FDA-Approved Sports Drink-Like Flavored Colonoscopy Preparation

FDA-Approved Sports Drink-Like Flavored Colonoscopy Preparation

Douglas K. Rex, MD, MASGE, reviewing Bhandari R, et al. J Clin Gastroenterol 2023 Jul 24.

This is a single, blind, multicenter, randomized, controlled trial that compared oral sulfate solution (OSS) to a sports drink-like flavored solution of polyethylene glycol and sodium sulfate (FPSS). Patients were instructed to drink 1 L of FPSS the evening before and 1 L the morning of colonoscopy, along with 16 ounces of water with each dose. Patients with severe renal, liver, or cardiac disease were excluded.

The overall rate of good or excellent preparation was 94% with both bowel preparations, confirmed by blinded, central readers. For the new flavored preparation, 18% of patients indicated consumption was very easy, 23% easy, and 45% tolerable. Eighty-seven percent of patients who consumed FPSS versus 74% of patients who drank OSS rated consumption of their respective bowel preparation as very easy, easy, or tolerable (P=.009). The overall experience was rated excellent or good by 74% with FPSS versus 58% with OSS (P<.001).

Douglas K. Rex, MD, FASGE


There is still a lot of use of homemade 2 L polyethylene glycol (PEG) 3350-based preparations in the U.S. These preparations typically require a boost with bisacodyl and/or magnesium citrate to achieve high levels of efficacy. PEG 3350-based preparations have high tolerability ratings. This new preparation approved by the U.S. Food and Drug Administration (FDA) appears designed to compete with homemade PEG 3350-based preparations. Compared to PEG 3350, this preparation has the advantages of FDA approval, a safer electrolyte mix, and no need for additional laxatives. The downside will surely be cost, and the relative tolerability of this preparation and PEG 3350-based preparations is currently unknown.

Note to readers: At the time we reviewed this paper, its publisher noted that it was not in final form and that subsequent changes might be made.


Bhandari R, Goldstein M, Mishkin DS, McGowan J, Cleveland MV, Di Palma, JA. Comparison of a novel, flavor-optimized, polyethylene glycol and sulfate bowel preparation with oral sulfate solution in adults undergoing colonoscopy. J Clin Gastroenterol 2023 Jul 24. (Epub ahead of print) (https://doi.org/10.1097/mcg.0000000000001894)

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