Preparing for a colonoscopy with Lavacol

Can:

• Soups with low-fat meat broth without vegetables, dishes made from lean beef, veal, fish, boiled chicken, eggs;
• Products rich in calcium (low-fat cottage cheese, cheeses), kefir, natural yogurt, no more than 2 glasses of milk;
• White bread, muffins, biscuits, bagels - without poppy seeds, vermicelli and noodles made from premium flour, porridge (rice and oatmeal), white rice;
• Vegetable decoctions, potatoes, mousses, peaches, melon, compotes, jelly, juices (without pulp), weak coffee, tea;
• Sugar, honey, jellies, syrups;
• Butter and vegetable oil, margarine, mayonnaise in limited quantities.

General information about the drug

Registration number: R№ LS - 000443

Trade name: Lavacol®

Dosage form: Powder for the preparation of solution for oral administration.

Composition per package (14.0 g):

• Polyethylene glycol MM 4000 - 12.0 g
• Sodium sulfate anhydrous - 1.0 g
• Sodium bicarbonate - 0.6 g
• Sodium chloride - 0.2 g
• Potassium chloride - 0.2 g

Description:

Powder of white or white with a yellowish or grayish tint. One packet of the drug is dissolved in 200 ml of water. The resulting solution is a colorless or slightly colored liquid, slight opalescence is allowed.

Pharmacological properties:

The action of the drug is based on the combination of a high molecular weight polymer with an isotonic solution of electrolytes. Polyethylene glycol MM 4000 prevents the absorption of water from the stomach and intestines and promotes accelerated evacuation of intestinal contents through frequent bowel movements. The electrolytes contained in the drug prevent disturbances in the body's water-electrolyte balance.

Indications for use:

Preparation for endoscopic or x-ray examination of the colon, as well as for surgical interventions that require the absence of contents in the intestine.

Contraindications:

Severe disturbances in the patient's general condition (including dehydration, heart failure), intestinal obstruction, toxic expansion of the colon, gastric stenosis, perforation of the stomach or intestines, erosive and ulcerative lesions of the gastrointestinal tract, impaired renal function.

Side effect:

In rare cases, nausea and vomiting, a feeling of heaviness and discomfort are possible when taking the first doses of the drug.

Release form:

Powder in bags of 14 g of combined film material. 15 bags, along with instructions for use, are placed in a cardboard pack.

It is allowed to pack packages together with an equal number of instructions for use in a group package.

Storage conditions:

At a temperature not exceeding 25°C, in a dry place out of reach of children.

Best before date:

3 years. Do not use after the expiration date stated on the package.

It is forbidden:

• Fatty fish and meats, duck, goose, smoked meats, sausages;
• Yogurts containing fillers (fruit, muesli), puddings, cream, sour cream, ice cream, fatty cottage cheese;
• All grain-containing products, brown bread, cereals (not included in the list of permitted ones), legumes, peas, etc.;
• Fresh and dried vegetables and fruits, cabbage in any form, raisins and berries, all varieties of greens;
• Alcoholic drinks, kvass, carbonated drinks, prune drinks;
• Hot seasonings (horseradish, pepper, mustard, onion, vinegar, garlic), all seasonings (sauces) with grains, herbs, pickles, canned food, etc.

Lavacol

Lavacol

® (
Lavacole
) is a Russian-made laxative drug used in bowel preparation before instrumental examinations.

