The text above reproduces the patient information leaflet approved for this medicine, restructured for easier reading.Source: electronic medicines compendium (emc), DatapharmActive substance: citric acid, anhydrous, magnesium oxide light, sodium picosulfateOfficial document: view the original leaflet on emc →Medical disclaimer: This page is for information only and does not replace advice from your doctor or pharmacist. Always read the leaflet supplied with your medicine. If you are unwell, call NHS 111; in an emergency, call 999.

← Back to all medicines

Picolax

⚠ This medicine appears to have been discontinued

The electronic medicines compendium (emc) no longer publishes a Summary of Product Characteristics for this product, which usually means it is no longer marketed in the UK. The patient leaflet below is kept for reference, but the product may not be available.

If you were prescribed this medicine, other products containing Citric acid, anhydrous, Magnesium oxide light, Sodium picosulfate may still be available. Do not stop your treatment — ask your pharmacist or GP what to use instead.

Active substance: Citric acid, anhydrous, Magnesium oxide light, Sodium picosulfate

Source: electronic medicines compendium (emc)

Official leaflet: Read the PIL on emc

What it is and what it is used for

for Picolax® is a powder that contains sodium picosulfate, a laxative that works by increasing the activity of the intestine. Picolax® also contains magnesium citrate, another type of laxative that works by holding back fluid in the bowel to provide a wash-out effect. Picolax® is used in adults, adolescents and children from the age of 1 year to clear the bowel before an x-ray examination, endoscopy or surgery when judged clinical necessary.

What you need to know before you take it

e Picolax® Do not take Picolax® if you:

are allergic to sodium picosulfate / magnesium oxide / citric acid or any of the other ingredients of this medicine (listed in section 6)
have reduced ability of the stomach to empty (gastric retention)
have stomach or intestinal ulcers
have severe problems with your kidneys
have a blockage or perforation of your bowel
are currently suffering from feeling or being sick
have a condition requiring abdominal surgery such as acute appendicitis
have been told by a doctor that you have congestive heart failure (the heart is unable to pump blood efficiently around the body)
have active inflammatory bowel disease such as Crohn's disease or ulcerative colitis
have been told by your doctor that you have too much magnesium in your blood
are very thirsty or may be severely dehydrated
have been told by your doctor that you have damaged muscles that are leaking their contents to your blood
have a condition called:
ileus (intestinal blockage or failure of normal bowel movements),
toxic colitis (damage to the intestinal wall)
toxic megacolon (expansion of the large bowel) In these conditions, the movement of the contents of the bowel may be impaired or prevented. Symptoms include nausea, vomiting, diarrhoea, abdominal pain, tenderness or swelling, colicky pain and fever. Warnings and precautions Talk to your doctor or pharmacist before taking Picolax®:
if you have recently had abdominal surgery
if you have a heart disease or kidney problems
if you have inflammatory bowel disease such as ulcerative colitis or Crohn's disease
if you are taking Picolax® prior to surgery involving the bowel You should make sure to drink a sufficient amount of fluid and electrolytes during the course of the treatment. This is particularly important if you are younger than 18 years, elderly or physically weak.

If you have an early time of the day procedure, you might need to take the second dose during night and possible sleep disturbance may occur. The period of bowel cleansing should not exceed 24 hours because longer preparation may increase the risk of water and mineral imbalance in the body. Other medicines and Picolax® Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines. It is especially important to tell your doctor if you are taking:

