Sodium picosulfate
{{Short description|Chemical compound}}
{{Use dmy dates|date=November 2022}}
{{Infobox drug
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| verifiedrevid = 477002878
| image = Sodium picosulfate.svg
| width = 260
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| image2 = Sodium picosulfate ions ball.png
| alt2 = Ball-and-stick model of the component ions of sodium picosulfate
| width2 = 240
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| Drugs.com = {{drugs.com|international|sodium-picosulfate}}
| MedlinePlus =
| DailyMedID = Sodium picosulfate
| pregnancy_AU =
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| routes_of_administration = By mouth
| class =
| ATC_prefix = A06
| ATC_suffix = AB08
| ATC_supplemental =
{{ATC|A06|AB58}} (combinations)
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| legal_US = Rx-only
| legal_US_comment = as part of Clenpiq
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| index_label = monohydrate
| CAS_number_Ref = {{cascite|changed|CAS}}
| CAS_number = 1307301-38-7
| CAS_supplemental =
| PubChem = 5282431
| IUPHAR_ligand =
| DrugBank_Ref = {{drugbankcite|changed|drugbank}}
| DrugBank = DBSALT001830
| ChemSpiderID_Ref = {{chemspidercite|changed|chemspider}}
| ChemSpiderID = 4445585
| UNII_Ref = {{fdacite|changed|FDA}}
| UNII = LR57574HN8
| KEGG = DG00072
| ChEBI =
| ChEMBL = 1741134
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| synonyms = Picosulfuric acid
| index2_label = anhydrous
| CAS_number2_Ref = {{cascite|correct|CAS}}
| CAS_number2 = 10040-45-6
| PubChem2 = 68654
| DrugBank2 = DBSALT001831
| ChemSpiderID2 = 61910
| UNII2_Ref = {{fdacite|correct|FDA}}
| UNII2 = VW106606Y8
| ChEBI2 = 32147
| ChEMBL2 = 1697768
| IUPAC_name = disodium (pyridin-2-ylmethylene)di-4,1-phenylene disulfate
| C=18 | H=15 | N=1 | Na=2 | O=9 | S=2
| SMILES = O.[Na+].[Na+].[O-]S(=O)(=O)OC1=CC=C(C=C1)C(C1=CC=C(OS([O-])(=O)=O)C=C1)C1=CC=CC=N1
| StdInChI = 1S/C18H15NO8S2.2Na.H2O/c20-28(21,22)26-15-8-4-13(5-9-15)18(17-3-1-2-12-19-17)14-6-10-16(11-7-14)27-29(23,24)25;;;/h1-12,18H,(H,20,21,22)(H,23,24,25);;;1H2/q;2*+1;/p-2
| StdInChIKey = FHYUVJHZGPGDSP-UHFFFAOYSA-L
| SMILES2 = [Na+].[Na+].[O-]S(=O)(=O)OC1=CC=C(C=C1)C(C1=CC=C(OS([O-])(=O)=O)C=C1)C1=CC=CC=N1
| StdInChI2_Ref = {{stdinchicite|changed|chemspider}}
| StdInChI2 = 1S/C18H15NO8S2.2Na/c20-28(21,22)26-15-8-4-13(5-9-15)18(17-3-1-2-12-19-17)14-6-10-16(11-7-14)27-29(23,24)25;;/h1-12,18H,(H,20,21,22)(H,23,24,25);;/q;2*+1/p-2
| StdInChIKey_Ref = {{stdinchicite|changed|chemspider}}
| StdInChIKey2 = GOZDTZWAMGHLDY-UHFFFAOYSA-L
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Sodium picosulfate (INN, also known as sodium picosulphate) is a contact stimulant laxative used as a treatment for constipation or to prepare the large bowel before colonoscopy or surgery.
It is available as a generic medication.{{cite web | title=2022 First Generic Drug Approvals | website=U.S. Food and Drug Administration (FDA) | date=3 March 2023 | url=https://www.fda.gov/drugs/drug-and-biologic-approval-and-ind-activity-reports/2022-first-generic-drug-approvals | archive-url=https://web.archive.org/web/20230630003602/https://www.fda.gov/drugs/drug-and-biologic-approval-and-ind-activity-reports/2022-first-generic-drug-approvals | archive-date=30 June 2023 | url-status=dead | access-date=30 June 2023}}
Medical uses
Sodium picosulfate used in combination with magnesium oxide and anhydrous citric acid is indicated for cleansing of the colon as a preparation for colonoscopy.
Effects
Orally administered sodium picosulfate is generally used for thorough evacuation of the bowel, usually for patients who are preparing to undergo a colonoscopy. It takes 12–24 hours to work, since it works in the colon.{{cite web|publisher = Food and Drug Administration|url = https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm312315.htm|archive-url = https://web.archive.org/web/20120720213748/http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm312315.htm|url-status = dead|archive-date = 20 July 2012|title = FDA News Release – FDA approves new colon-cleansing drug for colonoscopy prep|date = 17 July 2012|access-date = 1 December 2016}}
Abdominal cramps and diarrhea are normal effects of picosulfate and should be expected.
