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Suprep Extended
Bowel Preparation Instructions

These instructions are for patients WITHOUT severe kidney and heart disease. If you have severe kidney or heart disease, please call our office for alternative instructions: 303-604-5000


This bowel preparation requires a little organization but is an extremely important part of your colonoscopy to ensure you have the highest quality exam. Bowel preparation starts days prior to your procedure, as you need to stop taking certain medications or supplements and change your diet. If you do not follow these directions, your colonoscopy may be cancelled. Please note, it is your responsibility to contact your insurance company about coverage and cost for your upcoming colonoscopy procedure. Sometimes, colonoscopies result in a cost to the patient. You will need to tell your insurance company when your last colonoscopy was and if you are performing the colonoscopy because you have symptoms, a personal history or family history of colon cancer or polyps. 


Key Information: 

  • DO NOT EAT any solid food the ENTIRE DAY before your colonoscopy. Drink only clear fluids. 

  • Bring a list of all your MEDICATIONS (including over-the-counter medications), photo ID, insurance card, co-pay/co-insurance/deductible with you to your procedure. 

  • DO NOT bring unnecessary belongings.  We are not responsible for lost or misplaced items. 

  • Stop all clear liquids two hours before your procedure arrival time. 

  • Your colon must be COMPLETELY EMPTY so that your doctor can clearly view your colon. 
    Follow all instructions in this handout EXACTLY as they are written. If you have completed your prep, and your stools are not clear or yellow, please contact our office at 303-604-5000, even if after hours. 


Transportation on the day of your procedure: 

  • A responsible adult MUST BE PRESENT (18 years or older) with you at check-in before your procedure and MUST BE ABLE to pick you up IMMEDIATELY when you are discharged. You are NOT ALLOWED to drive, take a taxi or bus, or leave the Endoscopy Center alone. If you do not have a responsible driver with you to take you home, your procedure WILL BE CANCELLED

  • Because of the sedation, you are NOT ALLOWED to use a bus, taxi, Uber/Lyft, Access-a-Ride, walk home, etc. alone. 



  • Blood thinners: including Coumadin (warfarin), Plavix (clopidrogel), Ticlid (ticlopidine hydrochloride), Brilinta (ticagrelor), Aggrastat (tirofiban), Agrylin (anagrelide), Xarelto (rivaroxaban), Pradaxa (dabigatran), Eliquis (apixaban), Lovenox (low molecular weight heparin), Innohep (heparin) or Effient (Prasugrel), You must follow the instructions provided by our nurses. 

  • Diabetes medication: See instructions below. 

  • All other medications: Including aspirin, should be taken the day of the exam with a sip of water. 

Weight Loss/Diabetes Medications:

  • GLP-1 Agonists: including Mounjaro (tirzepatide), Trulicity (dulaglutide), Victoza, Saxenda (liraglutide), Adlyxin (lixisenatide), Ozempic, Wegovy (semaglutide subcutaneous), Bydureon BCise (exenatide extended-release), Byetta (exenatide), Rybelsus (semaglutide tablet), Stop the oral or injectable medication one week prior to your procedure.

  • Anorectics: including Adipex-P, Lomaira, Suprenza (phentermine hydrochloride), Qsymia (phentermine hydrochloride/topiramate), Stop 5 days prior to your procedure.

Procedure Cancellation Notice Requirements:

  • Procedure cancellations must be made three (3) business days prior to your appointment.

  • Failure to provide the required advance notice will result in a $150 Total Cancellation Fee.

         ($50 Physician cancellation fee from Gastroenterology of the Rockies + $100 Facility cancellation fee from the endoscopy center).

If you have diabetes, follow these instructions:

  • Long-Acting Insulins (ex. Lantus, Basaglar, Semglee, Toujeo, Insulin Glargine): Do not take any long-acting basal insulins the day before or the day of your procedure. 

  • Rapid-Acting and Regular Short-Acting Insulin (ex. Lispro, Humalog, Admelog, Regular Insulin): If your blood sugar is high and you need to take a correction, take ½ or 50% of your usual correction. This applies to the day before and the day of your procedure.

  • Insulin Pump: Decrease basal rate by ½ the day before and the day of your procedure. Do not administer bolus doses. 

  • Other Diabetic Oral & Injectable Medications (ex. Metformin, Glipizide, Sulfonylureas, Tradjenta, Dipeptidyl Peptidase IV (DPP IV) Inhibitors, Januvia, Janumet, Sodium-Glucose Cotransporter-2 (SGLT2) Inhibitors): Do not take the day before or the day of your procedure. 

  • Check your blood sugar at same intervals as usual, and additionally, if needed: If your blood sugar is less than 60, please take glucose tablets at any time before your procedure with a sip of water. 

Checklist to Ensure Proper Bowel Preparation


To ensure the proper completion of your colonoscopy preparation, we strongly suggest that you PRINT OUT this document and check off each of the instructions as you complete them. This will greatly help you in following the detailed instructions and help ensure you receive a proper colonoscopy.


GROCERY STORE LIST: Purchase your bowel preparation items below at least five days before your procedure: 

☐  1 - 8.3 oz bottle of MiraLAX (238 grams) or generic equivalent.

☐  4 - Gas-X tablets (simethicone) containing 125 mg of simethicone each.

