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Osmotic bowel cleanser Pregnancy: SPC 4.6 Pregnancy: there are no data on the use of Moviprep during pregnancy. The preparation should only be used during pregnancy if considered essential by the physician. Breastfeeding: there are no data on the use of Moviprep during lactation; the preparation should only be used during lactation if considered essential by the physician. Fertility: there are no data on the effects of Moviprep on fertility.

Macrogol 3350 with sulfate, ascorbate, KCl & NaCl (bowel prep)

Brand names: Moviprep, Plenvu

This combination of macrogol 3350 with sodium sulfate, ascorbic acid, sodium ascorbate, potassium chloride and sodium chloride is an oral bowel-cleansing preparation used before colonoscopy, bowel surgery or radiological imaging.

Adult dose

Dose: Bowel cleansing prior to any clinical procedure requiring a clean bowel, e.g. bowel endoscopy or radiology (adults). Product: Moviprep powder for oral solution, in two sachets. Sachet A contains macrogol 3350 100 g, sodium sulfate anhydrous 7.500 g, sodium chloride 2.691 g and potassium chloride 1.015 g; Sachet B contains ascorbic acid 4.700 g and sodium ascorbate 5.900 g. A litre of Moviprep is one sachet A and one sachet B dissolved together in water to make one litre of solution. Adults and older people: a course of treatment consists of two litres of Moviprep; each reconstituted litre is drunk over a period of one to two hours. It is strongly recommended that one litre of clear liquid (which may include water, clear soup, fruit juice without pulp, soft drinks, tea and/or coffee without milk) is also taken during the course of treatment. Divided doses: one litre of Moviprep in the evening before and one litre in the early morning of the day of the procedure. Single dose: two litres of Moviprep in the evening before the procedure, or two litres in the morning of the procedure.
Route: Oral (reconstituted solution drunk)
Frequency: One course of two litres per procedure, taken either as divided doses (one litre the evening before plus one litre early on the morning of the procedure) or as a single dose (two litres the evening before, or two litres on the morning of the procedure)
SCOPE - UMBRELLA PAGE, ONE PRODUCT COVERED: these figures are the UK SPC for MOVIPREP POWDER FOR ORAL SOLUTION only (Norgine Pharmaceuticals Limited, PL200110039). This page also names Plenvu, which is a different product with its own SPC, volume and regimen; Plenvu and any other bowel-cleansing preparation are NOT covered here, and the two-litre course above must not be applied to them. TIMING (SPC 4.2): for procedures under general anaesthesia - divided or single dose - ensure consumption of Moviprep and any other clear fluids has finished at least two hours before the start of the procedure. For procedures without general anaesthesia - divided doses: ensure consumption of Moviprep as well as any other clear fluids has finished at least one hour before the start of the procedure; single dose: ensure consumption of Moviprep has finished at least two hours before, and any clear fluids at least one hour before. No solid food should be taken from the start of the course of treatment until after the clinical procedure. Patients should be advised to allow appropriate time to travel to the colonoscopy unit. See SPC section 6.6 for reconstitution instructions (not retrieved). The SPC defines a course of treatment as two litres. SODIUM AND POTASSIUM (SPC 4.4): a course contains 363.2 mmol (8.4 g) sodium (only a proportion, up to 112.4 mmol or 2.6 g, is absorbed), to be taken into consideration by patients on a controlled sodium diet, and 28.4 mmol (1.1 g) potassium, to be taken into consideration by patients with reduced kidney function or on a controlled potassium diet. The product contains aspartame (0.233 g stated in SPC section 2), a source of phenylalanine. TOLERABILITY (SPC 4.4): diarrhoea is an expected effect; if patients experience severe bloating, abdominal distension, abdominal pain or any other reaction that makes it difficult to continue the preparation, they may slow down or temporarily stop consuming Moviprep and should consult their doctor. The fluid content of Moviprep does not replace regular fluid intake and adequate fluid intake must be maintained; dehydration should be corrected before use. Paediatric: not recommended below 18 years (see paedDose).

Dose adjustments

Renal

No numeric dose adjustment is printed. SPC 4.4: administer with caution to fragile patients in poor health or with serious clinical impairment such as severe renal insufficiency (creatinine clearance <30 mL/min). In debilitated fragile patients and those with clinically significant renal impairment, arrhythmia, or at risk of electrolyte imbalance, the physician should consider a baseline and post-treatment electrolyte test, renal function test and ECG as appropriate. A course contains 28.4 mmol (1.1 g) potassium, to be taken into consideration by patients with reduced kidney function.

Hepatic

No hepatic dose adjustment is stated in the SPC.

Dose independently re-sourced from UK Summary of Product Characteristics (SPC) via MHRA Products — clinician-reviewed. Always confirm against the product SmPC and your local formulary before prescribing.

