Bowel Prep: How to take Moviprep

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Why do I need to take MOVIPREP?

You have been prescribed Moviprep as a laxative to empty your bowel in preparation for your colonoscopy. It does this by causing you to have diarrhoea, or frequent bowel movements. A clean bowel will allow the endoscopist to have a clear view of the inner lining of your bowel, which is important for accurate diagnosis and treatment.

Please ensure that you follow the instructions carefully as your procedure may have to be cancelled and/or repeated at another time if your bowel is not clean enough.

These instructions may differ slightly from the manufacturer’s information leaflet, however, please follow this schedule. Do not take if you are allergic to any of the ingredients.

 Expected side effects?

  • You will experience diarrhoea as the purpose of Moviprep is to clear and cleanse the bowel.
  • You are also likely to experience some abdominal cramping.
  • Some patients may experience nausea and/or vomiting – if this is a problem, wait for ½ hour and then recommence taking Moviprep. Chilled Moviprep, drinking it through a straw and/or sucking a sweet may help resolve some side effects.
  • It is important that you continue to drink adequate amounts of fluid to avoid dehydration

Very Common 

  • Abdominal pain, a feeling of fullness in your stomach, bloating, tiredness, soreness/ pain of the anus (bottom), thirst and nausea.

Common

  • Hunger, headache, problems sleeping, dizziness, vomiting, indigestion, and chills.

Adverse reactions

  • Rarely, people can be allergic to Moviprep and may get an itchy rash (nettle rash or hives).

If any of the side effects become serious, or do not ease, or if you at all worried, or you notice any side- effects not listed above, you must seek advice from:

  • Endoscopy Department Tel: 01908 996 460 (Monday-Friday;8am- 6pm)
  • Your GP
  • NHS 111          

 What is Moviprep and how to take it?

Moviprep is a 1L PEG-based laxative designed to cleanse your bowel.

MOVIPREP® comes in a two-dose preparation:

  • Dose 1 is two sachets (A and B)
  • Dose 2 is two sachets (A and B)

All sachets must be taken with the right amount of water according to the timing of your appointment.

 How to prepare for your procedure

Seven days before your appointment

Stop taking any iron tablets as this can affect the quality of your test.

Five days before your appointment

Stop eating any food containing nuts/seeds/salads.

If you take any opioids painkillers (such as morphine/codeine/codydramol) on daily basis, consider the possibility to stop them or reduce the usual amount to increase the effectiveness of the laxatives.

Two days before your appointment

Start with your low fibre diet and stay on this diet until the procedure is done.

A low fibre diet before taking your laxative plays a key-role in making sure that your colonoscopy is effective.

 How to prepare MOVIPREP

Please make sure that you read the full instruction before you start preparing the laxative. Each Box of Moviprep contains two sealed bags. Each sealed bag contains 1 x sachet A and 1 X sachet B.

  1. Pour 1 sachet A and 1 sachet B into a jug.
  2. Make up to 1 litre with water (not chilled)
  3. Stir until dissolved (solution is clear or slightly hazy)
  4. Before taking the laxative, check the time of your appointment and select the appropriate instructions.

It is important that you take all doses of the medication, Moviprep works by emptying the content of your bowel, so you should expect to have watery bowel movements. You may want to ensure you have some soft toilet paper or wet wipes and you are allowed to apply a cream to the area if necessary.

 Morning Appointment

One day before your appointment

7-8 am Breakfast – See allowed food list.

No further solid foods until after the procedure – clear fluids only

You can make up the Moviprep solution now and refrigerate to make it easier to drink.

1 pm – Start drinking the 1st litre of Moviprep preparation.

One glassful (250mls/ ½ pint) of about every 15-30 minutes until you have drunk it all (1-2 hours). You may use a straw to help with the taste.

It is important to drink at least an additional 500ml of water (2 glasses) or clear fluids with each litre of Moviprep taken.

6 pm – Start drinking the 2nd litre of Moviprep preparation over 1-2 hours.

It is important to drink at least an additional 500ml of water (2 glasses) or clear fluids with each litre of Moviprep taken.

The day of your appointment: No solid food.

If you take blood pressure tablets, please take these with a small amount of water on the morning of your procedure.

If you are diabetic, do not take oral diabetic medications or short-acting insulin – if unsure please get in touch with your nurse/doctor about this.

Stop drinking 2 hours before your appointment time or 4 hours if you are having a Gastroscopy & Colonoscopy.

 Afternoon Appointment

One day before your appointment

7-8 am Breakfast – See allowed food list.

1pm Lunch – Have a light meal from the allowed foods list.

No further solid foods until after the procedure. – clear fluids only

You can make up the Moviprep solution now and refrigerate to make it easier to drink.

6 pm – Start drinking the 1st litre of the Moviprep preparation.

One glassful (250mls/ ½ pint) of about every 15-30 minutes until you have drunk it all (1-2 hours). You may use a straw to help with the taste.

It is important to drink at least an additional 500ml of water (2 glasses) or clear fluids with each litre of Moviprep taken.

The day of your appointment: No solid food.

If you take blood pressure tablets, please take these with water at least one hour before the final Moviprep on the morning of your procedure.

If you are diabetic, do not take oral diabetic medications or short-acting insulin – if unsure please get in touch with your nurse/doctor about this.

