Pico-Salax bowel prep — step-by-step
Most patients preparing for a colonoscopy with Dr. Kichian are asked to take Pico-Salax (or Purg-Odan). It is a low-volume prep that most people find easier to drink.
Important safety note
Pico-Salax is NOT safe for patients with kidney disease, congestive heart failure, liver disease with ascites, pregnancy, or after a colectomy. If you have any of these conditions, please call our office — you will be prescribed Peglite instead.
Where to get your prep kit
Buy Pico-Salax over the counter at any pharmacy
The Pico-Salax preparation kit is available <1>over the counter</1> at any pharmacy — no prescription is required. Simply ask the pharmacist for it by name.
If you prefer a written prescription (for insurance coverage or workplace reimbursement), please <1>coordinate directly with our office</1> at <3>(613) 728-1795</3> and we'll be happy to arrange one.
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Step 1
1 week before — Review your medications
Go over all your medications and supplements with our team. Some may need to be adjusted before your prep.
- Call our office immediately if you take prescription blood thinners (Pradaxa, Eliquis, Xarelto, Coumadin/Warfarin, etc.), Aspirin (ASA), or anti-inflammatories.
- You may continue all other medications, vitamins, and Tylenol as usual.
- If you are diabetic, monitor your blood sugars carefully and use clear juice to help control them — ask your family doctor if unsure.
- 2
Step 2
3 days before — Start the low-residue diet
Switch to gentle, easy-to-digest foods so your colon empties more thoroughly on prep day.
- Avoid: red meat, raw vegetables, seeds and nuts of all kinds, corn, and milk products.
- You can enjoy: eggs (not fried), pasta with cooked vegetables, seedless fruit, non-cream soups, crackers, lean chicken or fish, white bread, white rice, potatoes, plain cookies, Jell-O (not red or purple).
- At bedtime: take 1 Dulcolax laxative (5 mg bisacodyl tablet).
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Step 3
2 days before — Continue the diet
Stay on the same low-residue diet. Take one more Dulcolax tablet at bedtime.
- Same food list as day 3 — no red meat, raw veg, seeds, nuts, corn, or milk products.
- At bedtime: take 1 more Dulcolax laxative (5 mg bisacodyl tablet).
- Keep drinking water through the day — hydration makes the prep easier.
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Step 4
1 day before — Clear liquids only
No solid food today. Only clear fluids — this is the most important rule.
- Clear fluids: water, Gatorade (or similar electrolyte drink), clear broth (up to 1 L), ginger ale, Jell-O (not red or purple), clear juices, popsicles, tea or coffee with NO milk, cream, or soy.
- Absolutely NO solids are permitted from now until after your procedure.
- If Gatorade is hard to tolerate, dilute it with any clear liquid, or try Gastrolyte (available at any pharmacy).
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Step 5
Morning appointment — First Pico-Salax dose at 8:00 AM (day before)
If your procedure is between 8:00 AM and 11:00 AM, take the first Pico-Salax envelope in the morning the day before.
- At 8:00 AM the day before: prepare and drink the 1st envelope of Pico-Salax.
- Then drink 2 L of clear fluid — a combination of any clear fluid plus one bottle of a sports drink — over the next 4 hours.
- Stay near a bathroom — frequent bowel movements are expected and normal.
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Step 6
Morning appointment — Second Pico-Salax dose at 5:00 PM (day before)
For morning procedures, take the second envelope in the early evening the day before your procedure.
- At 5:00 PM the day before: drink the 2nd envelope of Pico-Salax.
- Follow with 2 L of clear fluid (any clear fluid + one bottle of sports drink) over 4 hours.
- You may continue clear fluids right up to your hospital arrival time.
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Step 7
Afternoon appointment — First Pico-Salax dose at 5:00 PM (day before)
If your procedure is between 11:30 AM and 2:30 PM, take the first envelope in the early evening the day before.
- At 5:00 PM the day before: prepare and drink the 1st envelope of Pico-Salax.
- Follow with 2 L of clear fluid (any clear fluid + one bottle of sports drink) over the next 4 hours.
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Step 8
Afternoon appointment — Second Pico-Salax dose the next morning
For afternoon procedures, take the second envelope about 5–6 hours before your scheduled appointment.
- About 5–6 hours before your appointment: drink the 2nd envelope of Pico-Salax.
- Follow with 2 L of clear fluid (any clear fluid + one bottle of sports drink) over 4 hours.
- You may continue clear fluids right up to hospital arrival.
- 9
Step 9
Procedure day — Arrive and relax
Come to Queensway Carleton Hospital 1 hour before your appointment with a responsible adult driver.
- Bring your OHIP card, an updated list of medications, a bag for belongings, and a small snack and drink for after.
- Sedation is strongly recommended. If sedated, you cannot legally drive for 24 hours and must have someone drive you home — taxi alone is against hospital policy.
- Please do not wear cologne, perfume, or other scents on the day of your procedure (deodorant is fine).
You'll know your prep is complete when
- Your stool is a clear yellow liquid — like pale tea or lemonade.
- There are no more solid pieces or dark bits.
- You have finished all of the prep as prescribed, not just "most of it".
Call us if you experience
- Uncontrolled vomiting that prevents you from finishing the prep — call our office.
- Severe abdominal pain that does not improve — call our office, or 911 if severe.
- Signs of dehydration (dizziness, no urination, confusion) — sip clear liquids and call us.
(613) 728-1795
Questions? We're here to help.
If anything in this guide is unclear, please call our office — we'd rather answer a question than have you stress about it.