NuLYTELY by is a Prescription medication manufactured, distributed, or labeled by Braintree Laboratories, Inc.. Drug facts, warnings, and ingredients follow.
NULYTELY- polyethylene glycol 3350, sodium chloride, sodium bicarbonate and potassium chloride powder, for solution
Braintree Laboratories, Inc.
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HIGHLIGHTS OF PRESCRIBING INFORMATIONThese highlights do not include all the information needed to use NuLYTELY safely and effectively. See full prescribing information for NuLYTELY.
NuLYTELY (polyethylene glycol 3350, sodium chloride, sodium bicarbonate and potassium chloride for oral solution) Initial U.S. Approval: 1991 RECENT MAJOR CHANGES
INDICATIONS AND USAGENuLYTELY is a combination of PEG 3350, an osmotic laxative, and electrolytes indicated for cleansing of the colon in preparation for colonoscopy in adults and pediatric patients aged 6 months or greater (1) DOSAGE AND ADMINISTRATION
DOSAGE FORMS AND STRENGTHSFor oral solution: polyethylene glycol 3350 420 grams, sodium bicarbonate 5.72 grams, sodium chloride 11.2 grams, potassium chloride 1.48 grams, and flavoring ingredients 2 grams; supplied in one 4 liter disposable jug (3) CONTRAINDICATIONSWARNINGS AND PRECAUTIONS
ADVERSE REACTIONSMost common adverse reactions (≥3%) are: nausea, abdominal fullness and bloating. Abdominal cramps, vomiting and anal irritation occur less frequently (
6)
DRUG INTERACTIONSSee 17 for PATIENT COUNSELING INFORMATION and Medication Guide. Revised: 5/2021 |
NuLYTELY is indicated for bowel cleansing prior to colonoscopy in adults and pediatric patients aged 6 months or greater.
On the day prior to the colonoscopy, instruct patients to:
a) Take only clear liquids, but avoid red and purple liquids. Patients may consume a light breakfast.
b) Early in the evening prior to colonoscopy, fill the supplied container containing the NuLYTELY powder with lukewarm water (to facilitate dissolution) to the 4 liter fill line. The solution is clear and colorless when reconstituted to a final volume of 4 liters.
c) After capping the container, shake vigorously several times to ensure that the ingredients are dissolved. When reconstituted use within 48 hours.
The following is the recommended dose of reconstituted NuLYTELY solution for adults and pediatric patients ≥ 6 months. Instruct patients they may consume water or clear liquids during the bowel preparation and after completion of the bowel preparation up until 2 hours before the time of the colonoscopy. The solution is more palatable if chilled prior to administration.
The first bowel movements should occur approximately one hour after the start of NuLYTELY administration. Continue drinking until the watery stool is clear and free of solid matter.
For oral solution: One 4 liter jug with powder for reconstitution with water.
Each 4 liter jug contains: polyethylene glycol 3350 420 g, sodium bicarbonate 5.72 g, sodium chloride 11.2 g, potassium chloride 1.48 g and flavoring ingredients 2 g. When made up to 4 liters volume with water, the solution contains PEG-3350 31.3 mmol/L, sodium 65 mmol/L, chloride 53 mmol/L, bicarbonate 17 mmol/L and potassium 5 mmol/L.
NuLYTELY is contraindicated in the following conditions:
Advise patients to hydrate adequately before, during, and after the use of NuLYTELY. Use caution in patients with congestive heart failure when replacing fluids. If a patient develops significant vomiting or signs of dehydration including signs of orthostatic hypotension after taking NuLYTELY, consider performing post-colonoscopy lab tests (electrolytes, creatinine, and BUN) and treat accordingly. Fluid and electrolyte disturbances can lead to serious adverse events including cardiac arrhythmias, seizures and renal impairment. Fluid and electrolyte abnormalities should be corrected before treatment with NuLYTELY.
In addition, use caution when prescribing NuLYTELY for patients who have conditions, or who are using medications, that increase the risk for fluid and electrolyte disturbances or may increase the risk of adverse events of seizure, arrhythmias, and renal impairment [see Drug Interactions ( 7.1)]
There have been rare reports of serious arrhythmias associated with the use of ionic osmotic laxative products for bowel preparation. Use caution when prescribing NuLYTELY for patients at increased risk of arrhythmias (e.g., patients with a history of prolonged QT, uncontrolled arrhythmias, recent myocardial infarction, unstable angina, congestive heart failure, or cardiomyopathy). Pre-dose and post-colonoscopy ECGs should be considered in patients at increased risk of serious cardiac arrhythmias.
