Photo of a clean colon

Importance of PM|AM Split Dosing™

The PM|AM Split-Dosing regimen

Although many bowel preparations have been used as split doses, MoviPrep is the only PEG-3350 formulation currently approved by the US Food and Drug Administration (FDA) as a split-dose regimen.1

  • FDA approved for split dosing since 2006, MoviPrep provides excellent cleansing in clinical practice2
  • With indications for both PM|AM Split-Dosing and evening-only dosing regimens, MoviPrep is appropriate for a variety of your patients2
  • In 2008, the American College of Gastroenterology (ACG) published guidelines recommending split dosing for bowel preparations with at least half of the dose given on the day of the colonoscopy for optimum visualization3

Dosage and administration

The MoviPrep dose for bowel preparation for adult patients is 2 L (approximately 64 oz) of MoviPrep solution (with 1 additional liter of clear fluids) taken orally prior to the colonoscopy in one of the following ways2:

  • PM|AM Split-Dosing MoviPrep regimen: The evening before the colonoscopy, take the first liter of MoviPrep solution over 1 hour (one 8-oz glass every 15 minutes), and then drink 0.5 L (approximately 16 oz) of clear liquid. Then, on the morning of the colonoscopy, take the second liter of MoviPrep solution over 1 hour, and then drink 0.5 L of clear liquid at least 1 hour prior to the start of the colonoscopy2
  • Evening-only (full dose) MoviPrep regimen: Around 6 PM in the evening before the colonoscopy, take the first liter of MoviPrep solution over 1 hour (one 8-oz glass every 15 minutes), and then about 1.5 hours later, take the second liter of MoviPrep solution over 1 hour. In addition, take 1 L (approximately 32 oz) of additional clear liquid during the evening before the colonoscopy2

Most patients are willing to take a bowel preparation as a split dose

In a recent survey, 85% of patients would be willing to get up during the night to take the second dose of their bowel prep when informed of the importance of the quality of preparation for early detection of colorectal cancer.4

85%, willing to rise early & complete AM dose of prep78%, followed instructions and rose in middle of night to take AM dose

Survey participants: upper endoscopy patients or "drivers" of colonoscopy patients (mean age=56)
Survey participants: actual colonoscopy patients interviewed about compliance with bowel preparation instructions just prior to colonoscopy.

Nine out of 10 patients would take MoviPrep again1

Patient Satisfaction With Split Dosing

PM|AM Split Dosing vs evening-only dosing

In a comparative study, 89.3% of bowel preparations were effective when split dosed vs 69.5% for evening-only preparations. Patients who took evening-only preparations had significantly poorer bowel preparations vs patients who followed a PM|AM Split-Dosing regimen (P<0.001).5

The articles below are just a few examples of research on the benefits of split dosing.

Important Safety Information about MOVIPREP

MOVIPREP® (PEG-3350, sodium sulfate, sodium chloride, potassium chloride, sodium ascorbate and ascorbic acid for oral solution) is an osmotic laxative indicated for cleansing of the colon as a preparation for colonoscopy in adults 18 years of age or older. MOVIPREP is contraindicated in patients with gastrointestinal (GI) obstruction, bowel perforation, gastric retention, ileus, toxic colitis or toxic megacolon, and patients who have had a severe hypersensitivity reaction to any of its components. MOVIPREP should be used with caution in patients at risk of or with fluid and electrolyte abnormalities, hyponatremia, arrhythmias, seizures, in patients with impaired renal function or patients taking concomitant medications that affect renal function, patients with known or suspected inflammatory bowel disease, patients with suspected GI obstruction or perforation, patients at risk for aspiration, and patients with glucose-6-phosphate dehydrogenase deficiency. Most common adverse reactions for split dosing (incidence ≥5%) are malaise, nausea, abdominal pain, vomiting, and upper abdominal pain. The most common adverse reactions for evening only dosing (incidence ≥5%) are abdominal distension, anal discomfort, thirst, nausea, abdominal pain, sleep disorder, rigors, hunger, malaise, vomiting, and dizziness. MOVIPREP contains 233 mg of phenylalanine per treatment. Advise patients to hydrate adequately before, during, and after the use of MOVIPREP.

You are encouraged to report negative side effects to the FDA. Visit www.fda.gov/safety/medwatch/ or call 1-800-FDA-1088.

Complete Prescribing Information pdf icon

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References: 1. Data on file. Salix Pharmaceuticals, Inc. 2. MoviPrep [prescribing information]. Morrisville, NC. Salix Pharmaceuticals, Inc; 2011. 3. Rex DK, Johnson DA, Anderson JC, Schoenfeld PS, Burke CA, Inadomi JM. American College of Gastroenterology guidelines for colorectal cancer screening 2008. Am J Gastroenterol. 2009;104:739-750. 4. Unger RZ, Amstutz SP, Seo da H, Huffman M, Rex DK. Willingness to undergo split-dose bowel preparation for colonoscopy and compliance with split-dose instructions. Dig Dis Sci. 2010;55:2030-2034. 5. Khan MA, Wasiuddin N, Brown M. Patient acceptance, convenience and efficacy of one-day versus two-day colonoscopy bowel preparation. Poster presented at: Digestive Disease Week; May 17-22, 2008; San Diego, CA. 6. Cohen LB. Split dosing of bowel preparations for colonoscopy: an analysis of its efficacy, safety, and tolerability. Gastrointest Endosc. 2011;73:848. 7. Johanson JF, Popp JW, Cohen LB, et al. A randomized, multicenter study comparing the safety and efficacy of sodium phosphate tablets with 2L polyethylene glycol solution plus bisacodyl tablets for colon cleansing. Am J Gastroenterol. 2007;102:1-9.