sodium sulfate/potassium sulfate/magnesium sulfate (Rx)

Brand and Other Names:Suprep
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Dosing & Uses

AdultPediatricGeriatric

Dosage Form & Strengths

sodium sulfate/potassium sulfate/magnesium sulfate

oral solution for dilution

  • (17.5g/3.13g/1.6g)/6 oz bottle for adults
  • Each kit contains 2 bottles of concentrated oral solution (6 oz each) for further dilution and a mixing bottle

Bowel Prep

Indicated for cleansing of the colon in preparation for colonoscopy

Administer in a split dose (2-day regimen) for a total volume of 96 oz (2880 mL)

Day prior to colonoscopy

  • May consume light breakfast or only clear liquids on day before (no solid foods)
  • Avoid red and purple liquids, milk, and alcoholic beverages
  • Early evening before colonoscopy: Dilute 1st 6-oz bottle to 16 oz (480 mL) with water in provided mixing container and drink entire amount
  • Drink additional 32 oz (960 mL) of water over the next hour

Day of colonoscopy

  • Have only clear liquids until after colonoscopy
  • Avoid red and purple liquids, milk, and alcoholic beverages
  • Morning of colonoscopy (10-12 hr after evening dose and at least 3.5 hr before colonoscopy): Prepare 2nd 6-oz bottle by diluting contents to 16 oz (480 mL) in provided mixing container and drink entire amount
  • Drink additional 32 oz (960 mL) of water over the next hour
  • Complete all of the bowel kit and required water at least 2 hr before colonoscopy

Dosage Form & Strengths

sodium sulfate/potassium sulfate/magnesium sulfate

oral solution for dilution

  • (13.13g/2.35g/1.2g)/4.5 oz bottle for children aged ≥12 yr
  • Each kit contains 2 bottles of concentrated oral solution (4.5 oz each) for further dilution and a mixing bottle

Bowel Prep

Indicated for cleansing of the colon in preparation for colonoscopy for adolescents aged ≥12 yr

≥12 years

Administer in a split dose (2-day regimen) for a total volume of liquid using 2 bottles is 72 oz (~2130 mL)

  • Day prior to colonoscopy
    • May consume light breakfast or only clear liquids on day before (no solid food)
    • Avoid red and purple liquids, milk, and alcoholic beverages
    • Early evening before colonoscopy: Dilute 1st 4.5-oz bottle to 12 oz (360 mL) with cool water in provided mixing container and drink entire amount
    • Drink additional 24 oz (720 mL) of water over the next hour
  • Day of colonoscopy
    • Have only clear liquids until after colonoscopy
    • Avoid red and purple liquids, milk, and alcoholic beverages
    • Morning of colonoscopy (10-12 hr after evening dose and at least 3.5 hr before colonoscopy): Prepare 2nd 4.5-oz bottle by diluting contents to 12 oz (360 mL) in provided mixing container and drink entire amount
    • Drink additional 24 oz (720 mL) of water over the next hour
    • Complete all of the bowel kit and required water at least 2 hr before colonoscopy

In clinical trials, 25% of participants were aged 65 yr or older; no overall differences were noted with the split-dose (2-day) regimen; however, geriatric patients tended to have more vomiting when administered as a 1-day regimen

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Interactions

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              • baloxavir marboxil

                sodium sulfate/potassium sulfate/magnesium sulfate decreases levels of baloxavir marboxil by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug.

              • bisacodyl

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of bisacodyl by Other (see comment). Avoid or Use Alternate Drug. Comment: Coadministration of stimulant laxatives and sodium sulfate/magnesium sulfate/potassium chloride may increase the risk of mucosal ulceration or ischemic colitis.

              • bisacodyl rectal

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of bisacodyl rectal by Other (see comment). Avoid or Use Alternate Drug. Comment: Coadministration of stimulant laxatives and sodium sulfate/magnesium sulfate/potassium chloride may increase the risk of mucosal ulceration or ischemic colitis.

              • demeclocycline

                sodium sulfate/potassium sulfate/magnesium sulfate decreases levels of demeclocycline by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Administer tetracyclines at least 2 hr before and no less than 6 hr after each dose to avoid chelation with magnesium. .

              • doxycycline

                sodium sulfate/potassium sulfate/magnesium sulfate decreases levels of doxycycline by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Administer tetracyclines at least 2 hr before and no less than 6 hr after each dose to avoid chelation with magnesium. .

              • eravacycline

                sodium sulfate/potassium sulfate/magnesium sulfate decreases levels of eravacycline by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Administer tetracyclines at least 2 hr before and no less than 6 hr after each dose to avoid chelation with magnesium. .

              • minocycline

                sodium sulfate/potassium sulfate/magnesium sulfate decreases levels of minocycline by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Administer tetracyclines at least 2 hr before and no less than 6 hr after each dose to avoid chelation with magnesium. .

              • omadacycline

                sodium sulfate/potassium sulfate/magnesium sulfate decreases levels of omadacycline by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Administer tetracyclines at least 2 hr before and no less than 6 hr after each dose to avoid chelation with magnesium. .

              • penicillamine

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of penicillamine by Other (see comment). Avoid or Use Alternate Drug. Comment: Administer penicillamine at least 2 hr before and no less than 6 hr after each dose to avoid chelation with magnesium. .

              • polyethylene glycol/electrolytes and bisacodyl

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of polyethylene glycol/electrolytes and bisacodyl by Other (see comment). Avoid or Use Alternate Drug. Comment: Coadministration of stimulant laxatives and sodium sulfate/magnesium sulfate/potassium chloride may increase the risk of mucosal ulceration or ischemic colitis.

              • raltegravir

                sodium sulfate/potassium sulfate/magnesium sulfate decreases levels of raltegravir by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug.

              • sarecycline

                sodium sulfate/potassium sulfate/magnesium sulfate decreases levels of sarecycline by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Administer tetracyclines at least 2 hr before and no less than 6 hr after each dose to avoid chelation with magnesium. .

              • senna

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of senna by Other (see comment). Avoid or Use Alternate Drug. Comment: Coadministration of stimulant laxatives and sodium sulfate/magnesium sulfate/potassium chloride may increase the risk of mucosal ulceration or ischemic colitis.

              • tetracycline

                sodium sulfate/potassium sulfate/magnesium sulfate decreases levels of tetracycline by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Administer tetracyclines at least 2 hr before and no less than 6 hr after each dose to avoid chelation with magnesium. .