There have been reports of generalized tonic-clonic seizures and/or loss of consciousness associated with use of bowel preparation products in patients with no prior history of seizures. The seizure cases were associated with electrolyte abnormalities (e.g., hyponatremia, hypokalemia, hypocalcemia, and hypomagnesemia) and low serum osmolality. The neurologic abnormalities resolved with correction of fluid and electrolyte abnormalities.
Use caution when prescribing NuLYTELY for patients with a history of seizures and in patients at increased risk of seizure, such as patients taking medications that lower the seizure threshold (e.g., tricyclic antidepressants), patients withdrawing from alcohol or benzodiazepines, or patients with known or suspected hyponatremia.
Use caution when prescribing NuLYTELY for patients with impaired renal function or patients taking concomitant medications that may affect renal function (such as diuretics, angiotensin converting enzyme inhibitors, angiotensin receptor blockers, or non-steroidal anti-inflammatory drugs). Advise these patients of the importance of adequate hydration, and consider performing baseline and postcolonoscopy laboratory tests (electrolytes, creatinine, and BUN) in these patients.
Administration of osmotic laxative products may produce colonic mucosal aphthous ulcerations, and there have been reports of more serious cases of ischemic colitis requiring hospitalization. Concurrent use of stimulant laxatives and NuLYTELY may increase this risk. The potential for mucosal ulcerations resulting from the bowel preparation should be considered when interpreting colonoscopy findings in patients with known or suspect inflammatory bowel disease (IBD).
If gastrointestinal obstruction or perforation is suspected, perform appropriate diagnostic studies to rule out these conditions before administering NuLYTELY. If a patient experiences severe bloating, distention or abdominal pain, administration should be slowed or temporarily discontinued until the symptoms abate. If gastrointestinal obstruction or perforation is suspected, appropriate studies should be performed to rule out these conditions before administration of NuLYTELY.
Use with caution in patients with severe active ulcerative colitis.
Use with caution in patients with impaired gag reflex, unconscious, or semiconscious patients, and patients prone to regurgitation or aspiration. Such patients should be observed during administration of NuLYTELY, especially if it is administered via nasogastric tube. Use with caution in patients with impaired gag reflex, unconscious, or semiconscious patients, and patients prone to regurgitation or aspiration. Such patients should be observed during administration of NuLYTELY, especially if it is administered via nasogastric tube.
Do not combine NuLYTELY with starch-based thickeners [see Dosage and Administration (2.1)]. Polyethylene glycol (PEG), a component of NuLYTELY, when mixed with starch-thickened liquids reduces the viscosity of the starch-thickened liquid. When a PEG-based product used for another indication was mixed in starch-based pre-thickened liquids used in patients with dysphagia, thinning of the liquid occurred and cases of choking and potential aspiration were reported.
The contents of each jug must be diluted with water to a final volume of 4 liters (4 L) and ingestion of additional water is important to patient tolerance. Direct ingestion of the undissolved powder may increase the risk of nausea, vomiting, dehydration, and electrolyte disturbances.
The following serious or otherwise important adverse reactions are described elsewhere in the labeling:
The following adverse reactions have been identified during post-approval use of NuLYTELY. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.
Nausea, abdominal fullness and bloating are the most common adverse reactions (occurred in up to 50% of patients) to administration of NuLYTELY. Abdominal cramps, vomiting and anal irritation occur less frequently. These adverse reactions are transient and usually subside rapidly. Isolated cases of urticaria, rhinorrhea, dermatitis and (rarely) anaphylactic reaction have been reported which may represent allergic reactions.
Published literature contains isolated reports of serious adverse reactions following the administration of PEG-electrolyte solution products in patients over 60 years of age. These adverse events include upper GI bleeding from Mallory-Weiss Tear, esophageal perforation, asystole, sudden dyspnea with pulmonary edema, and “butterfly-like” infiltrates on chest X-ray after vomiting and aspirating PEG.
Use caution when prescribing NuLYTELY for patients who are using medications that increase the risk for fluid and electrolyte disturbances or may increase the risk of adverse events of seizure, arrhythmias, and prolonged QT in the setting of fluid and electrolyte abnormalities. Consider additional patient evaluations as appropriate [see Warnings and Precautions ( 5.1, 5.2, 5.3, and 5.4)] in patients taking these concomitant medications.
