MiraLAX 2-Day Prep

MiraLAX 2-Day Prep Explained

This extended bowel preparation is used for patients who need a more thorough colon cleanse, such as those with constipation, patients taking GLP-1s, or prior incomplete prep results. It uses dietary restrictions and staged bowel cleansing to help ensure the colon is fully cleared so it can be carefully examined during colonoscopy.

Important Things to Know

Clear liquids ONLY for 2 days prior to your procedure, from the moment you wake up.
Continue all aspirin and anti-inflammatory medications including ibuprofen, Motrin, Aleve, naproxen, Naprosyn, sulindac, piroxicam, Feldene, indomethacin, diclofenac, and Voltaren. Tylenol (acetaminophen) is also safe to continue.
If you take a prescribed blood thinner you will need holding instructions from our office.
Arrange to have a driver take you home after the procedure. You will not be allowed to drive after receiving sedation.
If you have diabetes or are taking medications for weight loss, use the following instructions:
- Fasting (going without food) is required for this procedure, monitor your blood sugar and follow these directions
  - GLP-1 - STOP 7 days prior to your procedure. (ex: Ozempic, Wegovy, Mounjaro, Zepbound, Trulicity, Semaglutide, Tirzepatide)
  - SGLT2 - Stop 3 days prior to procedure (ex: Jardiance, Farxiga, Invokana, Steglatro, Brenzavvy, Glyxambi, Synjardy, Xigduo, Qtern)
  - Other oral diabetic medication: do not take the morning of your procedure.
  - Insulin Pump: Leave on, if you have questions refer to your endocrinologist.
  - Long-acting Insulin: half dose the evening before procedure. Do not take the morning of your procedure.
  - Short-acting insulin: dose as necessary with blood sugar monitoring.
  - If you are concerned about your blood sugar dropping, consider purchasing glucose tablets.

Timing & Schedule

MiraLAX 2-Day preparation follows a structured timeline that begins several days before your procedure and continues through the morning of your exam. You’ll make diet and supplement adjustments in advance, follow a clear-liquid diet for an extended period, and complete the prep in scheduled stages. Detailed instructions and exact timing are provided below.

Instructions:

Step 1.

7 Days Before Your Procedure

If Applicable,

STOP ALL GLP-1 medications 7 days prior to procedure.

Step 2.

5 Days Before Your Procedure

No nuts or seeds.
Stop all fiber supplements including Metamucil, Citrucel, Benefiber, FiberChoice and flax seeds. If you are taking these to treat constipation, take 17g of MiraLAX daily starting five days prior to your procedure in place of the fiber. (This will require you to purchase MiraLAX in addition to bowel preparation).
Stop all iron supplements, fish oil, CBD oil, or any oil-based supplements.

Step 3.

3 Days Before Your Procedure

If Applicable,

STOP SGLT2 medications 3 days prior to procedure.

Step 4.

2 Days Before Your Procedure

From the moment you wake up, start a clear liquid diet. Do not eat breakfast. Avoid red beverages.
Clear liquids only by mouth. This includes clear juices (apple, grape, strained orange, strained lemonade), tea, coffee (no milk or creamer), soft drinks, sports drinks (Gatorade, Powerade), clear broth or bouillon, Jell-O, and Popsicles.
Avoid red drinks, red Jell-O, and dairy products.
Consume large amounts of clear fluids to increase success of the bowel flush, help avoid hunger, and avoid dehydration.
6:00 pm take (4) Bisacodyl tablets – you may experience cramps and stools after ingestion.

Step 5.

