Safety and efficacy of two reduced dosing regimens of sodium phosphate tablets for preparation prior to colonoscopy

Abstract

Objectives: To evaluate the safety and efficacy of two reduced dosing regimens of sodium phosphate tablets (Visicol, InKine Pharmaceutical Co. Inc., Blue Bell, PA, USA) for colon cleansing prior to colonoscopy. Methods: In a randomized, multicentre, endoscopist‐blinded clinical study, adults undergoing colonoscopy received either 28 tablets (42 g) or 32 tablets (48 g) of sodium phosphate for colon cleansing. The endoscopist used a validated four‐point scale to rate the overall quality of colon cleansing, as well as cleansing in the ascending colon. Adverse events were collected and evaluated. Results: The quality of overall colon cleansing was `excellent' or `good' in 84% or more of both groups, with no significant difference between the two doses. No patient had a preparation rated as `inadequate' or required a repeat procedure. All patients were able to complete the assigned dose of tablets, and there were no deaths, serious adverse events or dropouts from the study. Conclusions: A reduced tablet regimen for sodium phosphate tablets, using either 28 or 32 tablets, is well tolerated and effective for colon cleansing prior to colonoscopy.

Meta‐analysis: the relative efficacy of oral bowel preparations for colonoscopy 1985–2010

“…The search strategy identified 292 potentially relevant studies, 154 of which were examined in detail and 104 of which were included in the final analysis 10–113 . (see Figure 1).…”

“…The addition of various antiemetics, 69 carbohydrate/electrolyte solution, 74 or simethicone 75 to liquid NaP did not alter bowel wall visibility, although the use of both antiemetics and the electrolyte solution improved patient tolerability. The use of a low residue, rather than liquid diet alongside the NaP also did not influence outcomes 73 …”

Bowel preparation for gastrointestinal procedures

“…Forty tablets are taken with 10 glasses of water (about 2.5 L). Rex et al [31] reported efficacy using 28 or 32 tablets. A new smaller tablet with less microcrystalline cellulose (reducing colonic residue) was approved by the US Food and Drug Administration (FDA) in March 2002.…”

Patient Preference and Acceptance with Sodium Phosphate Tablet Preparation for Colonoscopy

“…Rex et al [13] reported no significant differences in the quality of preparation when comparing a reduced regimen for NaP tablets (28 or 32 tablets) with the 40-tablet regimen that was recommended previously. As opposed to the 40-tablet regimen, where the presence of residual microcrystalline cellulose requires frequent irrigation and suctioning, this was not observed in our study patients, perhaps because the preparation consisted of a lower number of tablets and was ingested the night before colonoscopy.…”