Dosage form and composition of Lavacol

Lavacol is available in the form of sachets containing powder for the preparation of a solution for oral administration. Weight of powder in one sachet is 14.0 g, including:

• polyethylene glycol MM 4000 (macrogol 4000) - 12.0 g
• sodium sulfate anhydrous - 1.0 g
• sodium bicarbonate - 0.6 g
• sodium chloride - 0.2 g
• potassium chloride - 0.2 g

Indications for use of Lavacol

Lavacol is used in the preparation of:

• for instrumental studies of the lower intestine:
• colonoscopy
• X-ray examination of the colon
• anorectal and colonic manometry

Lavacol and colonoscopy. Including economic aspects

High-quality preparation of the colon is the most important factor determining the effectiveness of colonoscopy, its duration and the success of therapeutic procedures, reduces the risk of complications, eliminates the need for repeated examinations, which also affects the economic side.
The condition for ideal preparation of the colon for colonoscopy is the complete absence of contents in the intestine or a moderate amount of residual clear liquid, sometimes mixed with mucus, which does not interfere with a full examination and is freely aspirated. However, in daily clinical practice, endoscopists regularly encounter poor visualization during colonoscopy. Preparing the colon for colonoscopy is a complex process that usually disrupts the patient’s usual rhythm of life. The method of oral intestinal lavage using the drug Lavacol is the method of choice for the combination of safety, effectiveness and comfort for the patient when preparing the colon for examination and surgery. Taking the solution does not lead to disruption of the physiological constants of the body, hemodynamic parameters, and does not change the well-being of patients. Lavacol does not contain flavorings or additives, which makes it easier to take and improves compliance. Experience with the use of the drug Lavacol gives grounds to recommend it for widespread use in clinical practice. It is important that the use of the drug Lavacol is more economically justified for patients: Lavacol costs 170 rubles in pharmacies, Fortrans - 550 rubles. (both drugs are included in the Vital and Essential Drugs list), Endofalk - from 500 rubles, Fleet phospho-soda - from 1500 rubles. Undoubtedly, the classical scheme (using enemas) has the minimum cost, but with this method labor costs increase significantly, and such a scheme is much less comfortable for patients than taking modern means intended for high-quality preparation.*

*The text of the section is based on the article: Shindina T.S., Maksimov M.L. Use of the drug Lavacol for high-quality intestinal preparation for colonoscopic examination // Breast Cancer. 2015. No. 21. pp. 1287–1289.

How to use Lavacol

The contents of 1 sachet of the drug are diluted in 1 glass of water (200 ml) at room temperature.
You can add syrup or jam to the solution to improve the taste. Lavokol solution is taken 200 ml every 20-30 minutes. The solution can be washed down with water or water with lemon. The total amount of solution to drink is 3 liters (15 doses of 14 g each). Defecation begins an hour and a half after starting to take Lavokol and stops 1-3 hours after taking the last dose. Dosage regimens for Lavacol:

• if the study is scheduled for 8-10 am, then Lavacol is taken on an empty stomach from 16:00-17:00 to 21:00-22:00 the night before, after 22:00 food is not taken
• if the study is scheduled for 11-13 hours or later, then the entire dose of Lavacol is divided into 2 doses - from 18:00 to 21:00 and from 6:00 to 7:00 in the morning, after which food is not taken until the study

An examination (colonoscopy) is possible no earlier than 4 hours after the last dose of the drug.
See also the article: “Preparation of the colon for instrumental studies.”

Contraindications to the use of Lavacol

Lavacol is not recommended for severe disturbances in the general condition of the patient, dehydration, heart failure, intestinal obstruction, toxic expansion of the colon, gastric stenosis, perforation of the stomach or intestines, erosive and ulcerative lesions of the gastrointestinal tract, and renal dysfunction.

Side effects of Lavacol

During therapy with Lavokol, the following occasionally occurs: nausea, vomiting, a feeling of heaviness and discomfort when taking the first doses of the drug.

Other medicines containing the active ingredient macrogol

Macrogol, as an active ingredient, is included in the following medications: Osmogol, Realaxan, Tranzipeg, Forlax, Forteza Rompharm, Fortrans. Endofalk is a drug that contains, in addition to macrogol, the following active substances: sodium chloride, sodium bicarbonate, potassium chloride.

general information

According to the pharmacological index, Lavacol belongs to the group “Laxatives”.
According to ATC - to the group “A06 Laxatives”, subgroup “A06AD Osmotic laxatives”, code “A06AD15 Macrogol”. Manufacturer of Lavokol: Moscow Pharmaceutical Factory CJSC. Developer: State Scientific Center for Coloproctology named after A.N. Ryzhikh of the Russian Ministry of Health.

