For patients: How to take Lavacol before colonoscopy: instructions, description

How to prepare for a colonoscopy examination?

In order to examine the intestinal mucosa, it is necessary that there is no feces in the lumen and on the walls of the intestine. The success and information content of the study is determined mainly by the quality of preparation for the procedure, so be careful about following the recommendations for preliminary preparation and following the method of using the drug.

Preliminary preparation of the intestine for examination

If you do not suffer from constipation, you should follow the following diet for two days before your colonoscopy.

Exclude from the diet:

• all fresh vegetables and fruits, including beets (borscht), potatoes, herbs, berries
• “coloring” drinks: tomato, pomegranate juice, black coffee, Coca-Cola, etc.
• black bread, mushrooms, beans, peas
• Activated carbon

Allowed for food:

• bouillon
• semolina
• egg
• omelette
• boiled meat
• fish
• cheese
• oil
• fermented milk products, except hard cottage cheese

If you have a tendency to constipation (lack of independent bowel movements for 3 days), then you need to take your usual laxatives 2 days before the test, and also adhere to the diet described above.

While taking the drug, only liquid food (broth, sweet green tea) is consumed.

On the morning of the test, you should drink green sweet tea.

Can:

• Soups with low-fat meat broth without vegetables, dishes made from lean beef, veal, fish, boiled chicken, eggs;
• Products rich in calcium (low-fat cottage cheese, cheeses), kefir, natural yogurt, no more than 2 glasses of milk;
• White bread, muffins, biscuits, bagels - without poppy seeds, vermicelli and noodles made from premium flour, porridge (rice and oatmeal), white rice;
• Vegetable decoctions, potatoes, mousses, peaches, melon, compotes, jelly, juices (without pulp), weak coffee, tea;
• Sugar, honey, jellies, syrups;
• Butter and vegetable oil, margarine, mayonnaise in limited quantities.

Method of use of Lavacol and dose

Dilute the contents of 1 sachet of the drug in 1 glass of water (200 ml) at room temperature. You can add syrup or jam to the resulting solution (to adjust the taste).

Take the prepared solution 200 ml every 20-30 minutes.

The solution can be washed down with water or water with lemon. The stool begins to pass 1-1.5 hours after starting to take the drug and stops 1-3 hours after taking the last dose of the drug.

There are two ways to take the drug, one-stage and two-stage:

If the study is scheduled for 8-10 am, then the drug should be taken from 16.00-17.00 to 21.00-22.00 the night before. After 10 pm, eating is not recommended.

An examination (colonoscopy) is possible no earlier than 4 hours after the last dose of the drug.

Lavacol

Lavacol

® (
Lavacole
) is a Russian-made laxative drug used in bowel preparation before instrumental examinations.

Dosage form and composition of Lavacol

Lavacol is available in the form of sachets containing powder for the preparation of a solution for oral administration. Weight of powder in one sachet is 14.0 g, including:

• polyethylene glycol MM 4000 (macrogol 4000) - 12.0 g
• sodium sulfate anhydrous - 1.0 g
• sodium bicarbonate - 0.6 g
• sodium chloride - 0.2 g
• potassium chloride - 0.2 g

Indications for use of Lavacol

Lavacol is used in the preparation of:

• for instrumental studies of the lower intestine:
• colonoscopy
• X-ray examination of the colon
• anorectal and colonic manometry

Lavacol and colonoscopy. Including economic aspects

High-quality preparation of the colon is the most important factor determining the effectiveness of colonoscopy, its duration and the success of therapeutic procedures, reduces the risk of complications, eliminates the need for repeated examinations, which also affects the economic side.
The condition for ideal preparation of the colon for colonoscopy is the complete absence of contents in the intestine or a moderate amount of residual clear liquid, sometimes mixed with mucus, which does not interfere with a full examination and is freely aspirated. However, in daily clinical practice, endoscopists regularly encounter poor visualization during colonoscopy. Preparing the colon for colonoscopy is a complex process that usually disrupts the patient’s usual rhythm of life. The method of oral intestinal lavage using the drug Lavacol is the method of choice for the combination of safety, effectiveness and comfort for the patient when preparing the colon for examination and surgery. Taking the solution does not lead to disruption of the physiological constants of the body, hemodynamic parameters, and does not change the well-being of patients. Lavacol does not contain flavorings or additives, which makes it easier to take and improves compliance. Experience with the use of the drug Lavacol gives grounds to recommend it for widespread use in clinical practice. It is important that the use of the drug Lavacol is more economically justified for patients: Lavacol costs 170 rubles in pharmacies, Fortrans - 550 rubles. (both drugs are included in the Vital and Essential Drugs list), Endofalk - from 500 rubles, Fleet phospho-soda - from 1500 rubles. Undoubtedly, the classical scheme (using enemas) has the minimum cost, but with this method labor costs increase significantly, and such a scheme is much less comfortable for patients than taking modern means intended for high-quality preparation.*

*The text of the section is based on the article: Shindina T.S., Maksimov M.L. Use of the drug Lavacol for high-quality intestinal preparation for colonoscopic examination // Breast Cancer. 2015. No. 21. pp. 1287–1289.