☐  1 - Easily measurable 8-ounce glass/cup: You will be drinking multiple quantities of 8 oz liquids.

☐  1 - Suprep Bowel Kit

5 days before your colonoscopy: 

☐  Make sure you have purchased your bowel preparation items! (listed above!) 

☐  DO NOT take medications that stop diarrhea such as Imodium (loperamide), Pepto-Bismol (bismuth subsalicylate) or Lomotil


☐  DO NOT take fiber supplements such as Metamucil, Citrucel, Psyllium or Benefiber. 

☐  DO NOT take products that contain iron such as multi-vitamins or iron supplements. 
☐  Take one heaping teaspoon of MiraLAX® mixed with 8 oz. of a beverage twice daily until the day before your procedure when you will

follow your general prep instructions. MiraLAX® can be mixed into any beverage, hot or cold. Some examples include coffee, tea, water, orange juice, iced coffee, ice water, coconut water, smoothie, iced tea and seltzer.


3 days before your colonoscopy:

☐  Discontinue high-fiber foods – Please see Low Fiber Diet tips attached

Checklist: One Day Before Your Colonoscopy

☐  No marijuana on the day of your procedure.

☐  If you have diabetes, please see Diabetes instructions above.

☐  Only drink clear liquids the ENTIRE DAY before your procedure. NO solid foods.

☐  Drink at least 8-ounces of clear liquids EVERY HOUR after waking up. The charts below have examples of what you can & cannot drink:


  • Gatorade, Pedialyte, Powerade, Kool-Aid 

  • Gatorade G2, Propel, Crystal Light 

  • Popsicles 

  • Jell-o, Juice without Pulp (ex. Apple Juice) 

  • Black Coffee

  • Tea, Water  

  • Clear Sodas (ex. Sprite, Ginger Ale) 

  • Sparkling water


  • NO red or purple liquids 

  • NO Milk or non-dairy creamers 

  • NO Alcohol

  • NO Broth or soup

  • NO Juice with Pulp (ex. pineapple juice) 

  • NO Liquid you cannot see through 

  • NO Apple Sauce 

  • NO Smoothies 

5:00 pm - the evening before your procedure:

5:00 pm: Take two tablets of simethicone/Gas X

6:00 pm - the evening before your procedure:

☐ Pour one 6-ounce bottle of Suprep liquid into the mixing container.

☐ Add cool water to the 16-ounce line on the container and mix.

☐ Drink all the liquid in the container.

☐ Drink two more 16-ounce glasses of water over the next hour (one hour).

Before going to sleep: Take two additional simethicone tablets.

Set your alarm! Make sure to wake up at least 4 hours before your procedure check-in time.

4 hours - before your procedure check-in time - this may be in the middle of the night or early AM:

☐ Pour one 6-ounce bottle of Suprep liquid into the mixing container.

☐ Add cool water to the 16-ounce line on the container and mix.

☐ Drink all the liquid in the container.

☐ Drink two more 16-ounce glasses of water over the next hour (one hour).


2 hours - before your procedure check-in time

☐  Discontinue mints, gum, hard candy, and chewing tobacco.

☐  2 hours before check-in: STOP DRINKING ALL LIQUIDS!


Congratulations, you have completed your prep!

Low Fiber Diet

A low fiber diet limits the amount of food waste that must move through the large intestine.

Approved Foods

Bread, cereal, rice, and pasta

  • White bread, rolls, biscuits, croissants, melba toast

  • Waffles, French toast, pancakes

  • White rice, noodles, pasta, and macaroni

  • Peeled cooked potatoes

  • Plain crackers, saltines

  • Farina, cream of rice

  • Puffed rice, rice krispies, corn flakes, special K


  • Ground (beef, chicken, turkey)

  • Lamb

  • Pork

  • Veal

  • Fish

  • Poultry


  • Cooked carrots

  • Asparagus tips

  • Green or wax beans

  • Pumpkin

  • Lima Beans


  • Bananas, Honeydew, cantaloupe


  • Milk-plain or flavored

  • Yogurt, custard, ice cream, cheese, cottage cheese

Fats, snacks, sweets, condiments, and beverages

  • Margarine, butter, oils

  • Mayonnaise

  • Sour cream

  • Dressing

  • Plain gravy

  • Sugar

  • Clear jelly

  • Honey

  • Syrup

  • Spices/cooked herbs

  • Bouillon, broth

  • Coffee, tea, carbonated drinks

  • Plain cake, cookies

  • Gelatin, plain pudding, popsicles

  • Hard candy or pretzels

  • Mustard, ketchup

Foods to Avoid

  • Breads or rolls with nuts, seeds or fruit: whole wheat, pumpernickel, rye, corn bread, chia seeds

  • Brown or wild rice, buckwheat, quinoa

  • Vegetables (raw or steamed, with seeds) - winter squash, peas, broccoli, brussel sprouts

  • Cabbage, onions, cauliflower, sprouts, baked beans, peas, corn, potatoes with skin

  • Sauerkraut

  • Fruits (raw or dried) - all berries, figs, dates/raisins, prunes, prune juice

  • Yogurt with nuts or seeds

  • Processed meat - hotdogs, sausage, cold cuts, tough meat with gristle

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