This article is more than 5 years old. Information may no longer be current.
Risk for severe hyponatremia from sodium picosulfate bowel prep qualified for older adults
More instances of hyponatremia were reported from sodium picosulfate bowel preparations compared with polyethylene glycol, but researchers reported no greater risk for acute neurologic symptoms or mortality, according to new data.
Canadian researchers conducted a population-based retrospective cohort study of patients aged 66 years or older by using six linked databases managed by Canada’s Institute for Clinical Evaluative Sciences spanning 2006 to 2012. New users of sodium picosulfate (n=99,237) or polyethylene glycol (n=48,595) were analyzed based on a primary outcome of hospitalization with hyponatremia; secondary outcome of hospitalization with urgent head computed tomography (CT). Patients who received prescriptions for constipation were excluded, as were those who had bowel cleansing for bowel surgery (28% of cohort), patients with recent colonoscopy or those receiving chronic dialysis.
“The baseline characteristics of the two groups, including patient demographics, comorbid conditions, and concomitant medications, were nearly identical,” the researchers wrote.
When compared with polyethylene glycol, sodium picosulfate was linked to a higher adjusted risk for hospitalization with hyponatremia (aRR=2.4; 95% CI, 1.5-3.9) but not hospitalization with urgent CT head (aRR=1.1, 95% CI, 0.9-1.4) or mortality (aRR=0.9; 95% CI, 0.7-1.3).
“The increased risk of hospital admission with hyponatremia … with sodium picosulfate should not simply discourage its use,” the researchers wrote. “Sodium picosulfate is a very effective and well-tolerated agent. Rather, our findings should serve as a reminder to those prescribing sodium picosulfate that electrolyte-free water must be consumed in moderation during its use.”
Disclosures: The researchers report no relevant financial disclosures.