Instructions for taking PLENVU® bowel preparation – prior to surgery

You have been prescribed an oral bowel cleansing agent which is also known as bowel preparation. It is important to follow these instructions carefully to ensure that you take this bowel preparation in a safe manner.

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 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.

• If you have type 1 diabetes – it is essential that you contact your local diabetes specialist team for individual advice. If you are not able to contact your local diabetes team, please contact the diabetes specialist nurse (DSN) at The Christie on 07990 530161 or email the-christie.diabetes@nhs.net.
• If you have type 2 diabetes – please contact the DSN at The Christie who will provide you with support to manage your diabetes while you are preparing for your surgery.
• 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. 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.

The day before surgery

PLENVU® is a strong laxative which will cause diarrhoea and empty the bowel. It is wise to stay near to a toilet once you have taken this medicine. Avoid travelling once you have taken the first dose. You can have a light breakfast but not eat anything after this and ensure you drink plenty of clear fluids throughout the day. Prepare each 500ml of your PLENVU® as follows:

• at 10 am to 11 am, open the box and remove the Dose 1 sachet
• pour the contents of the sachet into a measuring container that can hold at least 500ml of fluid
• add water to make up to 500ml and stir until all the powder has fully dissolved
• each dose of PLENVU® must be sipped slowly over 30 minutes, followed by 500ml of additional clear fluid over a further 30 minutes
• 3 to 4 hour break
• at 2pm to 3pm, open the box and remove the Dose 2 sachets A and B
• pour the contents of both sachets into a measuring container that can hold at least 500ml of fluid
• add water to make up to 500ml and stir until all the powder has fully dissolved

Each dose of PLENVU® must be sipped slowly over 30 minutes. It is important that you drink an additional 500ml of water or clear fluid over a further 30 minutes as well as the PLENVU®.

Hints and tips

• Sip slowly over 30 minutes.
• 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 surgery

Please do not eat food. Please follow the instructions on your admission letter regarding fluid intake.

Fluids allowed while taking PLENVU® bowel preparation

You may choose from the following:

• tea with lemon or sugar, if desired, but without milk
• black coffee with sugar if desired
• water
• fruit squash
• Oxo, Bovril, Marmite (weak)
• stock cubes
• clear soups and broths (sieved) or consommé

You must not have any milk or any drinks containing milk. Please do not take any solid food once you have started your bowel prep or on the day of your surgery.

If you experience problems, advice is available on The Christie Hotline on 0161 446 3658 or you can contact your nurse specialist.