              Monitor Closely (250)

              • abobotulinumtoxinA

                sodium sulfate/potassium sulfate/magnesium sulfate increases effects of abobotulinumtoxinA by Other (see comment). Use Caution/Monitor. Comment: Magnesium may potentiate the effects of the neuromuscular blocking agents.

              • alendronate

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of alendronate by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • aluminum hydroxide

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of aluminum hydroxide by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • amikacin

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of amikacin by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • amikacin liposome inhalation

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of amikacin liposome inhalation by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • amiodarone

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of amiodarone by QTc interval. Use Caution/Monitor. Consider predose and post-colonoscopy ECGs in patients at increased risk of serious cardiac arrhythmias.

              • amitriptyline

                sodium sulfate/potassium sulfate/magnesium sulfate increases effects of amitriptyline by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of seizures when using higher dose of magnesium sulfate together with drugs that lower the seizure threshold.

              • amlodipine

                amlodipine, sodium sulfate/potassium sulfate/magnesium sulfate. Either increases effects of the other by unknown mechanism. Use Caution/Monitor. Monitor for hypotension or muscle weakness in patients receiving calcium channel blockers with elevated serum magnesium concentrations.

              • amoxapine

                sodium sulfate/potassium sulfate/magnesium sulfate increases effects of amoxapine by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of seizures when using higher dose of magnesium sulfate together with drugs that lower the seizure threshold.

              • amphotericin B cholesteryl sulfate

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of amphotericin B cholesteryl sulfate by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • amphotericin B deoxycholate

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of amphotericin B deoxycholate by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • amphotericin B liposomal

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of amphotericin B liposomal by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • amphotericin B phospholipid complex

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of amphotericin B phospholipid complex by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • anagrelide

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of anagrelide by QTc interval. Use Caution/Monitor. Consider predose and post-colonoscopy ECGs in patients at increased risk of serious cardiac arrhythmias.

              • aripiprazole

                sodium sulfate/potassium sulfate/magnesium sulfate increases effects of aripiprazole by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of enhanced CNS depression when using higher dose of magnesium sulfate together with a CNS depressant.

              • arsenic trioxide

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of arsenic trioxide by QTc interval. Use Caution/Monitor. Consider predose and post-colonoscopy ECGs in patients at increased risk of serious cardiac arrhythmias.

              • asenapine

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of asenapine by QTc interval. Use Caution/Monitor. Consider predose and post-colonoscopy ECGs in patients at increased risk of serious cardiac arrhythmias.

                sodium sulfate/potassium sulfate/magnesium sulfate increases effects of asenapine by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of enhanced CNS depression when using higher dose of magnesium sulfate together with a CNS depressant.

              • asenapine transdermal

                sodium sulfate/potassium sulfate/magnesium sulfate increases effects of asenapine transdermal by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of enhanced CNS depression when using higher dose of magnesium sulfate together with a CNS depressant.

              • aspirin

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of aspirin by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • aspirin rectal

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of aspirin rectal by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • aspirin/citric acid/sodium bicarbonate

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of aspirin/citric acid/sodium bicarbonate by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • atracurium

                sodium sulfate/potassium sulfate/magnesium sulfate increases effects of atracurium by Other (see comment). Use Caution/Monitor. Comment: Magnesium may potentiate the effects of the neuromuscular blocking agents.

              • azilsartan

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of azilsartan by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • benazepril

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of benazepril by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • betamethasone

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of betamethasone by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • bictegravir

                sodium sulfate/potassium sulfate/magnesium sulfate decreases levels of bictegravir by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Bictegravir sodium/emtricitabine/tenofovir alafenamide fumarate can be takenat least 2 hr before or 6 hr after taking a medication containing magnesium.

              • bumetanide

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of bumetanide by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • buprenorphine

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of buprenorphine by QTc interval. Use Caution/Monitor. Consider predose and post-colonoscopy ECGs in patients at increased risk of serious cardiac arrhythmias.

              • calcitriol

                calcitriol increases levels of sodium sulfate/potassium sulfate/magnesium sulfate by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely.

              • calcium acetate

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of calcium acetate by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • calcium carbonate

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of calcium carbonate by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • calcium chloride

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of calcium chloride by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • calcium citrate

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of calcium citrate by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • calcium gluconate

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of calcium gluconate by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • calcium/vitamin D

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of calcium/vitamin D by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • candesartan

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of candesartan by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • captopril

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of captopril by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • carbonyl iron

                sodium sulfate/potassium sulfate/magnesium sulfate decreases levels of carbonyl iron by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Administer iron products at least 2 hr before and no less than 6 hr after each dose to avoid chelation with magnesium. .

              • carboplatin

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of carboplatin by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • cariprazine

                sodium sulfate/potassium sulfate/magnesium sulfate increases effects of cariprazine by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of enhanced CNS depression when using higher dose of magnesium sulfate together with a CNS depressant.

              • celecoxib

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of celecoxib by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • chlorothiazide

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of chlorothiazide by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • chlorpromazine

                sodium sulfate/potassium sulfate/magnesium sulfate decreases levels of chlorpromazine by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Administer chlorpromazine at least 2 hr before and no less than 6 hr after each dose to avoid chelation with magnesium. .

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of chlorpromazine by QTc interval. Use Caution/Monitor. Consider predose and post-colonoscopy ECGs in patients at increased risk of serious cardiac arrhythmias. .

              • chlorthalidone

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of chlorthalidone by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • choline magnesium trisalicylate

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of choline magnesium trisalicylate by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • ciprofloxacin

                sodium sulfate/potassium sulfate/magnesium sulfate decreases levels of ciprofloxacin by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Administer fluoroquinolones at least 2 hr before and no less than 6 hr after each dose to avoid chelation with magnesium. .

              • cisatracurium

                sodium sulfate/potassium sulfate/magnesium sulfate increases effects of cisatracurium by Other (see comment). Use Caution/Monitor. Comment: Magnesium may potentiate the effects of the neuromuscular blocking agents.

              • cisplatin

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of cisplatin by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • citalopram

                sodium sulfate/potassium sulfate/magnesium sulfate increases effects of citalopram by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of seizures when using bowel preps together with drugs that lower the seizure threshold.

              • clevidipine

                clevidipine, sodium sulfate/potassium sulfate/magnesium sulfate. Either increases effects of the other by unknown mechanism. Use Caution/Monitor. Monitor for hypotension or muscle weakness in patients receiving calcium channel blockers with elevated serum magnesium concentrations.

