Citric acid with magnesium carbonate

Citric acid with magnesium carbonate, when reconstituted, forms magnesium citrate, an osmotic laxative. This agent works by drawing water into the intestinal lumen from the surrounding tissues. The increased intraluminal fluid distends the colon and softens the stool, thereby stimulating peristalsis and facilitating bowel evacuation.

Adult

1 sachet, given 8 a.m. the day before the procedure and 1 sachet, given between 2 and 4 p.m. the day before the procedure

Pediatric

Child 5–9 years: One-third of a sachet to be given at 8 a.m. the day before the procedure and, one-third of a sachet to be given between 2 and 4 p.m. the day before the procedure. Child 10–17 years: 0.5–1 sachet, given at 8 a.m. the day before the procedure and 0.5–1 sachet, given between 2 and 4 p.m.

Renal adjustment

Adults: Avoid if eGFR less than 30 mL/minute/1.73 m2—risk of hypermagnesaemia. Children: Avoid if estimated glomerular filtration rate less than 30 mL/minute/1.73 m2—risk of hypermagnesaemia.

Geriatric

Use half the dose in frail elderly patients

• Acute intestinal or gastric ulceration
• Acute severe colitis
• Gastric retention
• Gastro-intestinal obstruction
• Gastro-intestinal perforation
• Toxic megacolon