Instructions for taking Moviprep bowel preparation

If you have been prescribed an oral bowel cleansing agent (also known as bowel preparation), it is important to follow these instructions carefully. This is to ensure that you take this bowel preparation in a safe manner and also have a clear bowel so that good views are obtained during your test.

There is a risk of developing dehydration, low blood pressure or kidney problems with this medication. The doctor prescribing the oral bowel preparation will have assessed your risk and identified the most appropriate medication for you. You may also have had a blood test to assess your kidney function.

You should make sure that you drink enough fluids while you are taking the bowel preparation to avoid dehydration. The symptoms of dehydration include dizziness or light-headedness (particularly on standing up), thirst or a reduced urine production. Try to drink a glass of water every hour that you are awake.

Medications

You should follow any specific advice that you have been given regarding your regular medications.

Medications that you may have been asked to temporarily discontinue include:

antihypertensives (to lower your blood pressure, such as ACE inhibitors like ramipril)
diuretics (“water tablets” such as furosemide)
non-steroidal anti-inflammatory drugs (a type of painkiller, such as ibuprofen)
iron preparations (for anaemia, such as ferrous sulphate)
aspirin, dipyridamole, clopidogrel, warfarin, apixaban and rivaroxaban (these are medications that thin your blood; you may have been asked to discontinue them depending on the nature of the procedure that is planned).

If you have diabetes, please discuss this with your treatment team.

If you have not received specific advice regarding your regular medications, then you should continue to take them as normal. However, you may need to change the timing as it is preferable to avoid taking them less than 1 hour either side of bowel preparation.

Patients taking immunosuppression for transplanted organs should seek the advice of their doctor before taking bowel preparation.

Patients taking the oral contraceptive pill should take alternative precautions during the week following taking any bowel preparation.

We would like you to follow the following instructions while taking your bowel preparation as it is so important that we obtain a good view when you have your test. You may notice that there are some other instructions in your box of bowel preparation but we feel that you will have a better result by following these instructions.

3 days before colonoscopy

What to eat and what to avoid

You may eat	You should avoid
Cereals: Cornflakes, Rice Krispies, Sugar Puffs and Coco Pops	Wheat bran, All-bran, Weetabix, Shredded Wheat, oat bran, bran flakes, wheat flakes, muesli, Ready Brek, porridge
White bread (you may use butter/margarine)	Wholemeal, high-fibre white, soft grain or granary bread, oatbread
White pasta, white rice	Wholemeal pasta, brown rice
White flour	Wholemeal or granary flour, wheatgerm
Potatoes (no skin)	Fruit and vegetables
Savouries: chicken, turkey, fish, cheese and eggs	All red meat
Puddings, pastries, cakes. Milk puddings, mousse, jelly (not red) sponge cakes, Madeira cakes, rich tea, wafer biscuits	Those containing wholemeal flour, oatmeal, nuts, dried fruit, fruit cake, Ryvita, digestives or Hobnob biscuits
Preserves and sweets: sugar, jelly jam, jelly marmalade, honey, syrup, lemon curd	Jam or marmalade with pips, skins and seeds, sweets and chocolate containing nuts/ fruit, muesli bars
Soup: Clear or sieved soups	Chunky vegetable, lentil or bean soups
Miscellaneous: salt, pepper, vinegar, mustard, salad cream, mayonnaise	Nuts, Quorn, fresh ground peppercorns, hummus, anything containing seeds

Please note that instructions for taking Moviprep are different if you are having a colonoscopy in the morning (AM colonoscopy instructions), or in the afternoon (PM colonoscopy instructions).

Have breakfast before 9am. Do not eat anything after this because your bowel must be completely empty for the colonoscopy. For breakfast stick to the low fibre foods mentioned above in the table ‘What to eat and what to avoid’.
After 9am, you may also have clear soup, soft drinks, tea and coffee (without milk). All your drinks must be clear. Avoid milk, fruit and puddings. Do not take solid food.
At 5pm, make up your first litre of Moviprep (sachets A and B) and drink it over 1 to 2 hours. Have a rest for 2 hours. It is important to drink an additional 500ml of water or clear fluids with each litre of Moviprep.
At 8 to 9pm, make up your second litre of Moviprep (sachets A and B) and drink it over 1 to 2 hours. It is important to drink an additional 500ml of water or clear fluids with each litre of Moviprep during the evening.
Allow 2 hours for Moviprep to work after finishing the second litre. You can go to bed when you stop going to the toilet (for example 11pm).
You may drink as much clear fluid as you like until 2 hours before your treatment. This should be in addition to each litre of Movieprep and the essential 500ml clear fluid you must drink alongside these.

On the day before your colonoscopy, have lunch before 1pm. Do not eat anything after this because your bowel must be completely empty for the colonoscopy. For breakfast and lunch stick to the low fibre foods mentioned above on ‘What to eat and what to avoid’.
After 1pm, you may also have clear soup, soft drinks, tea and coffee (without milk). All your drinks must be clear. Avoid milk, fruit and puddings. Do not take solid food.
At 7pm, make up your first litre of Moviprep (sachets A and B) and drink it over 1 to 2 hours. It is important to drink an additional 500ml of water or clear fluids with each litre of Moviprep during the evening.
Allow 2 hours for Moviprep to work after finishing the second litre. You can go to bed when you stop going to the toilet (for example 10pm).
On the day of the colonoscopy, remember not to eat anything. At 6am make up your second litre of Moviprep (sachets A and B) and drink it over 1 to 2 hours. It is important to drink an additional 500ml of water or clear fluids with each litre of Moviprep during the morning.
Once again, you will have watery bowel movements which will stop after 2 hours allowing you to leave home in good time for your appointment. Allow 2 hours for Moviprep to work before leaving to attend your hospital appointment.

Hints and tips

Once dissolved, (this may take up to 8 minutes), the solution can be refrigerated.
Try using a straw.
Stay hydrated with plenty of clear fluids

On the day of colonoscopy

If you are concerned or worried during preparation for your colonoscopy, please do not hesitate to contact the hospital or your doctor for advice.

Continue to take plenty of clear fluids until 2 hours before the test.
Stop all intake of fluids 2 hours before your colonoscopy.
Do not take any solid food.

Fluids allowed

You may choose from the following:

tea with lemon or sugar if desired but without milk
black coffee with sugar if desired
herbal teas
water
diluted cordials (but not blackcurrant)
clear fruit juice (without pulp)
Oxo, Bovril, Marmite (weak)
stock cubes
clear soups and broths (sieved) or consommé
jelly (must be one containing no fruit)

You must not have any milk or any drinks containing milk.

Please do not take any solid food on the day of your colonoscopy.

If you experience problems, advice is available from the Integrated Procedures Unit on 0161 918 2420. Out of hours (7pm to 7am), please contact ward 10 on 0161 446 3860.