Sodium Picosulfate, Magnesium Oxide, and Anhydrous Citric Acid
Sodium picosulfate, magnesium oxide, and anhydrous citric acid is a combination laxative used to clean the colon before a colonoscopy in adults and children aged 9 and older.
🧬 Where this information comes from Click to expand
The clinical label records used on this page are FDA-filed Structured Product Labeling (SPL) retrieved through openFDA. We identified 2 clinical label sets within the page’s selected clinical scope after exact ingredient or ingredient-combination matching and applicable route/form matching. Forms, routes, brands, labelers, strengths, and NDC product-record counts are built separately from matching FDA National Drug Code Directory records. The linked DailyMed document is a representative official source for verification, not the page’s only clinical source. View the linked label on DailyMed →
📖 Sodium Picosulfate, Magnesium Oxide, and Anhydrous Citric Acid: Patient Information Guide
A plain-language walkthrough of Sodium Picosulfate, Magnesium Oxide, and Anhydrous Citric Acid — what it treats, how it works, how it’s taken, side effects, warnings and interactions. Tap any section to expand it.
🎯What it's used for▾
This combination of sodium picosulfate, magnesium oxide, and anhydrous citric acid is used for one purpose: clearing the colon so a colonoscopy can be performed safely and effectively.
- Clenpiq (oral solution) is indicated for colon cleansing before colonoscopy in adults and pediatric patients 9 years of age and older
- Magnesium Oxide And Anhydrous Citric Acid (oral powder) is indicated for colon cleansing before colonoscopy in adults and pediatric patients 9 years of age and older
⚙️How it works▾
This prep uses two different laxative actions at the same time. Sodium picosulfate is a prodrug — meaning it needs to be activated. Bacteria in the colon convert it into an active substance (BHPM) that directly stimulates the colon wall to contract, pushing contents through. Meanwhile, magnesium oxide and citric acid combine in solution to form magnesium citrate, an osmotic agent that pulls water into the gut and holds it there. Together, these stimulant and osmotic effects produce a powerful purging action: watery diarrhea that flushes the colon clean.
💊How it's taken▾
Both products are taken as two separate oral doses, and drinking plenty of clear liquids around each dose is required. The preferred method for both products is the split-dose regimen: first dose the evening before the colonoscopy, second dose the following morning. The oral powder also has an alternative day-before regimen if split-dosing is not suitable. Clenpiq is ready to drink with no mixing needed; the oral powder must be dissolved in 5 ounces of cold water right before each dose.
- Do not eat solid food or dairy from the start of the prep until after the colonoscopy
- Avoid red or purple drinks and alcohol throughout the prep
- Stop all fluids at least 2 hours before the procedure
- Do not take other laxatives during the prep
🤒Side effects — in detail▾
Most people will experience watery diarrhea — this is expected and means the prep is working. Other commonly reported side effects include:
- Nausea
- Headache
- Abdominal pain or cramping
- Vomiting (more common in children aged 9–16)
- Dizziness or feeling lightheaded, including when standing up (orthostatic changes)
- Temporary rise in blood magnesium levels (hypermagnesemia), which typically returns to normal within a week
Serious reactions — including seizures, significant irregular heart rhythms, or signs of severe dehydration — are rare but require immediate medical attention.
⚠️Warnings & precautions▾
- Fluid and electrolyte imbalance is the most important risk. Losing too much fluid or having shifts in sodium, potassium, magnesium, or calcium can lead to seizures, dangerous heart rhythms, or kidney injury. Drink all the clear liquids directed and tell your doctor about any excessive vomiting or lightheadedness.
- Seizures have been reported, mainly linked to low sodium or other electrolyte abnormalities. People with a history of seizures or who take medications that lower the seizure threshold are at higher risk.
- Cardiac arrhythmias (irregular heart rhythms) have been reported rarely. People with heart failure, recent heart attack, or a history of prolonged QT interval should discuss cardiac monitoring with their doctor before the prep.
- Kidney impairment: This prep is contraindicated in severe kidney disease. Even mild-to-moderate kidney disease increases the risk of magnesium buildup and kidney injury.