Contraindications

  • Known or suspected hypersensitivity to the active substances or to any of the excipients listed in section 6.1
  • Gastrointestinal obstruction or perforation
  • Disorders of gastric emptying (e.g. gastroparesis)
  • Ileus
  • Phenylketonuria (due to presence of aspartame)
  • Glucose-6-phosphate dehydrogenase deficiency (due to presence of ascorbate)
  • Toxic megacolon which complicates very severe inflammatory conditions of the intestinal tract including Crohn's disease and ulcerative colitis
  • Unconscious patients
  • Not recommended below 18 years of age (SPC 4.2: not studied in the paediatric population)

Side effects

  • Diarrhoea is an expected outcome of bowel preparation; undesirable effects occur in the majority of patients; nausea, vomiting, bloating, abdominal pain, anal irritation and sleep disturbance commonly occur; dehydration may occur as a result of diarrhoea and/or vomiting (SPC 4.8)
  • Very common: abdominal pain, nausea, abdominal distension, anal discomfort; malaise, pyrexia
  • Common: sleep disorder; dizziness, headache; vomiting, dyspepsia; rigors, thirst, hunger
  • Uncommon: dysphagia; abnormal liver function tests; discomfort
  • Not known: allergic reaction including anaphylactic reaction, dyspnoea and skin reactions (angioedema, urticaria, pruritus, rash, erythema); electrolyte disturbances (blood bicarbonate decreased, hyper- and hypocalcaemia, hypophosphataemia, hypokalaemia, hyponatraemia, changes in blood chloride levels); dehydration; convulsions associated with severe hyponatraemia, seizures; transient increase in blood pressure, arrhythmia, palpitations; oesophageal rupture (Boerhaave syndrome), flatulence, retching
  • Seizures associated with macrogol 3350 with electrolytes for bowel preparation have occurred in patients with or without a prior history of seizures, mostly associated with electrolyte abnormalities such as severe hyponatraemia; serious arrhythmias including atrial fibrillation have been rarely reported with ionic osmotic laxatives for bowel preparation (SPC 4.4)
  • Post-marketing ischaemic colitis, including serious cases, in patients treated with macrogol for bowel preparation (SPC 4.4)

Interactions

  • Oral medicines taken one hour before, during and one hour after Moviprep (e.g. oral contraceptive pill) may be flushed from the gastrointestinal tract unabsorbed; the therapeutic effect of drugs with a narrow therapeutic index or short half-life may be particularly affected (theoretical; interactions not studied)
  • Starch-based food thickeners: the macrogol ingredient counteracts the thickening effect of starch, liquefying preparations that need to remain thick for people with swallowing problems
  • Stimulant laxatives (such as bisacodyl or sodium picosulfate): use macrogol with caution in concomitant use because of the risk of ischaemic colitis (SPC 4.4)

Monitoring

  • Correct dehydration before use; maintain adequate fluid intake during the course
  • Closely observe semi-conscious patients or those prone to aspiration or regurgitation during administration, especially via a nasogastric route
  • If symptoms of arrhythmia or fluid/electrolyte shifts develop (e.g. oedema, shortness of breath, increasing fatigue, cardiac failure), measure plasma electrolytes, monitor the ECG and treat any abnormality; in neurologic symptoms correct fluid and electrolyte abnormalities
  • In debilitated fragile patients, those with clinically significant renal impairment, arrhythmia, or at risk of electrolyte imbalance, consider baseline and post-treatment electrolytes, renal function and ECG as appropriate
  • Use caution in patients with a history of seizures, at increased risk of seizure, or at risk of electrolyte disturbance
  • Evaluate promptly patients with sudden abdominal pain, rectal bleeding or other symptoms of ischaemic colitis
  • Advise patients to stop administration and seek immediate medical assistance if they experience incoercible vomiting with subsequent chest, neck and abdominal pain, dysphagia, haematemesis or dyspnoea (oesophageal rupture, mostly in elderly patients)
  • Caution in fragile patients in poor health or with serious clinical impairment: impaired gag reflex or tendency to aspiration/regurgitation, impaired consciousness, severe renal insufficiency (creatinine clearance <30 mL/min), cardiac impairment (NYHA grade III or IV), those at risk of arrhythmia (e.g. on treatment for cardiovascular disease or with thyroid disease), dehydration, severe acute inflammatory bowel disease

Clinical monograph

How it works

The macrogol and sodium sulfate act as osmotic agents that draw large volumes of water into the colon to produce a watery purge, while the ascorbate component contributes additional osmotic effect, together evacuating the bowel without significant net absorption.

Prescribing in practice

  • Bowel-cleansing solutions can cause clinically significant dehydration and electrolyte disturbance, so they are contraindicated in gut obstruction or perforation, ileus, toxic colitis and severe dehydration, and used with caution in frail, elderly, renally or cardiac-impaired patients.
  • Adequate intake of clear fluids alongside the preparation is essential, and the ascorbic acid content makes it unsuitable for patients with glucose-6-phosphate dehydrogenase deficiency.
  • Oral medicines taken around the time of the purge may be incompletely absorbed, so the timing of essential drugs should be reviewed.

Monitoring

Assess hydration, renal function and electrolytes before and, where indicated, after administration in patients at risk of fluid or electrolyte depletion.

Counselling the patient

  • Follow the split-dose timing exactly and drink plenty of the recommended clear fluids to avoid dehydration.
  • Expect frequent watery stools; stay near a toilet once you start.
  • Report dizziness, palpitations, severe abdominal pain or persistent vomiting promptly.

Evidence & guidelines

Low-volume macrogol-ascorbate bowel preparations are widely used in UK endoscopy services as an effective alternative to standard-volume regimens, with MHRA advice emphasising hydration and electrolyte safety.

Reference: NICE CG118; Confirm identity and dosing against the manufacturer SPC (eMC) and NICE. Verify against your local formulary and current prescribing references before prescribing. The structured dose values shown have been reviewed by a clinician. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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