bulk forming laxatives e.g. bran
prescribed oral medication, especially if it is regularly prescribed as their effects may be modified e.g. contraceptives, antibiotics, antidiabetics, iron, penicillamine or antiepileptics. These medicines should be taken at least 2 hours before and not less than 6 hours after administration of Picolax®
prescribed medication that may affect water and/or electrolyte balance e.g. water tablets, steroids, lithium, digoxin, antidepressants, carbamazepine or anti-psychotics Pregnancy, breast-feeding and fertility If you are pregnant or breast-feeding, think you may be pregnant or are trying to have a baby, ask your doctor or pharmacist for advice before taking this medicine. Driving and using machines Picolax® has no effect on the ability to drive and use machines. However, you should make sure that you have access to a toilet at all times following each dose, until the effect wears off. Picolax® contains potassium, lactose and sodium Each sachet contains 5 mmol (or 195 mg) potassium. You should discuss this with your doctor if you have kidney problems or you have been put on a controlled potassium diet. This medicine also contains lactose. If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicinal product. This medicine contains less than 1 mmol sodium (23 mg) per sachet, that is to say essentially 'sodium-free'.

How to take it

Picolax® Always take Picolax® exactly as your doctor has told you. Check with your doctor if you are not sure. Picolax® powder should be dissolved in a cup of cold water (approximately 150ml). Stir for 2-3 minutes and then drink the solution. Sometimes the solution becomes warm as Picolax® dissolves. If this happens, wait until it cools sufficiently before drinking it. Adults (including elderly) and children 9 and over The recommended dose is one sachet taken 10 to 18 hours before your procedure and one sachet taken 4 to 6 hours before your procedure. The first sachet taken, should be followed by at least five 250 ml drinks of clear liquids (not only water) spread over several hours and the second sachet taken, should be followed by at least three 250 ml drinks of clear liquids (not only water) spread over several hours. You may drink clear liquids (not only water) until 2 hours before your procedure. Do not drink only water. Children (under 9 years) For the timing of dosing in children, refer to the instructions given for adults A measuring spoon is provided with the product. From 1 and below 2 years: first dose is 1 spoonful, second dose is 1 spoonful From 2 and below 4 years: first dose is 2 spoonfuls, second dose is 2 spoonfuls From 4 and below 9 years: first dose is 1 sachet (taken as described under 'adults'), second dose is 2 spoonfuls 9 years and above: adult dose.

XXXXXXXXXX

To measure the dose with the measuring spoon:

Fill the spoon with a heap of powder from the sachet • top of the measuring spoon
The powder left in the measuring spoon is one spoonful (4g of powder)
Pour the powder from the spoon into a cup of water. The cup should contain:
Approximately 50 ml of water if you are measuring one spoonful of powder
Approximately 100 ml of water if you are measuring two spoonfuls of powder
Stir in the cup for 2-3 minutes
Drink the solution. Sometimes the solution becomes warm as Picolax® dissolves. If this happens, wait until it
Discard any remaining powder from the sachet You should expect frequent, loose bowel motions to start at any time after taking a dose of Picolax®. Please ensure that you have access to a toilet at all times following each dose, until the effects wear off. body, it is important to drink plenty of clear liquids (not only water) throughout the treatment with Picolax® until the bowel movements have ceased. In general, you should try to drink clear liquids (not only water) when you are thirsty. Do not drink only water. Clear liquids should include a variety of fruit juice without pulp, soft drinks, clear soup, tea, coffee (without milk, soy or cream) and water. Do not drink only water. The success of your hospital procedure that you undergo depends on the bowel being as clear as possible. The procedure may need to be repeated if you do not achieve a clear bowel. You should always follow the dietary instructions given by your doctor. PICOLAX® should not be used as a routine laxative. If you take more Picolax® than you should If you have taken more Picolax® than you should, contact your doctor immediately or go to the casualty department at your nearest hospital. If you forget to take Picolax® Please consult your doctor, nurse or pharmacist for advice.