6:00am – Make up the second litre of Moviprep and drink it over 1-2 hours.

It is important to drink at least an additional 500ml of water (2 glasses) or clear fluids with each litre of Moviprep taken.

You should finish taking your Moviprep and additional water at least 2 hours before your colonoscopy.

Stop drinking 2 hours before your appointment time or 4 hours if you are having a Gastroscopy & Colonoscopy.

 Information for patients with diabetes

Treatment by tablets and/or insulin

You should inform the Endoscopy admissions office about your diabetes so that they can arrange for an early morning procedure time.

 Adjusting your diabetes medication to prevent hypoglycaemia

You will need to adjust your treatment the evening before and the morning of your procedure to reduce the risk of hypoglycaemia. As a result, your blood sugar control may be a little higher than usual.

This is only temporary to maintain your blood sugars through the procedure and you should be back to your usual level of control within 24-28 hours after the procedure. If you have and questions or concerns about adjusting your dosage, please contact your Diabetes Specialist Nurse well in advance for further advice.

 Carrying Glucose Monitoring

If you usually test your blood sugar levels, check them as usual on the morning of the procedure and carry your equipment with you to the appointment.

If you do not usually check your blood sugar levels, please do not worry, they will be checked when you arrive for the procedure.

People on tablets for diabetes

Aim to replace your usual carbohydrate intake from the list of permitted clear fluids. You may have sugary fluids or clear fruit juice to replace your usual carbohydrates.

Metformin Gliclazide Pioglitazone Sitagliptin/

Saxagliptin/

Linagliptin
48 hours before procedure Continue tablets Continue tablets Continue tablets Continue tablets
24 hours before procedure Continue tablets Continue tablets Continue tablets Continue tablets
Evening before test Omit dose Omit dose Continue tablets Continue tablets
Morning of the test Omit dose Omit dose Omit dose Omit dose
When discharged Continue tablets Continue tablets Continue tablets Continue tablets
  • If on Glibenclamide/ Chlorpropamide or tolbutamide, change to gliclazide by obtaining a prescription from the GP
  • Test blood glucose 4-6 hourly
  • Treat ‘hypos’ with a glass of Lucozade/any other sugary drinks. No Carbohydrate.

People on insulin for diabetes

Aim to replace your usual carbohydrate intake from the list of permitted clear fluids. You may have sugary fluids or fruit juice to replace your usual carbohydrates.

Insulin once a day, morning Insulin once a day, evening Insulin twice a day Insulin three times a day Insulin four times a day
48 hours before procedure Normal dose Normal dose Normal dose Normal dose Normal dose
24 hours before procedure Half the usual dose of insulin NA Normal morning dose Normal morning dose, half lunch time dose Normal morning dose, half the lunch time dose with a liquid lunch at 11.00 hrs (e.g., clear soup, fruit juices no pulp)
Night before test

(evening meal replaced with a glass of Lucozade)

 NA Half the usual dose Half of the evening dose Half nighttime dose Half the evening dose. Give 75% of the long-acting insulin (Levemir/Detemir or Glargine/Lantus)
Morning of the procedure.

Needs to be on AM list.

 Omit insulin NA Omit morning insulin Omit morning insulin Omit morning insulin

 

Exenatide Liraglutide Exenatide LAR
48 Hours before procedure Continue Continue  

Once weekly injection-no change, take as usual
24 Hours before procedure Continue Continue
Night before procedure Omit Omit
Morning of procedure Omit Omit

Essentials

  • SHOULD BE FIRST ON MORNING LIST ONLY
  • 24 hours before the procedure, start testing blood glucose 2-4 hourly.
  • Treat ‘hypos’ with a glass of Lucozade/any other sugary drinks no carbohydrate.
  • Test blood glucose before procedure.
  • Bring a sandwich to eat after the procedure.

If you have concerns about adjusting your insulin dosage, please contact your Diabetes Specialist Nurse well in advance of the procedure for further advice.

What Low Fibre Diet shall I follow?

Here is the list of food and drink allowed, you may want to cut it to put it on your fridge or take a photo on your phone to help with your food shopping before your procedure.

Low residue foods you can eat High Fibre foods to avoid
White cereals such as cornflakes or rice-based cereals.

White rice and pasta.

Plain white biscuits such as rich tea, custard creams, nice or malted milk.

White bread, crumpets, and scones (without dried fruit).

Well cooked meat, fish, cheese, or egg

Potatoes without the skin.

Jelly (NOT red ones)

 

 ×      Bread – wholemeal, high bran, granary, high fibre or half wholegrain.

×      Wholemeal pittas, chapattis and muffins.

×      Cereal bars, digestive biscuits, fruit cake, fig rolls.

×      Wholemeal lasagne/pasta.

×      Brown rice.

×      High fibre or bran crisp breads and crackers.

×      Wholemeal, wholegrain bran or high fibre cereals, porridge, and muesli.

×      Nuts.

×      Fruit – fresh, frozen, cooked, and dried.

×      Beans, lentils, and chickpeas.

×      Potatoes with skin on.
Drinks allowed Drinks to avoid
Water

Tea and/or coffee without milk

Soft drinks

Fruit juices without pulp

Clear soup

 ×      Alcohol

×      Milk

×      Any red or purple drink

×      Drinks containing pulp