How to use Lavacol

The contents of 1 sachet of the drug are diluted in 1 glass of water (200 ml) at room temperature.
You can add syrup or jam to the solution to improve the taste. Lavokol solution is taken 200 ml every 20-30 minutes. The solution can be washed down with water or water with lemon. The total amount of solution to drink is 3 liters (15 doses of 14 g each). Defecation begins an hour and a half after starting to take Lavokol and stops 1-3 hours after taking the last dose. Dosage regimens for Lavacol:

• if the study is scheduled for 8-10 am, then Lavacol is taken on an empty stomach from 16:00-17:00 to 21:00-22:00 the night before, after 22:00 food is not taken
• if the study is scheduled for 11-13 hours or later, then the entire dose of Lavacol is divided into 2 doses - from 18:00 to 21:00 and from 6:00 to 7:00 in the morning, after which food is not taken until the study

An examination (colonoscopy) is possible no earlier than 4 hours after the last dose of the drug.
See also the article: “Preparation of the colon for instrumental studies.”

Contraindications to the use of Lavacol

Lavacol is not recommended for severe disturbances in the general condition of the patient, dehydration, heart failure, intestinal obstruction, toxic expansion of the colon, gastric stenosis, perforation of the stomach or intestines, erosive and ulcerative lesions of the gastrointestinal tract, and renal dysfunction.

Side effects of Lavacol

During therapy with Lavokol, the following occasionally occurs: nausea, vomiting, a feeling of heaviness and discomfort when taking the first doses of the drug.

Other medicines containing the active ingredient macrogol

Macrogol, as an active ingredient, is included in the following medications: Osmogol, Realaxan, Tranzipeg, Forlax, Forteza Rompharm, Fortrans. Endofalk is a drug that contains, in addition to macrogol, the following active substances: sodium chloride, sodium bicarbonate, potassium chloride.

general information

According to the pharmacological index, Lavacol belongs to the group “Laxatives”.
According to ATC - to the group “A06 Laxatives”, subgroup “A06AD Osmotic laxatives”, code “A06AD15 Macrogol”. Manufacturer of Lavokol: Moscow Pharmaceutical Factory CJSC. Developer: State Scientific Center for Coloproctology named after A.N. Ryzhikh of the Russian Ministry of Health.

On the website gastroscan.ru in the literature catalog there is a section “Laxatives”, containing medical articles relating to laxatives and their use.

Lavacol has contraindications, application features and side effects. Before using macrogol, you should consult your doctor.

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General information about the drug

Registration number: R№ LS - 000443

Trade name: Lavacol®

Dosage form: Powder for the preparation of solution for oral administration.

Composition per package (14.0 g):

• Polyethylene glycol MM 4000 - 12.0 g
• Sodium sulfate anhydrous - 1.0 g
• Sodium bicarbonate - 0.6 g
• Sodium chloride - 0.2 g
• Potassium chloride - 0.2 g

Description:

Powder of white or white with a yellowish or grayish tint. One packet of the drug is dissolved in 200 ml of water. The resulting solution is a colorless or slightly colored liquid, slight opalescence is allowed.

Pharmacological properties:

The action of the drug is based on the combination of a high molecular weight polymer with an isotonic solution of electrolytes. Polyethylene glycol MM 4000 prevents the absorption of water from the stomach and intestines and promotes accelerated evacuation of intestinal contents through frequent bowel movements. The electrolytes contained in the drug prevent disturbances in the body's water-electrolyte balance.

Indications for use:

Preparation for endoscopic or x-ray examination of the colon, as well as for surgical interventions that require the absence of contents in the intestine.

Contraindications:

Severe disturbances in the patient's general condition (including dehydration, heart failure), intestinal obstruction, toxic expansion of the colon, gastric stenosis, perforation of the stomach or intestines, erosive and ulcerative lesions of the gastrointestinal tract, impaired renal function.

Side effect:

In rare cases, nausea and vomiting, a feeling of heaviness and discomfort are possible when taking the first doses of the drug.

Release form:

Powder in bags of 14 g of combined film material. 15 bags, along with instructions for use, are placed in a cardboard pack.

It is allowed to pack packages together with an equal number of instructions for use in a group package.

Storage conditions:

At a temperature not exceeding 25°C, in a dry place out of reach of children.

Best before date:

3 years. Do not use after the expiration date stated on the package.

Lavacol powder for the preparation of oral solution 14g N15

Active substance

macrogol (macrogol)

ATX code

A06AD15 (Macrogol)

Release form, packaging and composition of the drug

◊ Powder for solution for oral administration

white or white with a yellowish or grayish tint; the prepared solution is a colorless or slightly colored liquid, slight opalescence is allowed.