              • clofazimine

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of clofazimine by QTc interval. Use Caution/Monitor. Consider predose and post-colonoscopy ECGs in patients at increased risk of serious cardiac arrhythmias. .

              • clomipramine

                sodium sulfate/potassium sulfate/magnesium sulfate increases effects of clomipramine by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of seizures when using higher dose of magnesium sulfate together with drugs that lower the seizure threshold.

              • clozapine

                sodium sulfate/potassium sulfate/magnesium sulfate increases effects of clozapine by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of enhanced CNS depression when using higher dose of magnesium sulfate together with a CNS depressant.

              • corticotropin

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of corticotropin by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • cortisone

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of cortisone by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • cyclophosphamide

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of cyclophosphamide by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • daxibotulinumtoxinA

                sodium sulfate/potassium sulfate/magnesium sulfate increases effects of daxibotulinumtoxinA by Other (see comment). Use Caution/Monitor. Comment: Magnesium may potentiate the effects of the neuromuscular blocking agents.

              • deferiprone

                sodium sulfate/potassium sulfate/magnesium sulfate decreases levels of deferiprone by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Administer deferiprone at least 2 hr before and after each dose to avoid chelation with magnesium. .

              • deflazacort

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of deflazacort by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • delafloxacin

                sodium sulfate/potassium sulfate/magnesium sulfate decreases levels of delafloxacin by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Administer fluoroquinolones at least 2 hr before and no less than 6 hr after each dose to avoid chelation with magnesium. .

              • desipramine

                sodium sulfate/potassium sulfate/magnesium sulfate increases effects of desipramine by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of seizures when using higher dose of magnesium sulfate together with drugs that lower the seizure threshold.

              • dexamethasone

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of dexamethasone by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • diclofenac

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of diclofenac by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • diflunisal

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of diflunisal by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • digoxin

                sodium sulfate/potassium sulfate/magnesium sulfate decreases levels of digoxin by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Administer digoxin at least 2 hr before and no less than 6 hr after each dose to avoid chelation with magnesium. .

              • diltiazem

                diltiazem, sodium sulfate/potassium sulfate/magnesium sulfate. Either decreases toxicity of the other by unknown mechanism. Use Caution/Monitor. Monitor for hypotension or muscle weakness in patients receiving calcium channel blockers with elevated serum magnesium concentrations.

              • disopyramide

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of disopyramide by QTc interval. Use Caution/Monitor. Consider predose and post-colonoscopy ECGs in patients at increased risk of serious cardiac arrhythmias. .

              • dofetilide

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of dofetilide by QTc interval. Use Caution/Monitor. Consider predose and post-colonoscopy ECGs in patients at increased risk of serious cardiac arrhythmias. .

              • dolutegravir

                sodium sulfate/potassium sulfate/magnesium sulfate decreases levels of dolutegravir by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Administer dolutegravir at least 2 hr before or 6 hr after each dose to avoid chelation with magnesium. .

              • doxepin

                sodium sulfate/potassium sulfate/magnesium sulfate increases effects of doxepin by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of seizures when using higher dose of magnesium sulfate together with drugs that lower the seizure threshold.

              • doxercalciferol

                doxercalciferol increases levels of sodium sulfate/potassium sulfate/magnesium sulfate by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Doxercalciferol may enhance the hypermagnesemic effect of magnesium salts. .

              • dronedarone

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of dronedarone by QTc interval. Use Caution/Monitor. Consider predose and post-colonoscopy ECGs in patients at increased risk of serious cardiac arrhythmias. .

              • droperidol

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of droperidol by QTc interval. Use Caution/Monitor. Consider predose and post-colonoscopy ECGs in patients at increased risk of serious cardiac arrhythmias. .

              • eliglustat

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of eliglustat by QTc interval. Use Caution/Monitor. Consider predose and post-colonoscopy ECGs in patients at increased risk of serious cardiac arrhythmias. .

              • enalapril

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of enalapril by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • eprosartan

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of eprosartan by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • escitalopram

                sodium sulfate/potassium sulfate/magnesium sulfate increases effects of escitalopram by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of seizures when using bowel preps together with drugs that lower the seizure threshold.

              • ethacrynic acid

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of ethacrynic acid by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • ethanol

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of ethanol by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • etidronate

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of etidronate by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • etodolac

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of etodolac by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • fenoprofen

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of fenoprofen by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • ferric carboxymaltose

                sodium sulfate/potassium sulfate/magnesium sulfate decreases levels of ferric carboxymaltose by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Administer iron products at least 2 hr before and no less than 6 hr after each dose to avoid chelation with magnesium. .

              • ferric citrate

                sodium sulfate/potassium sulfate/magnesium sulfate decreases levels of ferric citrate by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Administer iron products at least 2 hr before and no less than 6 hr after each dose to avoid chelation with magnesium. .

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of ferric citrate by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • ferric derisomaltose

                sodium sulfate/potassium sulfate/magnesium sulfate decreases levels of ferric derisomaltose by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Administer iron products at least 2 hr before and no less than 6 hr after each dose to avoid chelation with magnesium. .

              • ferric gluconate

                sodium sulfate/potassium sulfate/magnesium sulfate decreases levels of ferric gluconate by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Administer iron products at least 2 hr before and no less than 6 hr after each dose to avoid chelation with magnesium. .

              • ferric maltol

                sodium sulfate/potassium sulfate/magnesium sulfate decreases levels of ferric maltol by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Administer iron products at least 2 hr before and no less than 6 hr after each dose to avoid chelation with magnesium. .

              • ferric pyrophosphate DIALYSATE

                sodium sulfate/potassium sulfate/magnesium sulfate decreases levels of ferric pyrophosphate DIALYSATE by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Administer iron products at least 2 hr before and no less than 6 hr after each dose to avoid chelation with magnesium. .

              • ferric pyrophosphate IV

                sodium sulfate/potassium sulfate/magnesium sulfate decreases levels of ferric pyrophosphate IV by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Administer iron products at least 2 hr before and no less than 6 hr after each dose to avoid chelation with magnesium. .

              • ferrous fumarate

                sodium sulfate/potassium sulfate/magnesium sulfate decreases levels of ferrous fumarate by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Administer iron products at least 2 hr before and no less than 6 hr after each dose to avoid chelation with magnesium. .