Possible side effects

Like all medicines, this medicine can cause side effects, although not everybody gets them. Contact your doctor immediately in case of the following side effects as these might be severe:

allergic reaction including such as rash, redness of skin, hives, itching, swelling (uncommon)
change in consciousness, such as loss or reduced level of consciousness (uncommon)
confusion/disorientation (uncommon)
syncope/fainting (uncommon)
dizziness/light-headedness (uncommon)
seizures (uncommon)
abdominal pain (common)
vomiting (common) Other known side effects of Picolax® are described below: Common (affects less than 1 in 10 but more than 1 in 100 patients):
Headache
Nausea
Hypermagnesaemia (elevated levels of magnesium in the blood) Uncommon (affects less than 1 in 100 but more than 1 in 1,000 patients):
Low levels of potassium in the blood ('hypokalaemia')
As the primary clinical effect, very regular, loose bowel movements, or diarrhoea may happen. However, if your bowel movements become troublesome or give you concern, you should contact your doctor.

If any of the side effects gets serious contact your doctor or nurse. If you notice any side effects not listed in this leaflet, please tell your doctor, nurse or pharmacist. Reporting of side effects If you get any side effects, talk to your doctor or nurse. This includes any side effects not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme, website: www.mhra.gov.uk/yellowcard, or search for MHRA Yellow Card in the Google Play or Apple App Store. By reporting side effects you can help provide more information on the safety of this medicine.

How to store it

Picolax® Keep this medicine out of sight and reach of children. Store in the original packaging in order to protect from moisture. Single use only. Discard any unused contents. Do not use this medicine after the expiry date which is stated on the carton and sachet. The expiry date refers to the last day of that month. Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.

Contents of the pack and other information

What Picolax® contains The active substances of 1 sachet are 10 mg sodium picosulfate, 3.5 g magnesium oxide light and 12 g citric acid. The other ingredients are potassium hydrogen carbonate, saccharin sodium which includes acacia gum, lactose, ascorbic acid, butylated hydroxyanisole. What Picolax® looks like and contents of the pack Your medicine is called Picolax®. It is a powder for oral solution. It is supplied in packs of 2 sachets, 100 sachets (50 packs, each containing 2 sachets), or 300 sachets (150 packs, each containing 2 sachets). A measuring spoon is included in the pack, in order to ensure correct dosing for children. The spoon is used to measure 4 g of powder (4.75 ml). You should only use the spoon if you are dosing a child under 9 years. Not all pack sizes may be marketed. Marketing Authorisation Holder Ferring Pharmaceuticals Limited, Drayton Hall, Church Road, West Drayton, UB7 7PS, UK. Manufacturers Ferring GmbH, Wittland 11, D-24109 Kiel, Germany This medicinal product is authorised in the Member States of EEA under the following names Picolax® United Kingdom Picoprep® Austria, Belgium, Bulgaria, Cyprus, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Iceland, Italy, Latvia, Lithuania, Luxembourg, Netherlands. Norway, Portugal, Romania, Slovak Republic, Spain, Sweden Feb 2025

Rare (affects less than 1 in 1,000 but more than 1 in 10,000 patients):

Low levels of sodium in the blood ('hyponatraemia')
Ulcers of the bowel
Involuntary/accidental loss of bowel contents ('anal incontinence')
Anal pain XXXXXXXXXX

Date: 20 Mar 2025 Title

PICOLAX powd for oral sol 10mg sachet 20x 16.1g GB x 18 March 2025 PIL

Perigord No 876080 Proof No 01

N-MS N°/ Version 3003/03 Colours P. Pro Black.

Barcode No N/A Approving Country GB Dimensions 147 x 413 mm

Frequently asked questions about Picolax

What is the active substance in Picolax?

The active substance in Picolax is citric acid, anhydrous, magnesium oxide light, sodium picosulfate.

Where does this information come from?

This leaflet reproduces the patient information leaflet approved for Picolax, as published on the electronic medicines compendium (emc). The version printed inside your medicine’s packaging is the one that applies to you.

Can I get Picolax without a prescription?

Whether a medicine is available over the counter or on prescription only depends on its licence. Check the leaflet, or ask your pharmacist — they can tell you straight away.

About this leaflet

The text above reproduces the patient information leaflet approved for this medicine, restructured for easier reading.

