Suprep
Extended

Suprep Extended 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.

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.

Medications:

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/Weight Loss medication: See instructions below.
ACE Inhibitor Blood Pressure medications: Do NOT take medications ending ‘pril’ the day of your procedure. Examples: lisinopril, benazepril, ramipril, captopril, enalapril, quinapril
ARB Blood Pressure medications: Do NOT take medications ending in ‘sartan’ the day of your procedure. Examples: losartan, irbesartan, candesartan, valsartan, telmisartan, olmesartan
Diuretics: Do NOT take “water” pills the day of your procedure. Examples: furosemide (Lasix), bumetanide (Bumex), torsemide, hydrochlorothiazide (HCTZ), spironolactone (Aldactone), indapamide, chlorothiazide, chlorthalidone, metolazone
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 (Injectable): including Mounjaro (tirzepatide), Zepbound (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.
GLP-1 Agonists (Oral): including Rybelsus (semaglutide tablet), Stop 24 hours prior to procedure.
Anorectics: including Adipex-P, Lomaira, Suprenza (phentermine hydrochloride), Qsymia (phentermine hydrochloride/topiramate), Stop 5 days prior to your procedure.

If you have diabetes, follow these instructions:

Long-Acting Insulins (ex. Lantus, Basaglar, Semglee, Toujeo, Insulin Glargine): Decrease basal rate by ½ the day before and 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.
SGLT2 Inhibitors: including Jardiance (empagliflozin), Brenzavvy (bexagliflozin), Glyxambi (empagliflozin/linagliptin), Invokamet (canagliflozin/metformin), Invokana (canagliflozin), Qtern (dapagliflozin/saxagliptin), Segluromet (ertugliflozin/metformin), Steglatro (ertugliflozin), Steglujan (ertugliflozin/sitagliptin), Synjardy (empagliflozin/metformin), Inpefa (sotagliflozin), Trijardy (empagliflozin/linagliptin/metformin), Xigduo (dapagliflozin/metformin), Farxiga (dapagliflozin), Stop these medications four days prior to your procedure.
Other Diabetic Oral & Injectable Medications: including Glucophage (metformin), Glucotrol/Glynase Pres Tab/Micronase (glipizide), Amaryl (glimepiride), DiaBeta (glyburide), Tradjenta (linagliptin), Januvia (sitagliptin), Nesina (alogliptin), Onglyza (saxagliptin), Zituvio (sitagliptin), Actos (pioglitazone), Avandia (rosiglitazone) or any combination of these medications, Stop these medications the day before 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 the 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
☐ 1 – 16-gram packet of magnesium citrate OR 10 oz bottle of magnesium citrate

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(diphenoxylate/atropine).
☐ 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

☐ 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 will show you examples of what you can and cannot drink:

CLEAR LIQUIDS – YOU CAN 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

DO NOT DRINK:

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:

☐ 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.

9:00 pm – the evening before your procedure:

☐ If you have not had any bowel movements, drink either the 10 oz bottle of magnesium citrate or a 16-gram packet of magnesium citrate (mixed with 8 oz of clear liquid of your choice).

Checklist: The Day of Your Colonoscopy

☐ If you have diabetes, please see diabetes instructions above.
☐ No marijuana.
☐ No mints, gum, hard candy or chewing tobacco.
☐ You may drink clear liquids up to 2 hours before your procedure check-in time. NO solid foods.

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

2 hours – before your procedure check-in time

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

Congratulations, you have completed your prep! Please bring your medication list (including over-the-counter medications), photo ID, insurance card, co-pay/co-insurance/deductible with you to your procedure.

If you have any questions throughout your prep, please see our procedure FAQ’s: https://www.gastrorockies.com/procedure-faqs/

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).

Download Prep Instructions

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

Meat

Ground (beef, chicken, turkey)
Lamb
Pork
Veal
Fish
Poultry

Vegetables

Cooked carrots
Asparagus tips
Green or wax beans
Pumpkin
Lima Beans

Fruits

Bananas, Honeydew, cantaloupe

Milk/Dairy

Milk-plain or flavored, eggs
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, Brussels 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