              • ferrous gluconate

                sodium sulfate/potassium sulfate/magnesium sulfate decreases levels of ferrous gluconate by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Administer iron products at least 2 hr before and no less than 6 hr after each dose to avoid chelation with magnesium. .

              • ferrous sulfate

                sodium sulfate/potassium sulfate/magnesium sulfate decreases levels of ferrous sulfate by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Administer iron products at least 2 hr before and no less than 6 hr after each dose to avoid chelation with magnesium. .

              • ferumoxytol

                sodium sulfate/potassium sulfate/magnesium sulfate decreases levels of ferumoxytol by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Administer iron products at least 2 hr before and no less than 6 hr after each dose to avoid chelation with magnesium. .

              • fludrocortisone

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of fludrocortisone by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • fluoxetine

                sodium sulfate/potassium sulfate/magnesium sulfate increases effects of fluoxetine by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of seizures when using bowel preps together with drugs that lower the seizure threshold.

              • fluphenazine

                sodium sulfate/potassium sulfate/magnesium sulfate increases effects of fluphenazine by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of enhanced CNS depression when using higher dose of magnesium sulfate together with a CNS depressant.

              • flurbiprofen

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of flurbiprofen by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • fluvoxamine

                sodium sulfate/potassium sulfate/magnesium sulfate increases effects of fluvoxamine by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of seizures when using bowel preps together with drugs that lower the seizure threshold.

              • foscarnet

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of foscarnet by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • fosinopril

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of fosinopril by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • fosphenytoin

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of fosphenytoin by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • furosemide

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of furosemide by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • gabapentin

                sodium sulfate/potassium sulfate/magnesium sulfate decreases levels of gabapentin by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Administer gabapentin at least 2 hr after each dose to avoid chelation with magnesium. .

              • gemifloxacin

                sodium sulfate/potassium sulfate/magnesium sulfate decreases levels of gemifloxacin by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Administer fluoroquinolones at least 2 hr before and no less than 6 hr after each dose to avoid chelation with magnesium. .

              • gentamicin

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of gentamicin by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • glasdegib

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of glasdegib by QTc interval. Use Caution/Monitor. Consider predose and post-colonoscopy ECGs in patients at increased risk of serious cardiac arrhythmias. .

              • haloperidol

                sodium sulfate/potassium sulfate/magnesium sulfate increases effects of haloperidol by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of enhanced CNS depression when using higher dose of magnesium sulfate together with a CNS depressant.

              • hydrochlorothiazide

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of hydrochlorothiazide by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • hydrocortisone

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of hydrocortisone by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • hydroxychloroquine sulfate

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of hydroxychloroquine sulfate by QTc interval. Use Caution/Monitor. Consider predose and post-colonoscopy ECGs in patients at increased risk of serious cardiac arrhythmias. .

              • ibandronate

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of ibandronate by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • ibuprofen

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of ibuprofen by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • ibuprofen IV

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of ibuprofen IV by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • ibuprofen/famotidine

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of ibuprofen/famotidine by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • ibutilide

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of ibutilide by QTc interval. Use Caution/Monitor. Consider predose and post-colonoscopy ECGs in patients at increased risk of serious cardiac arrhythmias. .

              • ifosfamide

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of ifosfamide by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • iloperidone

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of iloperidone by QTc interval. Use Caution/Monitor. Consider predose and post-colonoscopy ECGs in patients at increased risk of serious cardiac arrhythmias. .

                sodium sulfate/potassium sulfate/magnesium sulfate increases effects of iloperidone by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of enhanced CNS depression when using higher dose of magnesium sulfate together with a CNS depressant.

              • imipramine

                sodium sulfate/potassium sulfate/magnesium sulfate increases effects of imipramine by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of seizures when using higher dose of magnesium sulfate together with drugs that lower the seizure threshold.

              • incobotulinumtoxinA

                sodium sulfate/potassium sulfate/magnesium sulfate increases effects of incobotulinumtoxinA by Other (see comment). Use Caution/Monitor. Comment: Magnesium may potentiate the effects of the neuromuscular blocking agents.

              • indomethacin

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of indomethacin by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • insulin aspart

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of insulin aspart by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • insulin aspart protamine/insulin aspart

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of insulin aspart protamine/insulin aspart by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • insulin degludec

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of insulin degludec by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • insulin detemir

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of insulin detemir by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • insulin glargine

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of insulin glargine by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • insulin glulisine

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of insulin glulisine by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • insulin inhaled

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of insulin inhaled by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • insulin isophane human/insulin regular human

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of insulin isophane human/insulin regular human by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • insulin lispro

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of insulin lispro by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • insulin lispro protamine/insulin lispro

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of insulin lispro protamine/insulin lispro by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • insulin NPH

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of insulin NPH by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • insulin regular human

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of insulin regular human by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • irbesartan

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of irbesartan by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • iron dextran complex

                sodium sulfate/potassium sulfate/magnesium sulfate decreases levels of iron dextran complex by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Administer iron products at least 2 hr before and no less than 6 hr after each dose to avoid chelation with magnesium. .

              • iron sucrose

                sodium sulfate/potassium sulfate/magnesium sulfate decreases levels of iron sucrose by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Administer iron products at least 2 hr before and no less than 6 hr after each dose to avoid chelation with magnesium. .

              • isoniazid

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of isoniazid by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • isradipine

                isradipine, sodium sulfate/potassium sulfate/magnesium sulfate. Either increases effects of the other by unknown mechanism. Use Caution/Monitor. Monitor for hypotension or muscle weakness in patients receiving calcium channel blockers with elevated serum magnesium concentrations.

              • ivosidenib

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of ivosidenib by QTc interval. Use Caution/Monitor. Consider predose and post-colonoscopy ECGs in patients at increased risk of serious cardiac arrhythmias. .

              • kanamycin

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of kanamycin by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • ketoconazole

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of ketoconazole by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • ketoprofen

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of ketoprofen by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • ketorolac

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of ketorolac by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • ketorolac intranasal

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of ketorolac intranasal by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • lanthanum carbonate

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of lanthanum carbonate by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • lefamulin

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of lefamulin by QTc interval. Use Caution/Monitor. Consider predose and post-colonoscopy ECGs in patients at increased risk of serious cardiac arrhythmias. .

              • lenvatinib

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of lenvatinib by QTc interval. Use Caution/Monitor. Consider predose and post-colonoscopy ECGs in patients at increased risk of serious cardiac arrhythmias. .