[PRING] sodium sulfate (sodium sulfate) - 1 g, sodium bicarbonate (sodium bicarbonate) - 0.6 g, sodium chloride - 0.2 g, potassium chloride - 0.2 g.

14 g - heat-sealable bags made of combined material (15) - cardboard packs.

Clinical and pharmacological group

Laxative drug with osmotic properties

Pharmacotherapeutic group

Laxative

pharmachologic effect

Pharmacokinetic studies confirm the lack of absorption and metabolism of macrogol when taken orally.

Indications for use

• preparation for endoscopic or x-ray examination of the colon, as well as for surgical interventions that require the absence of contents in the intestine;
• symptomatic treatment of constipation in adults.

Dosage

The drug is taken orally. The drug can only be used in adult patients

.

Preparation for endoscopic or x-ray examination of the colon, as well as for surgical interventions

The drug is taken on an empty stomach. The contents of the package (14 g) are dissolved in 200-250 ml of water immediately before use.

When scheduling a procedure (examination or surgery) for the first half of the day (up to 12 hours), the solution should be taken the night before - at the rate of 15 packets (approximately 200-250 ml each) with an interval of 20 minutes. Recommended hours for taking the drug are from 17:00 to 22:00.

If the procedure is scheduled for the second half of the day (after 12 noon), the solution should be divided into 2 stages (the night before, the patient takes the solution at the rate of 10 packets and 5 packets in the morning). Recommended reception hours: on the eve of the procedure 19-22 hours (10 packages), in the morning before the procedure from 6 to 9 hours (5 packages).

The drug must be taken 3-4 hours before the procedure. During and after the intake, only liquid food is consumed. After 10 pm, eating is not recommended.

Symptomatic treatment of constipation in adults

The contents of each package should be dissolved in a glass of water immediately before use. 1 packet in the morning or 1 packet in the morning and evening if taking 2 packets per day. The daily dosage should be adapted according to the clinical effect and may vary from 1 packet every day to 2 packets per day.

The effect of taking the drug is expressed within 24-28 hours after taking it. The recommended course of treatment is 1 month.

Maintaining the effect after restoring normal bowel function should be achieved through an active lifestyle and a diet rich in plant fiber. If symptoms of constipation persist for more than 1 month, a further extensive diagnostic examination should be performed.

Contraindications

• hypersensitivity to macrogol or any of the excipients included in the drug;
• dehydration;
• chronic heart failure;
• stomach ulcer;
• intestinal obstruction;
• perforation or risk of perforation of the intestinal wall;
• severe inflammatory bowel diseases;
• impaired gastric emptying (including gastroparesis);
• age under 18 years (efficacy and safety have not been established).

Carefully:

ulcerative colitis, patients with impaired swallowing reflex, reflux esophagitis, depression of consciousness, impaired renal function, tendency to develop water and electrolyte imbalance, neurological disorders, impaired motor functions, tendency to aspiration, pregnancy, old age.

Overdose

Exceeding the dose can lead to disturbances in water-electrolyte balance and the development of diarrhea, which, as a rule, stops on its own 1-2 days after discontinuation of the drug.

Side effects

From the digestive system:

a feeling of stretching of the anterior abdominal wall, abdominal pain, nausea, diarrhea, vomiting, strong urge to defecate, fecal incontinence, irritation of the perianal area, flatulence.

Allergic reactions:

urticaria, skin itching, skin rash, swelling of the face, Quincke's edema, anaphylactic shock, fulminant and acute pulmonary edema.

If any of the side effects indicated in the instructions are aggravated or any other side effects not listed in the instructions are noted, the patient should inform the doctor.

Overdose

Diarrhea caused by the use of Lavacol® may impair the absorption of other drugs taken at the same time. In the case of simultaneous use of the drug Lavacol® with other drugs, it is recommended to prescribe it 2 hours after taking them.

The simultaneous use of macrogol and digoxin leads to a decrease in the degree of absorption of the latter in the intestine.

Storage conditions

The drug should be stored out of the reach of children at a temperature not exceeding 25°C. Shelf life: 5 years.

Conditions for dispensing from pharmacies

The drug is available without a prescription.

Special Instructions

For elderly patients with various concomitant diseases, the drug is recommended to be used under medical supervision.

The patient should be warned about the need to inform the doctor about all concomitantly used drugs.

In the event of diarrhea, special control and monitoring of the electrolyte composition of the blood is necessary in patients prone to the development of electrolyte disorders.

It is recommended to use the drug with caution in patients with ulcerative colitis due to the high risk of perforation.

Impact on the ability to drive vehicles and operate machinery

Given the possibility of developing undesirable reactions, caution should be exercised when driving vehicles and operating machinery.