Source: electronic medicines compendium (emc), Datapharm
Active substance: citric acid, anhydrous, magnesium oxide light, sodium picosulfate
Official document: view the original leaflet on emc →

Medical disclaimer: This page is for information only and does not replace advice from your doctor or pharmacist. Always read the leaflet supplied with your medicine. If you are unwell, call NHS 111; in an emergency, call 999.

Medicines with the same active substance: Citric acid, anhydrous, magnesium oxide light, sodium picosulfate (1 medicine)

See every medicine containing this substance, or browse the full A–Z of active substances.

⚕For healthcare professionals — Summary of Product Characteristics (SmPC)Full SmPC: dosage, interactions, contraindications, warnings+

Technical information intended for healthcare professionals (doctors and pharmacists). The Summary of Product Characteristics (SmPC) is the official document approved by the MHRA/EMA. It does not replace the patient leaflet or a doctor’s advice.

4.1. Therapeutic indications

PICOLAX is indicated in adults, adolescents and children from the age of 1 year:

• To clean the bowel prior to X-ray examination or endoscopy.

• To clean the bowel prior to surgery when judged clinically necessary (see section 4.4 regarding open colorectal surgery).

4.2. Posology and method of administration

Posology

Adults (including elderly):

The two PICOLAX sachets (see Method of Administration section below for reconstitution guidance) are taken dependent on the planned time of the procedure:

• The first reconstituted sachet is taken 10 to 18 hours before the procedure, followed by at least 5 x 250 ml drinks of clear liquids (not only water), spread over several hours

• The second reconstituted sachet is taken 4 to 6 hours before the procedure, followed by at least 3 x 250 ml drinks of clear liquids (not only water), spread over several hours

• Clear liquids (not only water) may be consumed until 2 hours before the time of the procedure

Special populations

Limited data is available for treatment of patients with low body weight (BMI less than 18). The rehydration regimen above has not been tested in such individuals and therefore monitoring of their hydration status is required and the regimen may need to be altered appropriately (see section 4.4).

Paediatric population:

A measuring spoon is provided with the product. It is recommended that a narrow flat edge, for example the back of a knife blade, is drawn across the top of a heaped measuring spoon to obtain a flat surface of the measure. This will give ¼ of a sachet (4 g powder) per spoonful.

For the timing of dosing in children, refer to the instructions given for adults

from 1 up to 2 years: first dose is 1 spoonful, second dose is 1 spoonful

from 2 up to 4 years: first dose is 2 spoonfuls, second dose is 2 spoonfuls

from 4 up to 9 years: first dose is 1 sachet, second dose is 2 spoonfuls

9 years and above: adult dose

Maintaining hydration in children is very important. Guidelines for treating dehydration in children should be followed to ensure adequate hydration during treatment with PICOLAX.

Method of administration

Route of administration: Oral

A low residue diet is recommended on the day prior to the procedure. A clear liquid diet is recommended on the day of the procedure. To avoid dehydration, it is important to follow the liquid intake recommendation as advocated together with the PICOLAX dosing whilst the effects of PICOLAX persist (see section 4.2, Posology). Apart from the liquid intake together with the treatment regimen (PICOLAX + additional liquids), a normal, thirst driven intake of clear liquids is recommended.

Clear liquids should include a variety of fruit juice without pulp, soft drinks, clear soup, tea, coffee (without milk, soy or cream) and water. Liquid intake should not be restricted to only drinking water.

Directions for reconstitution in adults (including elderly):

Reconstitute the contents of one sachet in a cup of water (approximately 150 ml). Stir for 2-3 minutes, the solution should now become an off-white, cloudy liquid with a faint odour of orange. Drink the solution. If it becomes warm, wait until it cools sufficiently to drink.

Directions for reconstitution in children:

Reconstitute the required amount of powder in a cup containing approximately 50 ml water per spoonful. Stir for 2-3 minutes, the solution should now become an off-white, cloudy liquid with a faint odour of orange. Drink the solution. If it becomes warm, wait until it cools sufficiently to drink.