On the website gastroscan.ru in the literature catalog there is a section “Laxatives”, containing medical articles relating to laxatives and their use.

Lavacol has contraindications, application features and side effects. Before using macrogol, you should consult your doctor.

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Preparation of Lavacol solution

• The solution is prepared at the rate of 1 sachet per 200-250 ml of water;
• Take the solution in small sips, 200-250 ml at intervals of 20-30 minutes;
• Taking Lavacol must be completed no later than 3-4 hours before the scheduled procedure;
• 1-2 hours after the start of treatment, the urge to have a bowel movement will appear;
• Bowel movement will be completed 1-2 hours after taking the last packet of Lavacol;
• The doctor may change the time of taking the drug, but it is important to maintain the specified proportions and intervals.

If the procedure is scheduled for the first half of the day (before 12.00)

The day before, before 15.00, a light meal. Can be eaten: clear broth; green tea; clear juices without pulp; jelly without berries and grains; still water; clear liquids without red pigment. From 17.00 to 22.00, take Lavacol 15 sachets.

On the day of the study it is permissible: Tea with honey or jelly without pulp, berries and grains. Lavacol is not required.

How to prepare for a colonoscopy examination?

In order to examine the intestinal mucosa, it is necessary that there is no feces in the lumen and on the walls of the intestine. The success and information content of the study is determined mainly by the quality of preparation for the procedure, so be careful about following the recommendations for preliminary preparation and following the method of using the drug.

Preliminary preparation of the intestine for examination

If you do not suffer from constipation, you should follow the following diet for two days before your colonoscopy.

Exclude from the diet:

• all fresh vegetables and fruits, including beets (borscht), potatoes, herbs, berries
• “coloring” drinks: tomato, pomegranate juice, black coffee, Coca-Cola, etc.
• black bread, mushrooms, beans, peas
• Activated carbon

Allowed for food:

• bouillon
• semolina
• egg
• omelette
• boiled meat
• fish
• cheese
• oil
• fermented milk products, except hard cottage cheese

If you have a tendency to constipation (lack of independent bowel movements for 3 days), then you need to take your usual laxatives 2 days before the test, and also adhere to the diet described above.

While taking the drug, only liquid food (broth, sweet green tea) is consumed.

On the morning of the test, you should drink green sweet tea.

Preparation with LAVAKOL OR FORTRANS

1.5-2 hours after starting to take the drug, stool will appear. Bowel movements will occur many times while taking Lavacol or Fortrans. The effect of the drug will continue for 1-2 hours after the end of its administration. Colon cleansing ends with the release of a clear or slightly colored liquid.

The study is carried out on an empty stomach. You can't have dinner, breakfast, or drink! In the morning, on the day of the study, visit the toilet in order to evacuate residual fluid from the intestines.

There are patients who cannot take these drugs for some reason, most often it is a taste aversion to such volumes of the drug. More recently, a new group of drugs has appeared, their mechanism of action and quality of preparation is similar to the previously described Levacol and Fortrans, but the volume of the drug is smaller and the taste is better.

The severity of the diet is the same as described above.

The day before the study

In the morning: light breakfast (semolina, oatmeal), yogurt, white bread, cheese, butter, cottage cheese, confectionery products made from white flour without additives, chocolate, ice cream, etc.).

After breakfast and until the end of the study, you cannot take solid food; you need to drink clear liquids (for example: tea, broth, clarified juices).

Lunch: no later than 15.00 you can drink broth with a small piece of white bread.

From 17.00, you begin taking drugs to cleanse the intestines if the preparation for the study is one-stage (when the entire drug is taken the evening before the study). If the examination is under anesthesia either closer to noon or in the afternoon, then preparation begins at 19.00.