Ezyout

• Treatment of occasional constipation: Effective for short-term relief of infrequent or acute constipation.
• Bowel cleansing prior to diagnostic procedures: Used to prepare the bowel before colonoscopy, radiological examinations, or surgery by inducing bowel evacuation.
• Evacuation of the colon: In conditions requiring rapid clearance of the bowel.
• Off-label: Occasionally used under medical supervision in pediatric patients for constipation management.

• Adults and elderly:
• Constipation: 5 to 10 mg orally once daily, usually taken at bedtime.
• Bowel preparation: Often used in combination with magnesium citrate or other osmotic agents; dosing follows procedural protocols, typically the evening before the procedure.
• Pediatrics: Use only under strict medical supervision; dose is adjusted according to age and weight.
• Route: Oral administration.
• Frequency: Once daily for constipation; regimen-specific for bowel cleansing.
• Duration: Generally limited to short-term use (usually no longer than one week for constipation).
• Dose adjustments: Not typically required for renal or hepatic impairment; caution advised in elderly and debilitated patients.

Sodium picosulfate is a prodrug converted by colonic bacteria into its active metabolite, which stimulates the nerve plexus of the colon. This activation enhances peristalsis and increases motility, promoting bowel movements. Additionally, it induces secretion of water and electrolytes into the colon, softening stool consistency and facilitating defecation.

• Absorption: Minimal systemic absorption; activation occurs locally in the colon.
• Distribution: Remains localized within the gastrointestinal tract.
• Metabolism: Converted by colonic bacterial enzymes into the active form.
• Half-life: Not quantifiable systemically due to local action.
• Elimination: Primarily fecal; negligible renal excretion.

• Pregnancy: Classified as FDA Pregnancy Category C. Animal studies have shown some adverse effects; human data are insufficient. Use only if benefits outweigh risks.
• Lactation: Limited data available; caution is advised when administering to breastfeeding women.

• Primary class: Stimulant laxative.
• Subclass: Diphenylmethane derivative.

• Known hypersensitivity to sodium picosulfate or any component of the formulation.
• Intestinal obstruction, ileus, or perforation.
• Acute surgical abdomen or severe inflammatory bowel disease.
• Severe dehydration or electrolyte imbalance.
• Toxic megacolon.

• Avoid use in patients with unexplained abdominal pain.
• Monitor electrolytes with prolonged or excessive use.
• Risk of dependence and worsening constipation with chronic use.
• Use cautiously in elderly, pregnant, or lactating patients.
• Discontinue immediately if severe abdominal pain or rectal bleeding occurs.
• Maintain adequate hydration during treatment.

• Common: Abdominal cramps, diarrhea, nausea.
• Less common: Electrolyte disturbances (e.g., hypokalemia), headache, dizziness.
• Rare: Allergic reactions, dehydration, severe abdominal pain.

• Potentiation of other laxatives or diuretics increasing risk of electrolyte imbalance.
• Caution with drugs sensitive to electrolyte changes such as digoxin or corticosteroids.
• No significant cytochrome P450 interactions known.

• Current guidelines recommend sodium picosulfate primarily for short-term use.
• Emphasize combination use with osmotic agents for bowel cleansing.
• Highlight risks of long-term use and advise against routine chronic administration.

• Store at 20°C to 25°C (68°F to 77°F).
• Protect from moisture and light.
• Keep container tightly closed.
• Keep out of reach of children.