polyethylene glycol-electrolyte solution (PEG-ES)
CoLyte, GoLYTELY, NuLYTELY, OCL

Available forms
Available by prescription only
Oral solution: PEG 3350 (6 g), sodium sulfate decahydrate (1.29 g), sodium chloride (146 mg), potassium chloride (75 mg) sodium bicarbonate (168 mg), polysorbate-80 (30 mg) per 100 ml (OCL)
Powder for oral solution: PEG 3350 (240 g), sodium sulfate (22.72 g), sodium chloride (5.84 g), potassium chloride (2.98 g), sodium bicarbonate (6.72 g) per 4 L (CoLyte); PEG 3350 (236 g), sodium sulfate (22.74 g), sodium bicarbonate (6.74 g), sodium chloride (5.86 g), potassium chloride (2.97 g) per 4 L (GoLYTELY); PEG 3350 (420 g), sodium bicarbonate (5.72 g), sodium chloride (11.2 g), potassium chloride (1.48 g) per 4 L (NuLYTELY)

Indications and dosages
 Bowel preparation before GI examination. Adults: 240 ml P.O. q 10 minutes until 4 L are consumed or rectal effluent is clear. Typically, administer 4 hours before examination, allowing 3 hours for drinking and 1 hour for bowel evacuation.
 Management of acute iron overdose ◇. Children younger than age 3: 0.5 L/hour.
Note: If a patient experiences severe bloating, distention, or abdominal pain, slow or temporarily stop administration until symptoms abate.

Pharmacodynamics
Laxative and bowel evacuant action: Acts as an osmotic product. With sodium sulfate as the major sodium source, active sodium absorption is markedly reduced. Diarrhea results, which rapidly cleans the bowel, usually within 4 hours.

Pharmacokinetics
Absorption: Nonabsorbable solution.
Distribution: Not applicable; not absorbed.
Metabolism: Not applicable; not absorbed.
Excretion: Excreted via GI tract.

Contraindications and precautions
Contraindicated in patients with GI obstruction or perforation, gastric retention, toxic colitis, ileus, or megacolon.

Interactions
Drug-drug. Oral drugs: Drug given within 1 hour before start of therapy and throughout therapy may be flushed from GI tract and not absorbed. Avoid oral drug within this time frame if possible.

Adverse reactions
EENT: rhinorrhea.
GI: nausea, bloating, cramps, vomiting, abdominal fullness, anal irritation.
Skin: urticaria, dermatitis.
Other: anaphylaxis.

Effects on lab test results
None reported.

Overdose and treatment
No information available.

Special considerations
• Drug may be given via nasogastric tube (at 20 to 30 ml/minute, or 1.2 to 1.8 L/hour) to patients unwilling or unable to drink preparation. First bowel movement should occur within 1 hour.
• Tap water may be used to reconstitute solution. Shake container vigorously several times to ensure powder is completely dissolved. After reconstitution to 4 L with water, the solution contains PEG 3350 17.6 mmol/L, sodium 125 mmol/L, sulfate 40 mmol/L (CoLyte 80 mmol/L), chloride 35 mmol/L, bicarbonate 20 mmol/L, and potassium 10 mmol/L (1 mmol/L = 1 mEq/L).
• Store reconstituted solution in refrigerator (chilling before administration improves palatability); use within 48 hours.
• Don’t add flavorings or additional ingredients to solution before use.
• No major shifts in fluid or electrolyte balance have been reported.
• Patient preparation for barium enema may be less satisfactory with this solution because it may interfere with barium coating of colonic mucosa using the double-contrast technique.

Patient education
• Instruct patient to fast about 3 to 4 hours before ingesting solution.
• Tell patient not to take solid foods less than 2 hours before solution is administered. Also inform him that no foods except clear liquids are permitted after administration of solution until examination is completed.

Reactions may be common, uncommon, life-threatening, or COMMON AND LIFE THREATENING.
◆ Canada only
◇ Unlabeled clinical use