              • levamlodipine

                levamlodipine, sodium sulfate/potassium sulfate/magnesium sulfate. Either increases effects of the other by unknown mechanism. Use Caution/Monitor. Monitor for hypotension or muscle weakness in patients receiving calcium channel blockers with elevated serum magnesium concentrations.

              • levofloxacin

                sodium sulfate/potassium sulfate/magnesium sulfate decreases levels of levofloxacin by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Administer fluoroquinolones at least 2 hr before and no less than 6 hr after each dose to avoid chelation with magnesium. .

              • levothyroxine

                sodium sulfate/potassium sulfate/magnesium sulfate decreases levels of levothyroxine by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Administer levothyroxine at least 4 hr after each dose to avoid chelation with magnesium. .

              • lisinopril

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of lisinopril by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • lopinavir

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of lopinavir by QTc interval. Use Caution/Monitor. Consider predose and post-colonoscopy ECGs in patients at increased risk of serious cardiac arrhythmias. .

              • losartan

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of losartan by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • loxapine

                sodium sulfate/potassium sulfate/magnesium sulfate increases effects of loxapine by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of enhanced CNS depression when using higher dose of magnesium sulfate together with a CNS depressant.

              • loxapine inhaled

                sodium sulfate/potassium sulfate/magnesium sulfate increases effects of loxapine inhaled by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of enhanced CNS depression when using higher dose of magnesium sulfate together with a CNS depressant.

              • lurasidone

                sodium sulfate/potassium sulfate/magnesium sulfate increases effects of lurasidone by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of enhanced CNS depression when using higher dose of magnesium sulfate together with a CNS depressant.

              • macimorelin

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of macimorelin by QTc interval. Use Caution/Monitor. Consider predose and post-colonoscopy ECGs in patients at increased risk of serious cardiac arrhythmias. .

              • magaldrate

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of magaldrate by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • magnesium oxide

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of magnesium oxide by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • mannitol

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of mannitol by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • meclofenamate

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of meclofenamate by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • mefenamic acid

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of mefenamic acid by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • meloxicam

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of meloxicam by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • methadone

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of methadone by QTc interval. Use Caution/Monitor. Consider predose and post-colonoscopy ECGs in patients at increased risk of serious cardiac arrhythmias. .

              • methyclothiazide

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of methyclothiazide by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • methylprednisolone

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of methylprednisolone by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • moexipril

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of moexipril by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • molindone

                sodium sulfate/potassium sulfate/magnesium sulfate increases effects of molindone by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of enhanced CNS depression when using higher dose of magnesium sulfate together with a CNS depressant.

              • mometasone sinus implant

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of mometasone sinus implant by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • moxifloxacin

                sodium sulfate/potassium sulfate/magnesium sulfate decreases levels of moxifloxacin by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Administer fluoroquinolones at least 2 hr before and no less than 6 hr after each dose to avoid chelation with magnesium. .

              • nabumetone

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of nabumetone by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • naproxen

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of naproxen by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • neomycin PO

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of neomycin PO by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • nicardipine

                nicardipine, sodium sulfate/potassium sulfate/magnesium sulfate. Either increases effects of the other by unknown mechanism. Use Caution/Monitor. Monitor for hypotension or muscle weakness in patients receiving calcium channel blockers with elevated serum magnesium concentrations.

              • nifedipine

                nifedipine, sodium sulfate/potassium sulfate/magnesium sulfate. Either increases effects of the other by unknown mechanism. Use Caution/Monitor. Monitor for hypotension or muscle weakness in patients receiving calcium channel blockers with elevated serum magnesium concentrations.

              • nilotinib

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of nilotinib by QTc interval. Use Caution/Monitor. Consider predose and post-colonoscopy ECGs in patients at increased risk of serious cardiac arrhythmias. .

              • nimodipine

                nimodipine, sodium sulfate/potassium sulfate/magnesium sulfate. Either increases effects of the other by unknown mechanism. Use Caution/Monitor. Monitor for hypotension or muscle weakness in patients receiving calcium channel blockers with elevated serum magnesium concentrations.

              • nisoldipine

                nisoldipine, sodium sulfate/potassium sulfate/magnesium sulfate. Either increases effects of the other by unknown mechanism. Use Caution/Monitor. Monitor for hypotension or muscle weakness in patients receiving calcium channel blockers with elevated serum magnesium concentrations.

              • norfloxacin

                sodium sulfate/potassium sulfate/magnesium sulfate decreases levels of norfloxacin by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Administer fluoroquinolones at least 2 hr before and no less than 6 hr after each dose to avoid chelation with magnesium. .

              • nortriptyline

                sodium sulfate/potassium sulfate/magnesium sulfate increases effects of nortriptyline by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of seizures when using higher dose of magnesium sulfate together with drugs that lower the seizure threshold.

              • ofloxacin

                sodium sulfate/potassium sulfate/magnesium sulfate decreases levels of ofloxacin by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Administer fluoroquinolones at least 2 hr before and no less than 6 hr after each dose to avoid chelation with magnesium. .

              • olanzapine

                sodium sulfate/potassium sulfate/magnesium sulfate increases effects of olanzapine by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of enhanced CNS depression when using higher dose of magnesium sulfate together with a CNS depressant.

              • olmesartan

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of olmesartan by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • onabotulinumtoxinA

                sodium sulfate/potassium sulfate/magnesium sulfate increases effects of onabotulinumtoxinA by Other (see comment). Use Caution/Monitor. Comment: Magnesium may potentiate the effects of the neuromuscular blocking agents.

              • oxaprozin

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of oxaprozin by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • paliperidone

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of paliperidone by QTc interval. Use Caution/Monitor. Consider predose and post-colonoscopy ECGs in patients at increased risk of serious cardiac arrhythmias. .

                sodium sulfate/potassium sulfate/magnesium sulfate increases effects of paliperidone by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of enhanced CNS depression when using higher dose of magnesium sulfate together with a CNS depressant.

              • pancuronium

                sodium sulfate/potassium sulfate/magnesium sulfate increases effects of pancuronium by Other (see comment). Use Caution/Monitor. Comment: Magnesium may potentiate the effects of the neuromuscular blocking agents.

              • panobinostat

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of panobinostat by QTc interval. Use Caution/Monitor. Consider predose and post-colonoscopy ECGs in patients at increased risk of serious cardiac arrhythmias. .

              • paroxetine

                sodium sulfate/potassium sulfate/magnesium sulfate increases effects of paroxetine by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of seizures when using bowel preps together with drugs that lower the seizure threshold.

