Ascorbic Acid / Polyethylene Glycol 3350 / Potassium Chloride / Sodium Ascorbate / Sodium Chloride / Sodium Sulfate

This ingredient combination is the active basis for several prescription colonoscopy prep products, each indicated for the same purpose in adults.

• MoviPrep is indicated to cleanse the colon as a preparation for colonoscopy in adults
• PLENVU is indicated to cleanse the colon as a preparation for colonoscopy in adults
• Polyethylene Glycol-3350, Electrolytes, and Ascorbate for Oral Solution (generic) is indicated to cleanse the colon as a preparation for colonoscopy in adults

These ingredients work together through an osmotic effect — they are not well absorbed in the gut, so they draw large amounts of water into the colon and hold it there. The resulting surge of fluid produces a strong, watery diarrhea that flushes the bowel clean. PEG-3350, sodium sulfate, sodium ascorbate, and ascorbic acid all contribute to this osmotic pull. Most people experience their first bowel movement within about 1 to 2 hours of starting the preparation.

These preparations are taken as a reconstituted oral liquid — you mix powder pouches with water before drinking. Two separate doses are always needed for a complete bowel prep. Your prescriber will choose from two dosing schedules:

• Split-dose (Two-Day): First dose the evening before the colonoscopy, second dose the morning of the colonoscopy (roughly 12 hours apart) — this is the preferred method for MoviPrep and the generic, and a standard option for PLENVU
• Same-evening (One-Day Evening-Only): Both doses taken the evening before the colonoscopy, at least 90 minutes apart — an alternative method for MoviPrep and the generic
• One-Day Morning (PLENVU): Both doses taken the morning of the colonoscopy, with at least 2 hours between the start of dose 1 and the start of dose 2

Drink additional clear liquids after each dose, eat only clear liquids from the start of prep until after the colonoscopy, and take all other oral medications at least 1 hour before each dose. Follow your prescriber's specific instructions closely.

Most people experience some gastrointestinal discomfort — that's a normal part of how this preparation works.

• Nausea
• Abdominal pain or cramping
• Vomiting
• Bloating or abdominal distension
• Malaise (feeling generally unwell or run-down)
• Anal discomfort
• Thirst
• Dizziness
• Sleep disturbance

Diarrhea is expected and is how the preparation does its job. More serious reactions — including severe allergic reactions, irregular heartbeat, seizures, or signs of kidney injury — are rare but require immediate medical attention.

• Fluid and electrolyte imbalances are the most important risk. Losing too much fluid or having shifts in sodium, potassium, or other minerals can trigger serious heart rhythm problems, seizures, or kidney injury. Drink plenty of fluids and call your doctor if you vomit heavily or feel severely dehydrated.
• Cardiac arrhythmias (irregular heartbeat) have been reported rarely, mainly in people with existing heart conditions or electrolyte problems. Your doctor may order an ECG (heart tracing) before and after the procedure if you are at higher risk.
• Seizures have occurred rarely, linked to electrolyte imbalances. Extra caution is needed if you have a seizure history or take medications that lower the seizure threshold.
• Kidney injury is possible, especially if you have existing kidney disease or take medications that affect kidney function. Stay well hydrated.
• Severe allergic reactions (anaphylaxis), including swelling, trouble breathing, and rash, have been reported. Seek emergency care immediately if these occur.
• Aspiration risk: People with swallowing problems should be monitored while taking the liquid. Never mix with starch-based thickeners — doing so can thin the liquid and increase choking risk.
• Contains phenylalanine — people with phenylketonuria (PKU) must discuss this with their doctor before using.
• Use with extra caution if you have G6PD deficiency, as the ascorbate component may trigger hemolysis (breakdown of red blood cells).

Several medications and substances can interact with this bowel preparation by increasing the risk of electrolyte problems, kidney injury, or other complications.

• Diuretics (water pills): Already affect fluid and electrolyte balance; combining with this prep raises the risk of imbalances further
• ACE inhibitors and ARBs (blood pressure medications): Can worsen kidney stress and electrolyte shifts during the prep
• NSAIDs (like ibuprofen or naproxen): May increase the risk of kidney injury, especially with dehydration
• Tricyclic antidepressants and other medications that lower the seizure threshold: Raise seizure risk when electrolytes are disturbed
• All oral medications: This preparation can reduce how well your body absorbs other drugs — take all oral medications at least 1 hour before starting each dose
• Stimulant laxatives (bisacodyl, sodium picosulfate): Do not use at the same time — increases risk of ulceration or ischemic colitis in the colon
• Starch-based thickeners: Never mix these into the solution — PEG thins starch-thickened liquids and can cause choking or aspiration

This is not a complete list of interactions. Always talk with your doctor or pharmacist before starting, stopping, or changing any medication.

• Do not use if you have a bowel blockage (GI obstruction), bowel perforation, gastric retention, ileus, or toxic colitis or toxic megacolon — these are contraindications
• Tell your doctor about any allergy to any ingredient, including polyethylene glycol or lemon flavoring components
• Tell your doctor if you have kidney disease or take medications that affect kidney function
• Tell your doctor if you have heart disease, irregular heartbeat, heart failure, recent heart attack, or unstable angina
• Tell your doctor if you have a history of seizures or take medications that lower the seizure threshold
• Tell your doctor if you have G6PD deficiency — the ascorbate content may trigger hemolysis
• Tell your doctor if you have phenylketonuria (PKU) — this preparation contains phenylalanine
• Tell your doctor if you have severe ulcerative colitis or suspected inflammatory bowel disease
• If you have trouble swallowing or an impaired gag reflex, tell your care team — you should be monitored during administration
• Pregnancy: There are no adequate human data on safety; discuss with your doctor
• Breastfeeding: Not enough data is available; discuss risks and benefits with your doctor
• Children: Safety and effectiveness have not been established in pediatric patients
• Older adults: Used safely in clinical trials, but elderly patients are more susceptible to fluid and electrolyte problems and should be monitored closely

Taking more than the recommended amount can cause severe electrolyte disturbances — including dangerously low sodium (hyponatremia) or potassium (hypokalemia) — as well as dehydration and low blood volume. In serious cases, this can lead to heart rhythm problems, seizures, or kidney failure.

If overdose is suspected, seek medical attention and treatment will focus on monitoring and correcting fluid and electrolyte levels.

When swallowed, the unabsorbed PEG, ascorbate, and sulfate ions create a strong osmotic effect in the colon — pulling water into the bowel and keeping it there. This produces a large volume of watery diarrhea that flushes the colon clean. The first bowel movement typically occurs about 1 to 2 hours after starting PLENVU, and the effect is rapid and thorough by design.

Most of the PEG-3350 in these preparations stays in the gut and is excreted in the stool — studies show 85% to 99% of the PEG dose leaves the body in the feces. Similarly, the majority of ascorbate (about 69%) and sodium sulfate (69–73%) are eliminated in stool, with some ascorbate and sulfate also appearing in urine. PEG-3350 that is absorbed has a half-life (the time for the body to clear half of it) of about 4 hours; ascorbate has a half-life of about 7 hours; and sulfate about 10.5 hours. Because so little is absorbed into the bloodstream, these preparations act mainly within the digestive tract rather than throughout the body.

Store pack at room temperature, between 68°F to 77°F (20°C to 25°C) with excursions permitted to 59°F to 86°F (15°C to 30°C) . stored in a refrigerator.