- Colon lining irritation: The osmotic component can sometimes cause small ulcers in the colon — your doctor should know this when reviewing colonoscopy findings if you have inflammatory bowel disease.
- Do not swallow the oral powder dry — always dissolve it in water first. Taking it undissolved raises the risk of nausea, vomiting, dehydration, and electrolyte problems.
🔀What it interacts with▾
This prep can affect how well other medicines work, and some medicines can make the prep riskier. Key interactions to know:
- Most oral medications: Take them at least 1 hour before starting each dose, since the prep can wash other drugs through before they are absorbed
- Tetracyclines, fluoroquinolone antibiotics, iron, digoxin, chlorpromazine, and penicillamine: Take these at least 2 hours before and no less than 6 hours after each dose, as magnesium in the prep can bind to these drugs and reduce their absorption
- Antibiotics in general: Taking antibiotics at the same time may reduce how well this prep works, because gut bacteria are needed to activate sodium picosulfate
- Diuretics (water pills), ACE inhibitors, angiotensin receptor blockers, and NSAIDs: These drugs affect kidney function or fluid balance and increase the risk of kidney injury or dangerous electrolyte shifts when combined with this prep
- Medications that lower the seizure threshold (such as tricyclic antidepressants): These raise the risk of seizure if electrolytes drop during the prep
This is not a complete list of interactions. Always talk with your doctor or pharmacist before starting, stopping, or changing any medication.
📋Before taking it▾
- Do not use this medication if you have severe kidney impairment (creatinine clearance less than 30 mL/min)
- Do not use if you have a blockage in the bowel (obstruction or ileus), bowel perforation, gastric retention, toxic colitis, or toxic megacolon
- Do not use if you have had a serious allergic reaction to any ingredient in the product
- Tell your doctor if you have mild or moderate kidney disease, heart problems (including heart failure, arrhythmia, or recent heart attack), a history of seizures, or inflammatory bowel disease
- Correct any known fluid or electrolyte imbalances before starting this prep
- Older adults may be more vulnerable to fluid and electrolyte problems and should be monitored carefully
- Children under 9 years of age: safety and effectiveness have not been established
- Pregnancy: no human safety data are available; discuss risks and benefits with your doctor
- Breastfeeding: the active metabolite was not detectable in breast milk in published studies, but discuss with your doctor before use
- Pediatric patients should be watched for signs of low blood sugar, as this prep provides no calories
🚑If you take too much▾
Taking more than the recommended amount of this prep can cause severe electrolyte disturbances and serious dehydration. Signs may include dizziness, weakness, or symptoms related to abnormal salt and fluid levels in the body. If you suspect an overdose, seek medical attention immediately — treatment focuses on monitoring and correcting fluid and electrolyte levels.
📡Pharmacodynamics — effects in the body▾
Sodium picosulfate stimulates the colon to contract more actively, while magnesium citrate (formed from magnesium oxide and citric acid) retains water in the gastrointestinal tract by osmosis. Together, these two actions produce a strong purgative — essentially a watery diarrhea — that clears the colon. Drinking additional fluids as directed is important because it supports this effect and reduces the risk of dehydration.
🔬Pharmacokinetics — how your body processes it▾
After the oral powder is taken, peak blood levels of sodium picosulfate (picosulfate) are reached in about 2 hours after the first dose and around 7 hours after the second dose. The drug is a prodrug: it is converted by colonic bacteria into its active form (BHPM), which is found at very low levels in the bloodstream. The half-life of sodium picosulfate — the time it takes for the body to reduce its concentration by half — is about 7.4 hours in adults and approximately 7 hours in children aged 9–16. The drug is cleared mostly through the kidneys, predominantly as a conjugated metabolite in urine. Magnesium levels in the blood rise by roughly 20% after dosing but return to normal within about a week.
📦How to store it▾
Store CLENPIQ at 25°C (77°F). Do not refrigerate or freeze.