              • penicillamine

                sodium sulfate/potassium sulfate/magnesium sulfate decreases levels of penicillamine by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Administer penicillamine at least 2 hr before and no less than 6 hr after each dose to avoid chelation with magnesium. .

              • perindopril

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of perindopril by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • perphenazine

                sodium sulfate/potassium sulfate/magnesium sulfate increases effects of perphenazine by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of enhanced CNS depression when using higher dose of magnesium sulfate together with a CNS depressant.

              • phenytoin

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of phenytoin by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • pimavanserin

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of pimavanserin by QTc interval. Use Caution/Monitor. Consider predose and post-colonoscopy ECGs in patients at increased risk of serious cardiac arrhythmias. .

                sodium sulfate/potassium sulfate/magnesium sulfate increases effects of pimavanserin by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of enhanced CNS depression when using higher dose of magnesium sulfate together with a CNS depressant.

              • pimozide

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of pimozide by QTc interval. Use Caution/Monitor. Consider predose and post-colonoscopy ECGs in patients at increased risk of serious cardiac arrhythmias. .

                sodium sulfate/potassium sulfate/magnesium sulfate increases effects of pimozide by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of enhanced CNS depression when using higher dose of magnesium sulfate together with a CNS depressant.

              • piroxicam

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of piroxicam by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • pitolisant

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of pitolisant by QTc interval. Use Caution/Monitor. Consider predose and post-colonoscopy ECGs in patients at increased risk of serious cardiac arrhythmias. .

              • plazomicin

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of plazomicin by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • polysaccharide iron

                sodium sulfate/potassium sulfate/magnesium sulfate decreases levels of polysaccharide iron by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Administer iron products at least 2 hr before and no less than 6 hr after each dose to avoid chelation with magnesium. .

              • prabotulinumtoxinA

                sodium sulfate/potassium sulfate/magnesium sulfate increases effects of prabotulinumtoxinA by Other (see comment). Use Caution/Monitor. Comment: Magnesium may potentiate the effects of the neuromuscular blocking agents.

              • prednisolone

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of prednisolone by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • prednisone

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of prednisone by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • primidone

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of primidone by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • procainamide

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of procainamide by QTc interval. Use Caution/Monitor. Consider predose and post-colonoscopy ECGs in patients at increased risk of serious cardiac arrhythmias. .

              • protriptyline

                sodium sulfate/potassium sulfate/magnesium sulfate increases effects of protriptyline by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of seizures when using higher dose of magnesium sulfate together with drugs that lower the seizure threshold.

              • quetiapine

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of quetiapine by QTc interval. Use Caution/Monitor. Consider predose and post-colonoscopy ECGs in patients at increased risk of serious cardiac arrhythmias. .

                sodium sulfate/potassium sulfate/magnesium sulfate increases effects of quetiapine by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of enhanced CNS depression when using higher dose of magnesium sulfate together with a CNS depressant.

              • quinapril

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of quinapril by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • quinidine

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of quinidine by QTc interval. Use Caution/Monitor. Consider predose and post-colonoscopy ECGs in patients at increased risk of serious cardiac arrhythmias. .

              • quinine

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of quinine by QTc interval. Use Caution/Monitor. Consider predose and post-colonoscopy ECGs in patients at increased risk of serious cardiac arrhythmias. .

              • ramipril

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of ramipril by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • ribociclib

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of ribociclib by QTc interval. Use Caution/Monitor. Consider predose and post-colonoscopy ECGs in patients at increased risk of serious cardiac arrhythmias. .

              • rifampin

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of rifampin by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • rimabotulinumtoxinB

                sodium sulfate/potassium sulfate/magnesium sulfate increases effects of rimabotulinumtoxinB by Other (see comment). Use Caution/Monitor. Comment: Magnesium may potentiate the effects of the neuromuscular blocking agents.

              • risedronate

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of risedronate by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • risperidone

                sodium sulfate/potassium sulfate/magnesium sulfate increases effects of risperidone by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of enhanced CNS depression when using higher dose of magnesium sulfate together with a CNS depressant.

              • rocuronium

                sodium sulfate/potassium sulfate/magnesium sulfate increases effects of rocuronium by Other (see comment). Use Caution/Monitor. Comment: Magnesium may potentiate the effects of the neuromuscular blocking agents.

              • sacubitril/valsartan

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of sacubitril/valsartan by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • salsalate

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of salsalate by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • samidorphan

                sodium sulfate/potassium sulfate/magnesium sulfate increases effects of samidorphan by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of enhanced CNS depression when using higher dose of magnesium sulfate together with a CNS depressant.

              • sertraline

                sodium sulfate/potassium sulfate/magnesium sulfate increases effects of sertraline by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of seizures when using bowel preps together with drugs that lower the seizure threshold.

              • sevelamer

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of sevelamer by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • sodium polystyrene sulfonate

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of sodium polystyrene sulfonate by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • sotalol

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of sotalol by QTc interval. Use Caution/Monitor. Consider predose and post-colonoscopy ECGs in patients at increased risk of serious cardiac arrhythmias. .

              • streptomycin

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of streptomycin by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • succinylcholine

                sodium sulfate/potassium sulfate/magnesium sulfate increases effects of succinylcholine by Other (see comment). Use Caution/Monitor. Comment: Magnesium may potentiate the effects of the neuromuscular blocking agents.

              • sucralfate

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of sucralfate by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • sucroferric oxyhydroxide

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of sucroferric oxyhydroxide by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • sulindac

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of sulindac by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • telmisartan

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of telmisartan by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • tetrabenazine

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of tetrabenazine by QTc interval. Use Caution/Monitor. Consider predose and post-colonoscopy ECGs in patients at increased risk of serious cardiac arrhythmias. .

              • thioridazine

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of thioridazine by QTc interval. Use Caution/Monitor. Consider predose and post-colonoscopy ECGs in patients at increased risk of serious cardiac arrhythmias. .

              • thiothixene

                sodium sulfate/potassium sulfate/magnesium sulfate increases effects of thiothixene by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of enhanced CNS depression when using higher dose of magnesium sulfate together with a CNS depressant.

              • tiludronate

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of tiludronate by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • tobramycin

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of tobramycin by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • tobramycin inhaled

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of tobramycin inhaled by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • tolmetin

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of tolmetin by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • toremifene

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of toremifene by QTc interval. Use Caution/Monitor. Consider predose and post-colonoscopy ECGs in patients at increased risk of serious cardiac arrhythmias. .