Animal reproduction studies have not been conducted with NuLYTELY. It is also not known whether NuLYTELY can cause fetal harm when administered to a pregnant woman or can affect reproductive capacity. NuLYTELY should be given to a pregnant woman only if clearly needed.
It is not known whether this drug is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when NuLYTELY is administered to a nursing woman.
Safety and effectiveness of NuLYTELY in pediatric patients aged 6 months and older is supported by evidence from adequate and well-controlled clinical trials of NuLYTELY in adults with additional safety and efficacy data from published studies of similar formulations. Use of NuLYTELY in children younger than 2 years of age should be carefully monitored for occurrence of possible hypoglycemia, as this solution has no caloric substrate. Dehydration has been reported in one child and hypokalemia has been reported in 3 children.
Clinical studies of NuLYTELY did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. Other reported clinical experience has not identified differences in responses between the elderly and younger patients.
For oral solution: Each 4 liter (4L) NuLYTELY jug contains a white powder for reconstitution. NuLYTELY is a combination of polyethylene glycol 3350, an osmotic laxative, and electrolytes (sodium chloride, sodium bicarbonate and potassium chloride) for oral solution.
Each 4 liter jug contains: polyethylene glycol 3350 420 g, sodium bicarbonate 5.72 g, sodium chloride 11.2 g, potassium chloride 1.4 g, flavoring ingredients 2 g. The solution is clear and colorless when reconstituted to a final volume of 4 liters with water.
Polyethylene Glycol 3350, USP
Sodium Bicarbonate, USP
The chemical name is NaHCO 3. The average Molecular Weight is 84.01. The structural formula is:
Sodium Chloride, USP
The chemical name is NaCl. The average Molecular Weight: 58.44. The structural formula is:
Na+ Cl-
Potassium Chloride, USP
The chemical name is KCl. The average Molecular Weight: 74.55. The structural formula is:
K-Cl
The primary mode of action is thought to be through the osmotic effect of polyethylene glycol 3350 which causes water to be retained in the colon and produces a watery stool.
In powdered form, for oral administration as a solution following reconstitution. NuLYTELY is available in a disposable jug in powdered form containing:
Lemon-Lime Flavor NuLYTELY: polyethylene glycol 3350 420 g, sodium bicarbonate 5.72 g, sodium chloride 11.2 g, potassium chloride 1.48 g and flavoring ingredients 2.0 g. When made up to 4 liters volume with water, the solution contains PEG-3350 31.3 mmol/L, sodium 65 mmol/L, chloride 53 mmol/L, bicarbonate 17 mmol/L and potassium 5 mmol/L.
Storage:
Store at 25°C (77°F); excursions permitted to 15-30°C (59-86°F) [see USP Controlled Room Temperature]. When reconstituted, keep solution refrigerated. Use within 48 hours. Discard unused portion.
Keep out of reach of children.
Lemon-Lime Flavor NuLYTELY NDC: 52268-302-01
See FDA-Approved Patient Labeling (Medication Guide). Instruct patients:
Manufactured by Braintree Laboratories, Inc., Braintree, MA 02185
Marketed by Braintree, a part of Sebela Pharmaceuticals®
Medication Guide
NuLYTELY® (Noo-lite-ly) (PEG-3350, sodium chloride, sodium bicarbonate and potassium chloride oral solution)
Read this Medication Guide before you start taking NuLYTELY. This information does not take the place of talking with your healthcare provider about your medical condition or your treatment.
What is the most important information I should know about NuLYTELY?
NuLYTELY and other osmotic bowel preparations can cause serious side effects, including:
Serious loss of body fluid (dehydration) and changes in blood salts (electrolytes) in your blood.
These changes can cause:
Your chance of having fluid loss and changes in body salts with NuLYTELY is higher if you:
Tell your healthcare provider right away if you have any of these symptoms of a loss of too much body fluid (dehydration) while taking NuLYTELY:
See Section “What are the possible side effects of NuLYTELY” for more information about side effects.
What is NuLYTELY?
NuLYTELY is a prescription medicine used by adults to clean the colon before a colonoscopy. NuLYTELY cleans your colon by causing you to have diarrhea. Cleaning your colon helps your healthcare provider see the inside of your colon more clearly during your colonoscopy.
NuLYTELY is safe and effective for use in pediatric patients aged 6 months and older.
Who should not take NuLYTELY?