Discard the remaining contents of the sachet.

For directions on reconstitution of the full sachet for children of 4-9 years, refer to the instructions given for adults.

4.3. Contraindications

- Hypersensitivity to the active substances or to any of the excipients listed in section 6.1

- Congestive cardiac failure

- Gastric retention

- Gastro-intestinal ulceration

- Toxic colitis

- Toxic megacolon

- Ileus

- Nausea and vomiting

- Acute surgical abdominal conditions such as acute appendicitis

- Known or suspected gastro-intestinal obstruction or perforation.

- Severe dehydration

- Rhabdomyolysis

- Hypermagnesaemia

- Active inflammatory bowel disease

In patients with severely reduced renal function, accumulation of magnesium in plasma may occur. Another preparation should be used in such cases.

4.4. Special warnings and precautions for use

Because a clinically relevant benefit of bowel cleansing prior to elective, open colorectal surgery could not be proven, bowel cleansers should only be administered before bowel surgery if clearly needed. The risks of the treatment should be carefully weighed against possible benefits and needs depending on surgical procedures performed.

An insufficient or excessive oral intake of water and electrolytes could create clinically significant abnormalities, particularly in less fit patients. In this regard patients with low body weight, children, the elderly, debilitated individuals and patients at risk of hypokalaemia or hyponatremia may need particular attention. Prompt corrective action should be taken to restore fluid/electrolyte balance in patients with signs or symptoms of hypokalaemia or hyponatremia.

Drinking only water to replace the fluid losses may lead to electrolyte imbalance, which may in severe cases lead to complications such as seizures and coma. In rare cases, PICOLAX can cause severe or life-threatening electrolyte problems or impaired renal function in fragile or debilitated patients.

Few episodes of severe hypermagnesaemia have been reported following the use of PICOLAX. In the majority of the cases this occurred in association with other factors (e.g. renal impairment or concomitant medication).

Care should also be taken in patients with recent gastro-intestinal surgery, renal impairment, heart disease or inflammatory bowel disease.

Use with caution in patients on drugs that might affect water and/or electrolyte balance e.g. diuretics, corticosteroids, lithium (see 4.5).

PICOLAX may modify the absorption of regularly prescribed oral medication and should be used with caution e.g. there have been isolated reports of seizures in patients on antiepileptics, with previously controlled epilepsy (see 4.5 and 4.8).

The period of bowel cleansing should not exceed 24 hours because longer preparation may increase the risk of water and electrolyte imbalance.

For an early time of the day procedure it may be required to take the second dose during the night and possible sleep disturbance may occur.

This medicine contains 5 mmol (or 195 mg) potassium per sachet. This should be taken into consideration by patients with reduced kidney function or patients on a controlled potassium diet.

This medicine contains lactose as a component of the flavour. Patients with rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose-galactose malabsorption should not take this medicine.

This medicine contains less than 1 mmol sodium (23 mg) per sachet, that is to say essentially 'sodium-free'.

PICOLAX should not be used as a routine laxative.

4.5. Interaction with other medicinal products and other forms of interaction

As a purgative, PICOLAX increases the gastrointestinal transit rate. The absorption of other orally administered medicines (e.g. anti-epileptics, contraceptives, anti-diabetics, antibiotics) may be decreased during the treatment period (see 4.4). Medicines with the potential to chelate with magnesium (e.g. tetracycline and fluoroquinolone antibiotics, iron, digoxin, chlorpromazine and penicillamine) should be taken not later than 2 hours before and within 6 hours following administration of PICOLAX.

The efficacy of PICOLAX is lowered by bulk-forming laxatives.

Care should be taken with patients already receiving drugs which may be associated with hypokalaemia (such as diuretics or corticosteroids, or drugs where hypokalaemia is a particular risk i.e. cardiac glycosides). Caution is also advised when PICOLAX is used in patients on NSAIDs or drugs known to induce SIADH e.g. tricyclic antidepressants, selective serotonin re-uptake inhibitors, antipsychotic drugs and carbamazepine as these drugs may increase the risk of water retention and/or electrolyte imbalance.

