Miralax PM Prep
Please read through all the following information. Contact the office if you have any questions.
If you are on anticoagulants such as Couomadin (Warfarin), Pradaxa(Dabigatran), Eloquis (Apixaban), or Xarelto (Rivaroxaban or are on anti-platelets such as Plavix (Clopidogrel), Ticlid (Ticlopidine, Effient (Prasugrel)or Persantine (Dipyrimadole) you will also need to contact your prescribing physician regarding any adjustment to your medications or additional blood tests prior to your colonoscopy. Please then let my office know your medication adjustment. Without my office knowing this information your procedure may need to be rescheduled.
If you take a daily aspirin, please let the office know. You will not be asked to stop this medication.
If you are diabetic, you may need to adjust your insulin or oral medication. Prior to your colonoscopoy please consult with the MD who cares for your diabetes for any temporary changes to your dosing and schedule.
Because of the sedation, you must have someone drive or accompany you home, no exceptions. If you plan to take a taxi, you must have a person ride home with you. You cannot drive, operate machinery, nor should you sign any legal documents the day of your procedure.
Check with your insurance company prior to your procedure to assure that you understand your insurance benefits and coverage. Your colonoscopy is considered to be a screening or routine if have you have no GI symptoms. If you are experiencing GI symptoms (i.e. abdominal pain, bleeding, diarrhea, constipation, anemia) your colonoscopy is considered to be diagnostic. If a polyp or tissue is removed during the procedure your colonoscopy may no longer be considered a screening but a surgical procedure. Information on insurance claims adheres to your medical record.
ATTENTION ALL UNITEDHEALTHCARE SUBSCRIBERS: If you have a United Health Care Plan you may require an insurance authorization or insurance approval for your colonoscopy. Your insurance may also direct you to the facility where your policy will cover your procedure regardless of your physician affiliation or your choice of facility. Call your customer service dept. (phone number should be on the back of your insurance card. Tell the representative you are having a colonoscopy that will be billed using CPT code 45378 or 45380 or 45385 (depending upon findings at the time of your colonoscopy) and ask if your policy requires a UnitedHealthCare insurance prior authorization. Also tell the representative the facility where your procedure is scheduled. (Dr. Curran does procedures at Charles River Endoscopy Center which is a free standing ambulatory center or UMass Marlboro Hospital Outpatient Endoscopy Center or Marlboro Hospital Outpatient both hospital based facility.) Please then contact Doreen at my office with the customer rep responses as your appointment will need documentation that an authorization for the procedure and place of service is or is not required. If authorization required, Doreen will then contact your insurance for the authorization necessary to confirm the date and place of your appointment and to submit a claim for your colonoscopy.
Purchase at your pharmacy prior to your procedure:
-Miralax powder 8.3 oz (238g) or the generic equivalent ( ask your pharmacist to be sure)
-Plenty of clear liquids that include: coffee or tea without dairy/non-dairy creamers; all carbonated beverages and non carbonated beverages such as Gatorade or vitamin water, fruit juices without pulp, broths, jello, popsicles and Italian ice. Avoid any clear liquid that is red or purple in color such as cranberry or grape juice.
– (Optional): Aloe baby wipes, Desitin ointment for perirectal irritation, straws. Drinking your prep solution using a straw is sometimes helpful. If you become sick to your stomach while drinking your prep, stop until the nausea passes then resume the specified rate as best you can.
Miralax or generic solution will cause multiple bowel movements. It may cause cramps, gas or nausea. It may start to work in as little as 30 minutes, but it can take several hours. You should stay within close reach of toilet facilities. You must take the whole mixture of the Miralax or generic solution to complete the prep.
The day before your colonoscopy: take all your medications as scheduled. Mix the bottle of Miralax or generic powder in 64 oz of a clear liquid, mix until dissolved, refrigerate
8AM: You may have a protein breakfast consisting of an egg, or a small piece of skinless chicken, turkey or fish and one slice of white bread. No milk products. After this breakfast you may not eat any more solid foods. You are to start drinking 8-12 oz of a clear liquid each hour. You should drink 64 oz of clear liquids over the course of the day.
6:00- PM: Drink or sip through a straw 8oz of the Miralax or generic solution every 10-15 minutes until half (32 oz) of the solution is gone. Continue to drink 8-12oz of a clear liquid until bedtime. Anytime you get up during the night to go to the bathroom, have a drink of clear liquid.
5 hours before your colonoscopy: Drink or sip 8oz of the Miralax or generic solution every 10-15 minutes until the remaining 32 oz of the solution is gone. You must drink it all.
Nothing to drink for the four hours before the exam your colonoscopy. You may take all necessary medications the morning of your colonoscopy with a sip of water except for diuretics such as Lasix, hydrochlorothiazide or any medication ending in HCT. These medications can be taken after your procedure.
Please plan three hours from drop off to discharge though this estimate may vary from patient to patient. Every attempt is made to adhere to the schedule though there are occasions when unavoidably the schedule may run behind. Your patience and understanding are appreciated.
***Your colonoscopy brings together an endoscopy team that provides you the best possible care available. If you are not able to keep your procedure appointment we request at least a 72 hour notice. Less than 72 hours may result in a $50 cancellation fee.***