Citrafleet (Sodium Picosulfate, Magnesium Oxide, Light, Citric Acid)

Citrafleet is indicated for bowel preparation before diagnostic procedures and for the short‑term relief of constipation when other measures are insufficient.

• Colon cleansing prior to colonoscopy to ensure clear visualization of the colonic mucosa.
• Preparation for flexible sigmoidoscopy or other endoscopic examinations of the lower gastrointestinal tract.
• Adjunctive bowel evacuation in patients undergoing radiologic imaging that requires an empty colon.
• Short‑term treatment of functional constipation unresponsive to dietary fiber or mild laxatives.
• Use in pre‑operative protocols where a clean bowel is necessary for surgical access.

The safety profile of Citrafleet includes a range of gastrointestinal and systemic effects that vary in frequency.

Common

• Abdominal cramping or mild pain during the evacuation phase.
• Diarrhea or loose stools occurring within several hours after ingestion.
• Nausea or transient feeling of queasiness.
• Electrolyte shifts such as mild hypokalemia, especially with inadequate fluid intake.

Serious

• Severe dehydration due to excessive fluid loss.
• Marked electrolyte disturbances, including significant hypermagnesemia or hyponatremia.
• Acute colonic perforation, though rare, reported in high‑risk patients.

When prescribing Citrafleet, clinicians should consider several precautionary measures to minimize risks and ensure effective bowel preparation.

• Assess renal function; impaired kidneys may reduce magnesium clearance and increase toxicity risk.
• Evaluate electrolyte status before use, especially in patients with known imbalances.
• Avoid in individuals with known bowel obstruction, perforation, or severe inflammatory bowel disease.
• Ensure adequate oral fluid intake to prevent dehydration during the cleansing process.
• Use with caution in elderly or frail patients who are more susceptible to fluid shifts.
• Pregnancy and lactation status should be reviewed, as safety data are limited.
• Discontinue other stimulant laxatives while using Citrafleet to avoid cumulative effects.

Citrafleet may interact with other medications or substances that affect fluid balance, electrolyte levels, or gastrointestinal motility.

Avoid

• Concurrent use of other osmotic or stimulant laxatives, which can amplify dehydration and electrolyte loss.
• High‑dose antacids containing magnesium, increasing risk of hypermagnesemia.
• Potassium‑sparing diuretics or ACE inhibitors, which may exacerbate potassium disturbances.

Use with caution

• Loop or thiazide diuretics, as they can further alter sodium and potassium balance.
• Cardiac glycosides (e.g., digoxin) where electrolyte shifts may affect drug toxicity.
• Anticoagulants, because rapid bowel movements may affect absorption of oral agents.
• Oral antibiotics, as altered gut transit could modify their efficacy.