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Microsoft word - trilyte split pm.doc

INSTRUCTIONS for COLONOSCOPY
TRILYTE Preparation (Split-PM)
GASTROENTEROLOGY ASSOCIATES
of Northern Virginia, Ltd.
MEDICATIONS:
Take your usual prescription medications.
One week before procedure, stop taking iron,
PREP:
aspirin, Advil (ibuprofen), Aleve, Vitamin E or
herbal / iron supplements.
TRILYTE SOLUTION
You may take TYLENOL (acetaminophen) &
other non-narcotic pain relievers prescribed by
Starting at 7:00pm, drink an 8oz glassful every
your physician.
10 minutes until ½ the liquid is gone (2 liters.)
If you use other prescription pain relievers, ask
**Refrigerate the remainder of the solution**.
the doctor or nurse when the last dose can be
If you feel nauseated during the process, take a
taken prior to procedure.
break from drinking until your stomach settles
If you take Coumadin or blood thinners, please
and restart the process again.
contact your primary doctor for specific
At 9:00pm, take 4 Dulcolax tablets with water.
instructions on usage before, during and after
Before retiring, drink at least three (3) 8oz
your procedure.
glasses of clear liquids to help prevent
dehydration.
You will need to purchase:
TRILYTE KIT – PRESCRIPTION
* DAY OF COLONOSCOPY *
DULCOLAX LAXATIVE (5mg Tablets)
***No Prescription Needed***
DATE: ____________________________
At 5:00am, you must drink the rest of the
* DAY BEFORE COLONOSCOPY *
solution, 8oz every 10 minutes.
(This should be taken within two hours)
DATE: ______________________
AM - Fill the TriLyte container with water to the line
For PM appointments only:
indicated on the side of the bottle and refrigerate.
You are allowed to have a clear liquid breakfast
at 7:00am, then NOTHING TO EAT OR DRINK
DIET:
after that time.
CLEAR LIQUIDS ONLY
DO NOT EAT ANY SOLID FOODS ALL DAY
*YOUR PROCEDURE WILL BE CANCELLED IF YOU DO*
CLEAR LIQUIDS INCLUDE:
Water
* Your driver must accompany you to your procedure
Fruit juices w/o pulps – apple, white
and stay until the procedure is completed and you are
grape/cranberry, pineapple
ready to leave. NO TAXI CABS ARE ALLOWED. Do
Clear broth or bouillon (chicken, beef or
not drive an automobile, operate machinery or drink
vegetable flavor)
alcohol for 12 hours after the procedure due to
Tea
sedating effects of the medications used.
Sugar and/or Honey
Gatorade / Special K protein water
Soda (regular or diet)
* If you’re having a problem with your colonoscopy
Black Coffee (decaf / regular)
preparation after hours, please call our main line at
Jell-O (Green, yellow and orange flavor ONLY)
(703) 698 – 8960 and the answering service will contact
Popsicles or Italian Ice
the on call doctor for you.
Kool-Aid or Flavored Drinks
Hard Candy
DO NOT DRINK RED, BLUE OR PURPLE LIQUIDS

Source: http://novagi.com/prep/TriLyte%20Split%20PM.pdf

Pii: s0304-3940(98)00302-4

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