Do not take NuLYTELY if your heathcare provider has told you that you have:
What should I tell my healthcare provider before taking NuLYTELY? Before you take NuLYTELY, tell your healthcare provider if you:
Tell your healthcare provider about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements.
NuLYTELY may affect how other medicines work. Medicines taken by mouth may not be absorbed properly when taken within 1 hour before the start of NuLYTELY.
Especially tell your healthcare provider if you take:
Ask your healthcare provider or pharmacist for a list of these medicines if you are not sure if you are taking any of the medicines listed above.
Know the medicines you take. Keep a list of them to show your healthcare provider and pharmacist when you get a new medicine.
How should I take NuLYTELY?
You must read, understand, and follow these instructions to take NuLYTELY the right way.
What are the possible side effects of NuLYTELY?
NuLYTELY can cause serious side effects, including:
The most common side effects of NuLYTELY include:
Tell your healthcare provider if you have any side effect that bothers you or that does not go away.
These are not all the possible side effects of NuLYTELY. For more information, ask your healthcare provider or pharmacist.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
How should I store NuLYTELY?
Keep NuLYTELY and all medicines out of the reach of children. General information about the safe and effective use of NuLYTELY.
Medicines are sometimes prescribed for purposes other than those listed in a Medication Guide. Do not use NuLYTELY for a condition for which it was not prescribed. Do not give NuLYTELY to other people, even if they are going to have the same procedure you are. It may harm them.
This Medication Guide summarizes important information about NuLYTELY. If you would like more information, talk with your healthcare provider.
You can ask your pharmacist or healthcare provider for information that is written for healthcare professionals.
For more information, go to www.braintreelabs.com or call 1-800-874-6756.
What are the ingredients in NuLYTELY?
Active ingredients: polyethylene glycol 3350, sodium bicarbonate, sodium chloride, and potassium chloride.
Inactive ingredients: lemon-lime flavoring
Manufactured by Braintree Laboratories, Inc., Braintree, MA 02185
Marketed by Braintree, a part of Sebela Pharmaceuticals®
This Medication Guide has been approved by the U.S. Food and Drug Administration.
Revised 5/2021
NDC: 52268-302-01
FILL TO THE TOP OF THE LINE ON THE BOTTLE
To Pharmacist and Patient:
Mixing information is on base label.
Package insert may be removed before dispensing.
Dispense the enclosed Medication Guide to each patient.
LEMON-LIME FLAVOR
NuLYTELY®
PEG-3350, Sodium Chloride, Sodium Bicarbonate and Potassium Chloride for Oral Solution
When reconstituted with water to a volume of 4 liters, this solution contins PEG-3350 31.3 mmol/L, sodium 65 mmol/L, chloride 53 mmol/L, bicarbonate 17 mmol/L and potassium 5 mmol/L.
Each disposable jug contains, in powdered form: polyethylene glycol 3350 420 g, sodium bicarbonate 5.72 g, sodium chloride 11.2 g, potassium chloride 1.48 g, flavor ingredients 2.0 g.
Manufactured by Braintree Laboratories, Inc., Braintree, MA 02185
Marketed by Braintree A PART OF SEBELA PHARMACEUTICALS®
Rx Only
© 1998 Braintree, MA 02185
S 05/21
LEMON-LIME FLAVOR
NuLYTELY® INSTRUCTIONS
PEG-3350, Sodium Chloride, Sodium Bicarbonate and Potassium Chloride for Oral Solution
NOTE: The solution is more palatable if chilled in the refrigerator before drinking. However, chilled solution is not recommended for infants. Keep reconstituted solution refrigerated. Use within 48 hours. Discard unused portion.
NDC: 52268-302-01
S 05/21
Manufactured by Braintree Laboratories, Inc., Braintree, MA 02185
Marketed by Braintree, a part of Sebela Pharmaceuticals
NULYTELY
polyethylene glycol 3350, sodium chloride, sodium bicarbonate and potassium chloride powder, for solution |
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Labeler - Braintree Laboratories, Inc. (107904591) |
Establishment | |||
Name | Address | ID/FEI | Business Operations |
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Braintree Laboratories, Inc. | 617357954 | manufacture(52268-302) , analysis(52268-302) |
Mark Image Registration | Serial | Company Trademark Application Date |
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NULYTELY 75047805 2020999 Live/Registered |
Braintree Laboratories, Inc. 1996-01-24 |
NULYTELY 73796743 1572848 Dead/Cancelled |
BRAINTREE LABORATORIES, INC. 1989-05-01 |