The Day Before Your Procedure

Continue the clear liquid diet from the day before, do not eat any solid food. Avoid red beverages.
3:00 pm, take another (4) Bisacodyl tablets - you may experience cramps and stools after ingestion.
5:00 pm, mix the full bottle of MiraLAX (238 g or 14 capfuls) into 64 ounces (8 Cups) of your selected sports drink. Shake until completely dissolved
- To decrease the chance of nausea, you may take one Zofran tablet 30-60 minutes prior to drinking your prep.
- Drink one 8 - ounce glass every 10-15 minutes until you have finished the 64 ounces (8 cups).
If no stools occur within 2 hours of completion, please repeat this step. This will require you to purchase more MiraLAX and sports drinks.
If you experience nausea while taking your prep, stop drinking and allow the nausea to settle. You may take a Zofran tablet to help ease your nausea. When you resume drinking, drink slower or through a straw to help avoid nausea. If vomiting occurs, please call us at the numbers above.
Continue drinking clear liquids. This helps your prep be more successful.

Step 6.

The Day Of Your Procedure

6 hours prior to your procedure (i.e., if your appointment is at 10 am, start at 4 am. If appointment is 1 pm, start at 7 am).
- Mix the second bottle of MiraLAX (238g or 14 capfuls) with the remaining amount of your selected sports drink. Shake until completely dissolved. Drink the mixture starting).
- Drink 8 ounces every 10-15 minutes. It is necessary to drink the ENTIRE 2nd bottle, even if your bowels appear clear.
- To decrease the chance of nausea, you may take one Zofran tablet 30-60 minutes prior to drinking your prep. If you experience nausea while drinking your prep you may take the fourth and final Zofran tablet.
Stools should be watery, yellow and see-through. If you have concerns about the quality of your prep, please call us.
Continue consuming clear liquids after prep completion to avoid dehydration up until 4 hours prior to your scheduled procedure.
4 hours prior to your procedure STOP drinking fluid. You may take small sips of water only to take your prescribed medications – this is very important. Drinking within 4 hours of your procedure may result in delay or cancellation.
Bring a list of your current medications and correct dosages to your appointment.

Step 7.

After Your Procedure

NO DRIVING – you cannot drive for the remainder of the day if you are sedated. You need to have a responsible driver to take you home after your procedure. If your driver wishes to discuss the results of your procedure with the doctor, have them accompany you to your procedure and remain on site.
We do not recommend Uber, Lyft, or taking a taxi – these are not acceptable forms of transportation.
You will be sedated for your procedure. Please avoid alcohol and making legal decisions for the remainder of the day after your procedure.

Take Aways

Additional Details

Medication:

STOP GLP-1 medications 7 days prior to your procedure.
STOP SGLT2 medications 3 days prior to procedure.
Clear liquids only for two days before and the day of your exam. Do NOT drink any fluids 4 hours prior to your exam.
You must complete your entire bowel prep. We often see poor bowel preparations because patients stop drinking.
If you have trouble drinking the prep, try sucking on ice or a lemon wedge, brush your teeth, chew gum, or rinse your mouth.
If you finish the whole prep and your stool is brown, thick, or not clear please call us for advice.
If you are nauseated or vomit with the prep, stop drinking to allow your stomach to settle and take the Zofran we provide.
You may not remember your conversation with your doctor after your procedure – we STRONGLY recommend your driver stays IN our facility to speak with the doctor after your test.

Your procedure time will be approximately 90 minutes from the scheduled check-in time to discharge for procedures in the Meridian, Boise, and Canyon County Endoscopy Centers. Please coordinate with your driver to alleviate delays in discharge. Patients’ stay times for hospital procedures may be longer.
We cannot be responsible for your valuables (watches or various jewelry items). Please leave them at home.
Bring all insurance cards and a photo ID with you.
Please check with your insurance company regarding prior authorization. Fee for services is required at time of check-in.
Please be prepared to make a payment.
IGA recognizes that your time is valuable, and so is ours. If you need to cancel or reschedule an appointment, please do so more than 48 business hours prior to your scheduled appointment arrival time at 208-343-6458. Late cancellations and no shows may be assessed a $200 fee.

These instructions summarize the MiraLAX Two-Day Constipation prep used at Idaho Gastroenterology Associates. They do not replace the detailed written directions you receive. Always follow the specific instructions provided for your procedure and contact us if anything is unclear.

MiraLAX 2-Day Prep