📄 Written from Sodium Picosulfate, Magnesium Oxide, and Anhydrous Citric Acid’s FDA-approved label information, summarized in plain language with AI, and reviewed by our pharmacy team before publication. Every point is grounded in that labeling — nothing is invented. How we use AI →
Supplements & herbs that interact with Sodium Picosulfate, Magnesium Oxide, and Anhydrous Citric Acid
17 supplements and herbal products have documented interactions with Sodium Picosulfate, Magnesium Oxide, and Anhydrous Citric Acid in the licensed clinical database we use. Most are manageable — but your pharmacist should know about everything you take, including vitamins and herbals.
- Major · 1
- Moderate · 7
- Minor · 9
Educational information from a licensed clinical database (Natural Medicines) — see our data sources & update cadence. Not medical advice: an interaction being documented does not mean it will happen to you; do not start or stop medications or supplements without professional guidance.
🩺 Pharmacist Counseling Corner
Quick, plain-English answers to the questions patients ask most about Sodium Picosulfate, Magnesium Oxide, and Anhydrous Citric Acid — the kind of thing our pharmacy team would talk through with you at the counter.
What exactly does this prep do to my body? ▾
How much should I be drinking during the prep? ▾
What side effects should I expect versus when should I actually call my doctor? ▾
Can I take my regular medications during the prep? ▾
Is this prep safe if I have kidney problems? ▾
What if I'm pregnant or breastfeeding? ▾
Is Sodium Picosulfate, Magnesium Oxide, and Anhydrous Citric Acid available over the counter? ▾
When was Sodium Picosulfate, Magnesium Oxide, and Anhydrous Citric Acid first available? ▾
Who makes Sodium Picosulfate, Magnesium Oxide, and Anhydrous Citric Acid? ▾
💬 Answers drafted from Sodium Picosulfate, Magnesium Oxide, and Anhydrous Citric Acid’s FDA-approved label information, summarized in plain language with AI, and reviewed by our pharmacy team before publication. Grounded in that labeling — nothing is made up. How we use AI →
🧰 Keep exploring
💊 How Sodium Picosulfate, Magnesium Oxide, and Anhydrous Citric Acid comes
Sodium Picosulfate, Magnesium Oxide, and Anhydrous Citric Acid is available in 2 forms. Different forms and brands can have different approved uses, doses, schedules, and directions. Follow the instructions for your exact product, and do not switch forms without guidance from your prescriber or pharmacist.
Oral solution
How this form is used
- Clenpiq is used to cleanse the colon before colonoscopy in adults and pediatric patients 9 years of age and older
- Clenpiq is ready to drink and does not need to be mixed or diluted before use
- Clenpiq: two bottles (one per dose) are required using the split-dose regimen — first bottle during the evening before the colonoscopy, second bottle the morning of the colonoscopy
- Clenpiq: drink at least five 8-ounce cups of clear liquids after the first dose and at least four 8-ounce cups after the second dose; include a balanced electrolyte solution among those liquids
- Clenpiq: if severe bloating, distension, or abdominal pain occurs after the first dose, wait for symptoms to ease before taking the second dose
Oral powder
How this form is used
- Magnesium Oxide And Anhydrous Citric Acid oral powder is used to cleanse the colon before colonoscopy in adults and pediatric patients 9 years of age and older
- Magnesium Oxide And Anhydrous Citric Acid: dissolve each packet in 5 ounces of cold water immediately before use — do not prepare in advance and do not swallow the powder undissolved
- Magnesium Oxide And Anhydrous Citric Acid: two packets (one per dose) are required; the preferred split-dose method is first dose the evening before and second dose the morning of the colonoscopy
- Magnesium Oxide And Anhydrous Citric Acid: an alternative day-before method is available if split-dosing is not appropriate — first dose in the afternoon or early evening, second dose 6 hours later
- Magnesium Oxide And Anhydrous Citric Acid: drink plenty of additional clear liquids after each dose and stop all fluids at least 2 hours before the colonoscopy
📊 Sodium Picosulfate, Magnesium Oxide, and Anhydrous Citric Acid across the U.S. market
How Sodium Picosulfate, Magnesium Oxide, and Anhydrous Citric Acid appears in the FDA’s National Drug Code Directory — including its dosage forms, strengths, brand names, manufacturers, and FDA-listed product records. These are directory records, not sales or prescription volume.
