Microsoft word - prepopik prep.doc

Obtain one PREPOPIK KIT from the pharmacy. ONE WEEK PRIOR TO THE PROCEDURE: Please do not take, Advil, Motrin, Aleve, Ibuprofen, etc., Fish Oil or Vitamin E. Tylenol is o.k. If you take Aspirin, Persantine, Plavix, Ticlid, Coumadin, Effent, Aggrenox, Pletal, Cilostazol or any non-steroidal anti-inflammatory drug or if you take any medication for diabetes, you must ask your prescribing physician for special instructions and then call us and let us know. Please continue to take your other medications as usual. ONE DAY BEFORE THE PROCEDURE: CLEAR LIQUIDS ONLY THE ENTIRE DAY BEFORE
Beginning at 5 p.m. fill the disposable container with water to the 5oz line add one packet of PREPOPIK . Mix to dissolve. Over the next five hours or until bedtime drink five 8oz glasses of clear liquid. It is normal for this drink to be warm, you may add ice. YOU MUST continue drinking clear fluids until bedtime. The more fluids you drink the
better your prep will be. It is advisable that you place a towel under your hip/buttock area at
bedtime to protect your sheets from possible stool leakage.
ON THE DAY OF THE PROCEDURE: A. Beginning at least 4 hours prior to the procedure take the second dose of PREPOPIK and mix with 5oz of cold water followed by three 8oz glasses of clear liquid. B. Nothing by mouth for 2 hours prior to the procedure.
C. If you take medications, you may take it on the morning of the procedure with a small
amount of water. (Call the office if you have questions regarding these instructions.) CLEAR LIQUID DIET --- ONLY THESE ITEMS ARE ALLOWED: DO NOT HAVE ANYTHING RED OR PURPLE IN COLOR. Gatorade and Powerade. We encourage you to drink as much as possible of these two
items to prevent dehydration.

SOUPS: Clear bouillon, broth or consommě BEVERAGES: Tea, coffee, decaffeinated tea/coffee, Kool-Aid, carbonated beverages. DO NOT put any milk or cream in your tea or coffee. JUICES: Apple, White grape juice, white cranberry juice, strained lemonade, limeade, orange drink, Gatorade and powerade. ANY JUICE THAT YOU CAN SEE THROUGH AND HAS NO PULP IS ACCEPTABLE. DESSERT: Water ices, Italian ices, Popsicles, Jello, Sorbet
DATE: ___________DOCTOR: ___________APPOINTMENT TIME:_______ARRIVE AT:________
REPORT TO: ( ) St. Vincent’s Medical Center ( ) The Endoscopy Center of Fairfield
2800 Main Street, BPT 425 Post Road, FFLD
NO DRIVING: You cannot drive, take a taxi alone, or take a bus alone after the procedure.
You must be accompanied by an adult. If this rule is not followed, we may cancel your
Revised 6/13
Gastroenterology Associates of Fairfield County, PC & d/b/a The Endoscopy Center of Fairfield 425 Post Road • Fairfield, Connecticut 06824 • Telephone 203.292.9000 •Fax 203.292.0833 2660 Main Street • Bridgeport, Connecticut 06606 •Tel 203.333.3328 • Fax 203.336.3823



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