sodium sulfate/​magnesium sulfate/potassium chloride (Rx)

Brand and Other Names:Sutab
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Dosing & Uses

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Dosage Forms & Strengths

sodium sulfate/magnesium sulfate/potassium chloride

tablet

  • 1.479g/0.225g/0.188g
  • Each carton contains

    • 2 bottles; each bottle contains 12 tablets.
    • 1 container with a 16-ounce fill line

Bowel Preparation

Indicated for cleansing of the colon in preparation for colonoscopy

Administer as a split dose (2-dose) regimen

Split-dose regimen consists of 2 doses: First dose during the evening prior to colonoscopy and second dose the next day, during the morning of the colonoscopy

Dose 1 (evening before colonoscopy)

  • A low-residue breakfast (eg, eggs, white bread, cottage cheese, yogurt, coffee, tea) may be consumed
  • After breakfast, consume only clear liquids until after the colonoscopy
  • Early in the evening prior to colonoscopy, open one bottle of 12 tablets
  • Fill provided container with 16 ounces of water (up to the fill line); swallow each tablet with a sip of water and drink entire amount over 15-20 min
  • ~1 hr after the last tablet is ingested, drink 16 ounces of water over 30 minutes
  • Wait ~30 min after finishing the second container of water; drink another 16 ounces of water over 30 minutes
  • If patients experience preparation-related symptoms (eg, nausea, bloating, cramping), pause or slow the rate of drinking the additional water until symptoms diminish

Dose 2 (morning of colonoscopy)

  • Continue to consume only clear liquids until after colonoscopy
  • Morning of colonoscopy (5-8 hr before colonoscopy and no sooner than 4 hr from starting Dose 1), open second bottle of 12 tablets
  • ~1 hr after the last tablet is ingested, drink 16 ounces of water over 30 minutes
  • Wait ~30 min after finishing the second container of water; drink another 16 ounces of water over 30 minutes
  • If patients experience preparation-related symptoms (eg, nausea, bloating, cramping), pause or slow the rate of drinking the additional water until symptoms diminish
  • Complete all tablets and water at least 2 hr prior to colonoscopy

Dosage Modifications

Renal impairment

  • Use with caution in patients with renal impairment or patients taking concomitant medications that may affect renal function; these patients may be at risk for renal injury

Safety and efficacy not established

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Interactions

Interaction Checker

and sodium sulfate/​magnesium sulfate/potassium chloride

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              Serious - Use Alternative (13)

              • baloxavir marboxil

                sodium sulfate/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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. .

              • polyethylene glycol/electrolytes and bisacodyl

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

              • calcium acetate

                sodium sulfate/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride. 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride. 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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.

                sodium sulfate/?magnesium sulfate/potassium chloride 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. .

              • ferric derisomaltose

                sodium sulfate/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride. 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride. 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride. 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/?magnesium sulfate/potassium chloride. 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride. 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/?magnesium sulfate/potassium chloride. 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride. 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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/?magnesium sulfate/potassium chloride 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%

                Mild upper abdominal pain (65-82%)

                Mild nausea (71-74%)

                Mild abdominal distension (68-73%)

                Mild vomiting (48-53%)

                Moderate vomiting (47-52%)

                Moderate upper abdominal pain (16-35%)

                Moderate abdominal distension (27-30%)

                Moderate nausea (20-27%)

                1-10%

                Severe nausea (2-6%)

                Severe abdominal pain (2%)

                Severe abdominal distension (1%)

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                Warnings

                Contraindications

                Gastrointestinal obstruction or ileus

                Bowel perforation

                Toxic colitis or toxic megacolon

                Gastric retention

                Cautions

                Encourage adequate hydration, assess concurrent medications, and consider laboratory assessments (electrolytes, creatinine, BUN) before and after each use

                There have been rare reports of serious arrhythmias associated with the use of ionic osmotic laxative products for bowel preparation; use with caution in patients at increased risk of arrhythmias (eg, patients with a history of prolonged QT, uncontrolled arrhythmias, recent myocardial infarction, unstable angina, congestive heart failure, cardiomyopathy); consider predose and postcolonoscopy ECGs in patients at increased risk of serious cardiac arrhythmias

                Use with caution in patients with impaired renal function or patients taking concomitant medications that may affect renal function (eg, diuretics, ACE inhibitors, angiotensin receptor blockers, NSAIDs); advise these patients of the importance of adequate hydration and consider performing baseline and postcolonoscopy laboratory testing

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

                Seizures

                • Reports of generalized tonic-clonic seizures and/or loss of consciousness have been associated with use of bowel preparation products in patients with no prior history of seizures
                • Use caution in patients with a history of seizures and in patients at increased risk of seizure, such as patients taking medications that lower the seizure threshold (eg, tricyclic antidepressants), patients withdrawing from alcohol or benzodiazepines, or patients with known or suspected hyponatremia

                Drug interaction overview

                • Caution with coadministration of drugs that increase risk of fluid and electrolyte disturbances or that 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, angiotensin receptor blockers, NSAIDs)
                • Potential for reduced drug absorption
                  • Oral medication administered within 1 hr before bowel preparation may not be absorbed properly
                  • Administer tetracycline or fluoroquinolone antibiotics, iron, digoxin, chlorpromazine, or penicillamine at least 2 hr before and not less than 6 hr after administration of bowel preparation to avoid chelation
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                Pregnancy & Lactation

                Pregnancy

                No data available data on use in pregnant females to evaluate for a drug-associated risk of major birth defects, miscarriage, or adverse maternal or fetal outcomes

                No reproduction or developmental studies in animals have been conducted with sodium sulfate, magnesium sulfate, and potassium chloride

                Lactation

                There are no available data on drug presence in human or animal milk, effects on the breastfed child, or effects on milk production

                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 action of sodium sulfate and magnesium sulfate induces a laxative effect

                The physiological consequence is increased water retention in the lumen of the colon, resulting in loose stools

                Absorption

                Median serum sulfate concentration increased by about 2.5-fold at 5-8 hr post Dose 2 (0.61 mmol/L) compared with baseline (0.25 mmol/L) and returned to baseline by 24-48 hr after colonoscopy

                Elimination

                Excretion: Fecal

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                Administration

                Oral Administration

                Correct fluid and electrolyte abnormalities before treatment

                Administration of 2 doses (each dose is 12 tablets) is required for a complete preparation for colonoscopy

                Consume water with each dose and additional water must be consumed after each dose

                Consume a low-residue breakfast on the day before colonoscopy, followed by clear liquids up to 2 hr prior to colonoscopy.

                Do not drink alcohol or milk, and do not eat or drink anything colored red or purple

                Do not take other laxatives during treatment

                Do not take oral medications within 1 hour of starting each dose

                If taking tetracycline or fluoroquinolone antibiotics, iron, digoxin, chlorpromazine, or penicillamine, take these medications at least 2 hr before and not less than 6 hr after administration of each dose

                Stop consumption of all fluids at least 2 hr before the colonoscopy

                Storage

                Tablets: Store at 20-25ºC (68-77ºF); excursions permitted to 15-30ºC (59-86ºF)

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                Images

                No images available for this drug.
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                Patient Handout

                A Patient Handout is not currently available for this monograph.
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                Formulary

                FormularyPatient Discounts

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                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
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                ST Step Therapy
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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.