              • torsemide

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of torsemide by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • trandolapril

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of trandolapril by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • triamcinolone acetonide extended-release injectable suspension

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of triamcinolone acetonide extended-release injectable suspension by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • triamcinolone acetonide injectable suspension

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of triamcinolone acetonide injectable suspension by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • trientine

                sodium sulfate/potassium sulfate/magnesium sulfate decreases levels of trientine by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Administer trientine at least 1 hr before and after each dose to avoid chelation with magnesium. .

              • trifluoperazine

                sodium sulfate/potassium sulfate/magnesium sulfate increases effects of trifluoperazine by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of enhanced CNS depression when using higher dose of magnesium sulfate together with a CNS depressant.

              • trimipramine

                sodium sulfate/potassium sulfate/magnesium sulfate increases effects of trimipramine by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of seizures when using higher dose of magnesium sulfate together with drugs that lower the seizure threshold.

              • valsartan

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of valsartan by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • vandetanib

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of vandetanib by QTc interval. Use Caution/Monitor. Consider predose and post-colonoscopy ECGs in patients at increased risk of serious cardiac arrhythmias. .

              • vardenafil

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of vardenafil by QTc interval. Use Caution/Monitor. Consider predose and post-colonoscopy ECGs in patients at increased risk of serious cardiac arrhythmias. .

              • vecuronium

                sodium sulfate/potassium sulfate/magnesium sulfate increases effects of vecuronium by Other (see comment). Use Caution/Monitor. Comment: Magnesium may potentiate the effects of the neuromuscular blocking agents.

              • verapamil

                verapamil, sodium sulfate/potassium sulfate/magnesium sulfate. Either decreases toxicity of the other by unknown mechanism. Use Caution/Monitor. Monitor for hypotension or muscle weakness in patients receiving calcium channel blockers with elevated serum magnesium concentrations.

              • ziprasidone

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of ziprasidone by QTc interval. Use Caution/Monitor. Consider predose and post-colonoscopy ECGs in patients at increased risk of serious cardiac arrhythmias. .

                sodium sulfate/potassium sulfate/magnesium sulfate increases effects of ziprasidone by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of enhanced CNS depression when using higher dose of magnesium sulfate together with a CNS depressant.

              • zoledronic acid

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of zoledronic acid by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              Minor (0)

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                Adverse Effects

                >10%

                Adults

                • Discomfort (54%)
                • Abdominal distension (40%)
                • Abdominal pain (36%)
                • Nausea (36%)
                • Decreased bicarbonate (13%)
                • Hyperuricemia (23.5%)
                • Metabolic acidosis (12.7%)
                • Hypercalcemia (10.4%)

                Aged 12-16 years

                • Nausea
                • Abdominal pain
                • Abdominal bloating
                • Vomiting

                1-10% (Adults)

                Elevated anion gap (8.9%)

                Hyperbilirubinemia (8.5%)

                Vomiting (8%)

                Hyperosmolality (5.8%)

                Hyponatremia (3.1%)

                Hyperchloremia (2.4%)

                Elevated serum creatinine (1.9%)

                Hyperkalemia (1.8%)

                Elevated BUN (1.6%)

                Headache (1.1%)

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                Warnings

                Contraindications

                Hypersensitivity

                Gastrointestinal obstruction or ileus

                Bowel perforation

                Gastric retention

                Toxic colitis or toxic megacolon

                Cautions

                Caution with increased incidence of elevated serum electrolytes, serum creatinine, and BUN

                Caution in patients with renal impairment or patients taking concomitant medications that may affect renal function; patients may be at risk for renal injury; advise patients of importance of adequate hydration before, during and after use of product and consider performing baseline and post-colonoscopy laboratory tests

                Seizures: Reports of generalized tonic-clinic seizures with use of bowel preparations products; associated with electrolyte abnormalities (eg, hyponatremia, hypokalemia, hypocalcemia, hypomagnesemia); caution in patients at risk of seizures (alcohol withdrawal, drugs lowering seizure threshold, suspected/known hyponatremia)

                Cardiac arrhythmias: Rare reports of serious arrhythmias associated with ionic osmotic laxative products

                Osmotic laxative products may produce colonic mucosal aphthous ulcerations; reports of serious cases of ischemic colitis requiring hospitalization; coadministration with stimulant laxatives may increase risk

                If GI obstruction or perforation suspected, perform appropriate diagnostic studies to rule out these conditions before administering; caution with severe active ulcerative colitis

                Patients with impaired gag reflex or other swallowing abnormalities are at risk for regurgitation or aspiration of bowel prep solution

                Fluid and serum chemistry abnormalities

                • Advise patients to hydrate adequately before, during, and after use
                • Correct fluid and electrolyte abnormalities before treatment to avoid serious adverse effects (eg, arrhythmias, seizures, renal impairment)
                • Caution in patients with conditions or medications that increase risk for fluid and electrolyte disturbances or may increase the risk of adverse events of seizure, arrhythmias, and renal impairment
                • If significant vomiting or signs of dehydration develops consider performing post-colonoscopy laboratory tests (eg, electrolytes, creatinine, BUN)
                • Can cause temporary elevations in uric acid; monitor patients with gout for acute flare

                Drug interaction overview

                • Oral medication administered within 1 hr before bowel prep may not be absorbed properly
                • Caution if coadministration with drugs that increase risk of fluid and electrolyte disturbances or may increase risk of seizure, arrhythmias, or prolonged QT
                • Avoid coadministration with stimulant laxatives owing to increased risk of mucosal ulceration or ischemic colitis
                • Caution if coadministered with medications that may affect renal function (eg, diuretics, ACE inhibitors, ARBs, NSAIDs)
                • Chelation with magnesium
                  • Take tetracycline or fluoroquinolone antibiotics, iron, digoxin, chlorpromazine, or penicillamine at least 2 hr before and not less than 6 hr after administration of bowel prep to avoid chelation
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                Pregnancy & Lactation

                Pregnancy

                Data are unavailable data on use in pregnant women to evaluate for a drug-associated risk of major birth defects, miscarriage, or adverse maternal or fetal outcomes

                Animal reproductive studies have not been conducted

                Lactation

                There are no data available on presence of drug combination in human or animal milk, effects on breastfed child, or on milk production; developmental and health benefits of breastfeeding should be considered along with mother’s clinical need for prep kit and any potential adverse effects on breastfed child from product or from underlying maternal condition

                Pregnancy Categories

                A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

                B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

                C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

                D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

                X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

                NA: Information not available.