The use of sodium picosulfate has also been associated with certain electrolyte disturbances, such as hyponatremia and hypokalemia.{{cite journal |date=February 2002 | title = Electrolyte disturbances with sodium picosulfate bowel cleansing products | author = ADRAC | author-link = Adverse Drug Reactions Advisory Committee | journal = Aust Adv Drug React Bull | volume = 21 | issue = 1}} [http://www.tga.gov.au/adr/aadrb/aadr0202.htm#elec Free full text] {{Webarchive|url=https://web.archive.org/web/20110422110737/http://www.tga.gov.au/adr/aadrb/aadr0202.htm#elec |date=22 April 2011 }} from the Australian Therapeutic Goods Administration Patients are often required to drink large amounts of clear fluids, to compensate for dehydration and to reestablish normal electrolyte balance.
Mechanism of action
Sodium picosulfate is a prodrug.{{cite journal | vauthors = Adamcewicz M, Bearelly D, Porat G, Friedenberg FK | title = Mechanism of action and toxicities of purgatives used for colonoscopy preparation | journal = Expert Opinion on Drug Metabolism & Toxicology | volume = 7 | issue = 1 | pages = 89–101 | date = January 2011 | pmid = 21162694 | pmc = 3030244 | doi = 10.1517/17425255.2011.542411 }} It has no significant direct physiological effect on the intestine; however, it is metabolised by gut bacteria into the active compound 4,4'-dihydroxydiphenyl-(2-pyridyl)methane (DPM, BHPM).{{cite journal | vauthors = Forth W, Nell G, Rummel W, Andres H | title = The hydragogue and laxative effect of the sulfuric acid ester and the free diphenol of 4,4'-dihydroxydiphenyl-(pyridyl-2)-methane | journal = Naunyn-Schmiedeberg's Archives of Pharmacology | volume = 274 | issue = 1 | pages = 46–53 | date = 1 March 1972 | pmid = 4262724 | doi = 10.1007/BF00501005 | s2cid = 13177533 }} This compound is a stimulant laxative and increases peristalsis in the gut.{{cite journal | vauthors = Jauch R, Hankwitz R, Beschke K, Pelzer H | title = Bis-(p-hydroxyphenyl)-pyridyl-2-methane: The common laxative principle of Bisacodyl and sodium picosulfate | journal = Arzneimittel-Forschung | volume = 25 | issue = 11 | pages = 1796–1800 | date = November 1975 | pmid = 1243088 }}
Sodium picosulfate is typically prescribed in a combined formulation with magnesium citrate, an osmotic laxative. This combination is a highly effective laxative, often prescribed to patients for bowel cleansing prior to colonoscopies.{{cite journal | vauthors = Regev A, Fraser G, Delpre G, Leiser A, Neeman A, Maoz E, Anikin V, Niv Y | display-authors = 6 | title = Comparison of two bowel preparations for colonoscopy: sodium picosulphate with magnesium citrate versus sulphate-free polyethylene glycol lavage solution | journal = The American Journal of Gastroenterology | volume = 93 | issue = 9 | pages = 1478–82 | date = September 1998 | doi = 10.1111/j.1572-0241.1998.00467.x | pmid = 9732929 | s2cid = 7579449 }}
Society and culture
= Brand names =
It is sold under the brand names Sodipic Picofast, Laxoberal, Laxoberon,[http://www.merck.pk/en/pharmaceutical_products/merck_serono/Copy_of_neurocare/laxoberon/laxoberon.html Website of Merck Pakistan] Purg-Odan, Picolax, Guttalax, Namilax, Pico-Salax,[http://www.pico-salax.ca/product-information.html PICO SALAX Product Information] {{webarchive|url=https://web.archive.org/web/20120322215255/http://www.pico-salax.ca/product-information.html |date=22 March 2012 }} PicoPrep,{{cite journal | vauthors = Tjandra JJ, Chan M, Tagkalidis PP | title = Oral sodium phosphate (Fleet) is a superior colonoscopy preparation to Picopre (sodium picosulfate-based preparation) | journal = Diseases of the Colon and Rectum | volume = 49 | issue = 5 | pages = 616–20 | date = May 2006 | pmid = 16525746 | doi = 10.1007/s10350-005-0323-2 | s2cid = 36729352 }} and Prepopik, among others.
Clenpiq is a combination of sodium picosulfate, magnesium oxide, and citric acid.{{cite web | title=Clenpiq- sodium picosulfate, magnesium oxide, and anhydrous citric acid liquid | website=DailyMed | date=5 September 2023 | url=https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=e95fff66-4ec0-4001-a727-33e66a5ec7d5 | access-date=30 December 2023}}
References
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{{Laxatives}}
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