FDA-listed product records by dose form (tablet variants merged) — FDA National Drug Code Directory. Record counts are not sales or prescription volume.
Share of FDA-listed product records by manufacturer — FDA National Drug Code Directory. Record counts are not sales or prescription volume.
📈 How widely Sodium Picosulfate, Magnesium Oxide, and Anhydrous Citric Acid is used
A general measure of how commonly Sodium Picosulfate, Magnesium Oxide, and Anhydrous Citric Acid is prescribed, based on Medicaid — one of the largest public drug programs. The figure below is prescriptions filled in Q1–Q4 2025, summed across every form and brand of the drug.
Think of this as a proxy for how widely Sodium Picosulfate, Magnesium Oxide, and Anhydrous Citric Acid is used, drawn from freely available public data. Medicaid is just one program — these numbers don’t include Medicare, other government coverage, or commercial and cash-pay prescriptions, so real-world use is higher than what’s shown here.
How commonly is Sodium Picosulfate, Magnesium Oxide, and Anhydrous Citric Acid prescribed? Of the 1,594 medications we measure, Sodium Picosulfate, Magnesium Oxide, and Anhydrous Citric Acid ranks #874 by Medicaid prescriptions — more than 45% of them.
Utilization by Sodium Picosulfate, Magnesium Oxide, and Anhydrous Citric Acid product
Pick a product to see its own Medicaid numbers. Each chip is one clinical product — a specific strength & dosage form as defined by RxNorm — with brand-name and generic versions combined.
citric acid 68.6 MG/ML / magnesium oxide 20 MG/ML / picosulfate sodium 0.0571 MG/ML Oral Solution
Summed across the 1 of 3 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 2626364
Shares are of the Medicaid prescriptions shown here. Product grouping follows RxNorm (the National Library of Medicine’s drug terminology), so “one product” means one strength & dosage form regardless of manufacturer. Dollar figures are gross Medicaid reimbursement before mandatory rebates — rebates (often large, especially for brand-name drugs) are confidential, so actual net cost to Medicaid is lower than shown.
Source: Medicaid State Drug Utilization Data (CMS), aggregated by generic ingredient — summed across every NDC (all brands, strengths, salt forms and dosage forms) of Sodium Picosulfate, Magnesium Oxide, and Anhydrous Citric Acid, and across all states and both fee-for-service and managed-care claims. A general popularity signal; it excludes Medicare, commercial insurance and cash prescriptions, so it is not total U.S. use. Based on the 1 of 3 listed Sodium Picosulfate, Magnesium Oxide, and Anhydrous Citric Acid NDCs with Medicaid activity.
🔍 Compare Sodium Picosulfate, Magnesium Oxide, and Anhydrous Citric Acid products
A representative set of FDA-listed product records for Sodium Picosulfate, Magnesium Oxide, and Anhydrous Citric Acid — across manufacturers, strengths, and dosage forms, grouped by form with each product’s manufacturer and how the FDA approved it. The same medicine may be made and packaged by different companies, so a single drug can have many directory entries. (It’s also why a refill can look different — a new shape, color, or box — even though it contains the same medication.)
| Strength | Route | Manufacturer / Labeler | Category ⓘ | Details |
|---|---|---|---|---|
| 💊Oral powder | ||||
| 12; 3.5; 10 g/16.1 g; g/16.1 g; mg/16.1 g | Oral | Camber Pharmaceuticals, Inc. | ANDA | View NDC → |
| 💊Oral solution | ||||
| SODIUM PICOSULFATE 10 mg/175 mL; MAGNESIUM OXIDE 3.5 g/175 mL; ANHYDROUS CITRIC ACID 12 g/175 mL | Oral | Ferring Pharmaceuticals Inc. | NDA | View NDC → |
| 12; 3.5; 10 g/160 mL; g/160 mL; mg/160 mL | Oral | Ferring Pharmaceuticals Inc. | NDA | View NDC → |
| 12; 3.5; 10 g/175 mL; g/175 mL; mg/175 mL | Oral | Ferring Pharmaceuticals Inc. | NDA | View NDC → |
Showing 4 of 4 products — FDA National Drug Code Directory. See every product, package size and price: browse all 4 Sodium Picosulfate, Magnesium Oxide, and Anhydrous Citric Acid NDCs →
📈 What people report — real-world data (FDA FAERS)
After a medicine reaches the market, patients, doctors and drugmakers can send the FDA reports of problems they think may be linked to it. Here’s what’s been reported for Sodium Picosulfate, Magnesium Oxide, and Anhydrous Citric Acid — a signal of what to watch for, not proof the drug caused it.