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                Pharmacology

                Mechanism of Action

                Osmotic laxative; sulfate salts provide sulfate anions and associated cations causing water retention within bowel; osmotic effect of unabsorbed ions and large volume of water ingested produces copious watery diarrhea

                Pharmacokinetics

                Half-Life: 8.5 hr

                Peak Plasma Time (serum sulfate): 17 hr (1st dose); 5 hr (2nd dose); renal impairment increases Tmax by 44% and AUC by 54%

                Excretion (sulfate): predominantly in feces

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                Administration

                Oral Preparation

                Correct fluid and electrolyte abnormalities before treatment

                Dilute bowel prep kit in water before ingestion

                Consume additional water after each dose of bowel prep

                On day before colonoscopy, consume only a light breakfast or clear liquids (eg, water, strained fruit juice without pulp, lemonade, plain coffee or tea, chicken broth, gelatin dessert without fruit)

                On day of colonoscopy only consume clear liquids up to 2 hours before colonoscopy Do not eat solid food, drink milk, or eat or drink anything colored red or purple

                Do not drink alcohol

                Do not take other laxatives while taking bowel prep

                Do not take oral medications within 1 hr of starting each dose of bowel prep

                Stop consumption of all fluids at least 2 hr before colonoscopy

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                Images

                BRAND FORM. UNIT PRICE PILL IMAGE
                Suprep Bowel Prep Kit oral
                -
                17.5-3.13-1.6 gram solution

                Copyright © 2010 First DataBank, Inc.

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                Patient Handout

                Patient Education
                sodium, potassium, and magnesium sulfates oral

                SODIUM/POTASSIUM/MAGNESIUM SULFATE SOLUTION - ORAL

                (SOE-dee-um/poh-TASS-ee-um/mag-NEE-zee-um/SUL-fate)

                COMMON BRAND NAME(S): Suprep

                USES: Sodium/potassium/magnesium sulfate solution is used to clean out the intestines before a certain bowel exam procedure (colonoscopy). It is a laxative that works by drawing large amounts of water into the colon. This causes watery bowel movements. Clearing stool from the intestines helps your doctor to better examine the intestines during your procedure.

                HOW TO USE: Read the Medication Guide and Instructions for Use provided by your pharmacist before you start using this product and each time you get a refill. If you have any questions, ask your doctor or pharmacist.Follow any special diet instructions provided by your doctor. Usually, you may have a small breakfast or only clear liquids on the day before your procedure. After breakfast, you may only drink clear liquids until after your procedure. Do not drink milk or alcoholic beverages or eat/drink anything colored red or purple. To prevent becoming dehydrated, drink as much clear liquid as you can before, during, and after drinking this medication unless otherwise directed by your doctor.Do not take any other medications by mouth within 1 hour of starting to drink the mixture. Ask your doctor or pharmacist if you are not sure when to take your other medications.Use this product as directed by your doctor, usually one dose the evening before the colonoscopy and the second dose the next day in the morning. The dosage is based on your age and medical condition.Before using this product, pour the contents into the mixing container as directed by the manufacturer. Add cool water, mix, and drink all of the mixture. After drinking the mixture, drink 2 additional containers filled with water over the next hour. Be sure to finish drinking all of the mixture and required water at least 2 hours before your procedure, or as directed.Ask your doctor or pharmacist if you have any questions about how to mix or take this product or what to expect after taking this product.Watery bowel movements usually begin about 1 hour after you drink the mixed liquid. The bowel movements can be very large and watery.

                SIDE EFFECTS: Very watery bowel movements are expected with this medication. Nausea, vomiting, bloating, or stomach/abdominal cramping may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.This medication can cause your body to lose too much fluid and salts (dehydration, electrolyte problems). Tell your doctor right away if you have any of these serious side effects: severe dizziness, fainting, fast/irregular heartbeat, trouble keeping liquids down, prolonged vomiting, headache, seizure.Tell your doctor right away if you have any serious side effects, including: signs of kidney problems (such as change in the amount of urine), severe or persistent stomach/abdominal pain, bloody stools, rectal bleeding.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

                PRECAUTIONS: Before taking this medication, tell your doctor or pharmacist if you have any allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: blocked intestines (gastrointestinal obstruction), hole in the intestines, severe ulcers/swelling of the colon (ulcerative colitis), severe infection in the intestines (such as toxic colitis, toxic megacolon), stomach/intestines that empty slowly or are not moving (gastric retention, ileus), trouble swallowing, trouble keeping food down (regurgitation), history of breathing food/other substances into the lungs (aspiration), gout, heart problems (such as irregular heartbeat, chest pain, heart failure), kidney problems, seizure, regular use of alcohol or other sedatives.Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.It is unknown whether this drug passes into breast milk. Consult your doctor before breast-feeding.

                DRUG INTERACTIONS: See also How to Use section.Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Some products that may interact with this drug include drugs that can change the amount of water, sodium, or potassium in your body, such as: heart/blood pressure medications called ARBs (such as valsartan), heart/blood pressure medications called ACE inhibitors (such as captopril, enalapril), nonsteroidal anti-inflammatory drugs - NSAIDs (such as ibuprofen, naproxen), "water pills" such as thiazide diuretics.Do not take/use other laxatives while taking this product.

                OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.

                NOTES: Do not share this medication with others.Laboratory tests (such as sodium, potassium levels) may be performed before or after taking this medication to check for side effects. Consult your doctor for more details.

                MISSED DOSE: If you are unable to drink all of the solution and water as directed, call your doctor right away. Your test may need to be rescheduled.

                STORAGE: Store the unmixed container at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.

                Information last revised August 2021. Copyright(c) 2021 First Databank, Inc.

                IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

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                Formulary

                FormularyPatient Discounts

                Adding plans allows you to compare formulary status to other drugs in the same class.

                To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

                Adding plans allows you to:

                • View the formulary and any restrictions for each plan.
                • Manage and view all your plans together – even plans in different states.
                • Compare formulary status to other drugs in the same class.
                • Access your plan list on any device – mobile or desktop.

                The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

                Tier Description
                1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
                2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
                3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
                4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
                5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
                6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
                NC NOT COVERED – Drugs that are not covered by the plan.
                Code Definition
                PA Prior Authorization
                Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
                QL Quantity Limits
                Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
                ST Step Therapy
                Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
                OR Other Restrictions
                Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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                Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.