Portland Gastroenterology Center

161 Marginal Way • Portland, Maine 04101 • 207-773-7964
Standard MiraLAX Prep
Please read through the instructions at least one week before your procedure.

If you have any questions, please call 207-773-7964.

Download these Prep Instructions for Printing

About Your Appointment

A responsible adult will need to drive you home. Taxis, Ubers, buses, medical ride services, or walking are not options unless a responsible adult accompanies you. You will not be able to drive for the rest of the day.

Plan on being at our facility for about 1 1⁄2 hours from arrival to departure (although this may vary depending on the day/procedure/location – ex. approx. 2.5 hrs for MMC)

For appointments with a scheduled arrival time of 4:00 pm or later, have your ride plan to be at the facility no later than 5:30 pm.

If you are unable to keep your appointment, please call at least 3 business days prior to your procedure to reschedule. We reserve the right to charge a penalty fee for patients who “no show” or cancel without adequate notice.

Medication Instructions

  • Aside from the medications below, we recommend you take all home medications as usual with a small amount of water, at least 3 hours before your arrival time.
  • If you take blood thinners (Plavix®, warfarin, Eliquis®, Xarelto®, etc.) and haven’t been given directions to stop them by our office or your prescribing physician’s office, please call us to clarify. It is ok to continue your Aspirin.
  • Take 1⁄2 your morning insulin dose. Bring the other 1⁄2 with you.

Stop the following medications until after your procedure as directed below

7 days before your procedure

  • Iron supplements, Fiber supplements (e.g. Metamucil®, Citrucel®)
  • Weekly dosed GLP-1 agonists: Trulicity®(Dulaglutide), Bydureon® BCise®(Exenatide ER), Ozempic®/Wegovy®(Semaglutide), Mounjaro®/Zepbound® (Tirzepatide)
  • Adipex-P®/Lomaira® (Phentermine), Qsymia® (Phentermine/Topiramate), Topamax® (Topiramate)

The day before your procedure

  • Questran® (cholestyramine), Lomotil®, Imodium® (loperamide), Colestid® (colestipol)

The day of your procedure

  • Daily dosed GLP-1 agonists: Saxenda®/Victoza® (Liraglutide), Byetta® (Exenatide IR), Rybelsus® (Semaglutide), Adlyxin® (Lixisenatide)
  • Morning dose of oral diabetic medication (Bring it with you)

Step-by-Step Preparation Instructions

1 Week Prior to Colonoscopy

  • Stop eating seeds, nuts, popcorn, tomatoes, corn, berries, granola with dried fruit, raisins
  • Purchase the following items:
    • 1 box Simethicone or Gas-X® tablets
    • 1 – 8.3 oz. container of MiraLAX® or Gavi LAX powder
    • 64 ounces of Gatorade®, Propel Water®, Vitamin Water®, Coconut Water or smartwater®
    • 2 – 10 oz. bottles of liquid magnesium citrate
  • Call the office if you are pregnant, have an internal cardiac defibrillator, had a recent cardiac procedure or a new cardiac health concern.
  • Review the Medication Instructions above.

Day BEFORE Colonoscopy for ALL

Before 11 am

Eat a light Breakfast from the following list of foods:

  • Boiled or poached egg
  • Applesauce
  • Yogurt (no granola or fruit chunks in it)
  • Skinless chicken, turkey or fish
  • Cottage cheese
  • White bread or toast without butter
  • Plain tofu

At 11 am

  • Do not eat solid foods until your procedure is completed.
  • Drink one 10 oz. bottle of magnesium citrate.
  • Drink additional clear liquids while you prep up until 3 hours before your procedure.

At 1 pm

  • Mix 8.3 oz MiraLAX® in the 64 oz of liquid (e.g. Gatorade®, Propel®, smartwater®, etc.) and refrigerate.
  • TIP: it is best tolerated cold!

For Colonoscopies before 10 am

At 2 pm the day before

  • Drink 8 ounces of the MiraLAX® mixture every 10 to 20 minutes until you have finished the entire 64 oz.
  • Once you have finished the MiraLAX® mixture, take two simethicone (Gas-X®) tablets.
  • Continue to drink clear fluids up to 3 hours prior to your procedure.
  • TIP: it is important to HYDRATE!
  • Review Colonoscopy preparation tips to determine if you are ready for your colonoscopy. If you are worried your prep is not complete, take a 2nd bottle of magnesium citrate.

For Colonoscopies later than 10 am

After 2 pm the day before

  • Drink 8 ounces of the MiraLAX® mixture every 10 to 20 minutes until you have finished half (32 oz). Refrigerate the remainder.
  • If you have not started moving your bowels 2 hours after you started drinking the MiraLAX® prep, drink the other half of the solution (32 oz).

Day of the Procedure

  • If you have MiraLAX® mixture left from the day before, drink the second 32 oz. Consider taking 2nd bottle of magnesium citrate.
  • If you took all the MiraLAX® mixture the day before, take 2nd bottle of magnesium citrate.
  • Once you have finished, take two simethicone (Gas-X®) tablets.
  • Continue to drink clear fluids up to 3 hours prior to your procedure.
  • TIP: it is important to HYDRATE!
  • Review Colonoscopy preparation tips below to determine if you are ready for your colonoscopy.

Please review the following prior to starting your prep

Examples of clear liquids

  • Popsicles, EXCEPT for red, purple, or blue
  • Coconut water (NOT coconut milk)
  • Gatorade®
  • Kool-Aid®
  • Strained fruit juice (apple or white grape)
  • Jell-O®
  • Coffee and tea (without dairy products/creamer)
  • Soft drinks

 

Tips

If you start to feel nauseous while prepping, try:

  • Pause drinking the prep until the feeling improves, then resume
  • Decrease the amount you drink at a time
  • Take more time between drinks
  • Refrigerate the prep mixture
  • Use a straw

Prep goal: your stool should be clear and yellow. This chart will help you judge your progress!

Your prep is one of the most important parts of your colonoscopy. Without a good prep—your bowel empty and clean—your gastroenterologist will not be able to see your colon clearly. This could lead to missing a polyp or having to reschedule your colonoscopy.

Here are photos that show the difference between a good prep and a bad prep so you can see why it’s essential.

 

What are the risks of a colonoscopy?

Colonoscopy is a standard medical procedure. Although rare, colonoscopies like all procedures have some risks.

  • The instrument may tear the wall of the colon which may require surgery to repair.
  • There may be adverse drug reactions or heart/breathing complications.
  • Bleeding may occur and is more often a risk when tissue or polyps are removed.
  • There may be discomfort during and after the procedure.