Source: openFDA, from the FDA Adverse Event Reporting System (FAERS). These are voluntary reports — they don’t prove the drug caused the effect, and counts reflect how often something was reported, not how often it actually happens. Reports also often name the very problem the medicine is taken for — a common reason to file one is that the drug didn’t help — so for a pain reliever you may see “pain” high on the list; that points to why the report was filed, not to the drug causing the symptom. This counts every report that lists Sodium Picosulfate, Magnesium Oxide, and Anhydrous Citric Acid in any role, so the total runs higher than the FDA’s official dashboard, which counts only cases where the drug is the suspect. For the authoritative figures, see the FDA FAERS Public Dashboard. Always talk to your pharmacist or doctor.
🏛️ The road to your pharmacy
How Sodium Picosulfate, Magnesium Oxide, and Anhydrous Citric Acid went from FDA review to the pharmacy shelf — the key milestones in its regulatory journey.
Source: Drugs@FDA.
🚨 Recall history
A recall is when a specific batch of a medicine is pulled from the market — usually a manufacturing issue, not a problem with the drug itself. Class I is most serious, Class III least.
Source: openFDA drug enforcement (recall) reports.
📦 Supply & shortage status
Whether Sodium Picosulfate, Magnesium Oxide, and Anhydrous Citric Acid is in short supply in the U.S. right now, plus any shortage history the FDA has on record. A shortage usually reflects a manufacturing or demand issue — not a safety problem with the drug.
Source: openFDA, from the FDA Drug Shortages database.
🏷️ Sold under these brand names
🏭 Manufacturers & labelers
RxNorm drug class
Sodium Picosulfate, Magnesium Oxide, and Anhydrous Citric Acid belongs to the Contact laxatives class.
Classified by RxNorm RxClass — the U.S. National Library of Medicine's standardized drug-classification service (Established Pharmacologic Class from the FDA, the ATC drug family from the WHO, and mechanism of action). Reference only, not medical advice.
🔬 Where this comes from
Core label, product, RxNorm, safety, and utilization data on this page come from the sources identified below. AI-written, editorial, and licensed sections are labeled separately.
How we combine label and product data
HelloPharmacist combines public FDA and NLM records; we don’t author the underlying clinical facts. We identified 2 FDA-filed SPL label sets within the page’s selected clinical scope after exact ingredient or ingredient-combination matching and applicable route/form matching. The representative label is the starting point for the displayed reference monograph; the 12 largest stored in-scope SPL records, which may include that representative, are compared section by section, and the longest available version of each section is retained. Forms, routes, brands, labelers, product-listed strengths, and product-record counts are aggregated separately from ingredient-matched FDA NDC Directory records; package records listed above are associated with the linked SPL; and the normalized concept hierarchy comes from NLM RxNorm.
For canonical ingredient pages, bounded product-attributed indication and administration excerpts may be added to the AI evidence, and the generator is instructed to preserve available product, brand, route, and form qualifiers instead of treating one label as universal. Where a section is identified as AI-written, its plain-language text is generated from bounded label evidence. New draft drug pages remain in the admin review queue before first publication. Ferring Pharmaceuticals Inc. is the representative DailyMed label linked for verification and dates; it is not the sole source used for the page.
This is general education, not medical advice — always consult your doctor or pharmacist about your medications and any medical condition. For the exact wording of the linked representative label, view that label on DailyMed; some displayed composite sections may come from other in-scope SPL labels. Learn how we use AI and our data sources & update cadence.