4.6. Fertility, pregnancy and lactation

Pregnancy

For PICOLAX no clinical data on exposed pregnancy are available.

Studies in animals have shown reproductive toxicity (see section 5.3). As picosulfate is a stimulant laxative, for safety measure, it is preferable to avoid the use of PICOLAX during pregnancy.

Breastfeeding

There is no experience with the use of PICOLAX in nursing mothers. However, due to the pharmacokinetic properties of the active ingredients, treatment with PICOLAX may be considered for females who are breastfeeding.

Fertility

There are no data on the effect of PICOLAX on fertility in humans.

Male and female rat fertility was not affected by oral doses of sodium picosulfate up to 100 mg/kg (see section 5.3).

4.7. Effects on ability to drive and use machines

Not relevant.

4.8. Undesirable effects

The most common adverse reactions are vomiting, nausea, abdominal pain and headache. Hyponatraemia is rare but is the most commonly reported serious adverse reaction.

Adverse reactions from spontaneous reports are presented by frequency category based on incidence in clinical trials when known. Frequency from spontaneous reports for adverse reactions never observed in clinical trials is based on an algorithm as recommended in the European Commission SmPC guideline, 2009, rev 2.

MedDRA Organ Class

Common (≥1/100 to <1/10)

Uncommon (≥1/1000 to <1/100)

Rare (≥1/10,000 to <1/1000)

Immune system disorder

Anaphylactic reaction, hypersensitivity

Metabolism and nutrition disorders

Hypermagnesaemia

Hypokalaemia

Hyponatraemia

Nervous system disorders

Headache

Epilepsy, generalised tonic-clonic seizurea, seizure, Loss of or depressed level of consciousness, syncope, dizziness, Confusional state including disorientation

Presyncope

Gastrointestinal disorders

Vomiting, nausea, abdominal pain

Diarrhoeab

Ileal ulcerc, anal incontinence, proctalgia

Skin and subcutaneous tissue disorders

Rash (including erythematous rash and maculo-papular rash, urticaria, purpura)

a In epileptic patients, there have been isolated reports of seizure/generalised tonic-clonic seizure without associated hyponatraemia.

b Isolated cases of severe diarrhoea have been reported post-marketing.c Isolated cases of mild reversible aphthoid ileal ulcers have been reported.

Reporting of suspected adverse reactions

Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product. Healthcare professionals are asked to report any suspected adverse reactions via the Yellow Card Scheme, website: www.mhra.gov.uk/yellowcard, or search for MHRA Yellow Card in the Google Play or Apple App Store.

4.9. Overdose

Overdose would lead to profuse diarrhoea. Treatment is by general supportive measures and correction of fluid and electrolyte balance.

🇷🇴 Known in Romania as

Medicines sold in Romania with the same active substance: Cunoscut în România ca

⚠ Not the same combination. This medicine contains Citric acid, anhydrous, Magnesium oxide light, Sodium picosulfate. The products below do not contain exactly the same set of active substances — they are not direct substitutes.

⚠ Same active substance, but a different pharmaceutical form (for example a gel instead of a tablet). Not interchangeable — ask a pharmacist.

MAGNESII SULFURICI POLPHARMA 200 mg/ml prescription partial — not the same combinationMAGNESII SULFAS · injection / infusion
MAGNESIUM SULFATE KALCEKS 200 mg/ml prescription partial — not the same combinationMAGNESII SULFAS · injection / infusion

Some of these do not contain exactly the same active substances — check each one. The strength, the form and whether you need a prescription can differ. Always ask a pharmacist before you switch. Romanian medicines in the UK →

🇵🇱 Known in Poland as

Medicines sold in Poland with the same active substance: W Polsce znany jako