleasant lemon aroma and a specific salty-sweet taste. To form the composition of the second sachet, the manufacturer used only two components - ascorbic acid and its derivative sodium ascorbate. After diluting the dark beige powder in water, a colorless solution with a pronounced sour taste and no odor is formed.
special instructions
Diarrhea is an expected reaction after taking Moviprep.
The drug should be used with caution in debilitated patients and patients with severe clinical disorders, in particular:
- impaired gag reflex or tendency to aspiration or belching;
- disturbance of consciousness;
- severe renal failure (creatinine clearance <30 ml/min);
- heart failure (III–IV functional class according to the NYHA classification);
- dehydration;
- severe acute inflammatory diseases.
Before taking the medicine, you should not allow your body to become dehydrated. During the use of the drug, patients who are semi-conscious or prone to aspiration or belching should be monitored, especially if the drug is administered through a nasogastric tube.
If the patient experiences symptoms indicating changes in fluid/electrolyte levels (eg, edema, shortness of breath, fatigue, heart failure), plasma electrolyte levels should be checked and appropriate treatment administered.
In debilitated patients, those in poor health, those with severe renal impairment, and those at risk for electrolyte imbalance, the physician should check electrolyte levels and renal function before and after treatment.
If the patient experiences symptoms such as severe flatulence, bloating, abdominal pain, or other reactions that make it difficult to use the medication, slow down or temporarily stop using the medication and consult a doctor.
Use during pregnancy or breastfeeding. No data available. Macrogol is used after consultation with a doctor in case of urgent need, when the expected benefit to the mother outweighs the potential risk to the fetus and child.
The ability to influence the reaction speed when driving vehicles or working with machinery. Not found.
Children. The drug is not recommended for use in children under 18 years of age, since there is no clinical data on the safety of the drug in this age category of patients.
Purposes of using the drug Moviprep
The main indication for taking a laxative is a complete cleansing of the digestive tract 1-2 days before the scheduled diagnostic instrumental or endoscopic examination. It often becomes the first choice drug to prepare a patient for surgery. Even with severe chronic constipation, the use of Moviprep is prohibited. Its use is advisable in the following cases:
- before endoscopic examination of the gastrointestinal tract;
- before an X-ray examination of the intestines, for example, colonoscopy, rectoscopy, both with and without contrast;
- at the preparatory stage for any surgical operation.
After a single dose of the product, the intestines are cleansed more efficiently than after using oil or saline solutions for enemas. Moviprep and drugs with similar effects are often used without a doctor’s prescription for detoxification, including for preventive purposes. And also for weight loss. The instructions do not contain such indications, so it is not recommended to violate its recommendations for the use of Moviprep.
