SODIUM SULFATE, POTASSIUM SULFATE AND MAGNESIUM SULFATE- sodium sulfate, potassium sulfate, magnesium sulfate solution, concentrate

SODIUM SULFATE, POTASSIUM SULFATE AND MAGNESIUM SULFATE by

Drug Labeling and Warnings

SODIUM SULFATE, POTASSIUM SULFATE AND MAGNESIUM SULFATE by is a Prescription medication manufactured, distributed, or labeled by Affordable Pharmaceuticals, LLC, Braintree Laboratories, Inc.. Drug facts, warnings, and ingredients follow.

Drug Details [pdf]

  • 1 INDICATIONS AND USAGE

    Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution is indicated for cleansing of the colon as a preparation for colonoscopy in adult and pediatric patients 12 years of age and older.

  • 2 DOSAGE AND ADMINISTRATION

    2.1 Dosage and Adminstration Overview

    Administration of two bottles of Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution and additional water is required for a complete preparation for colonoscopy. One bottle of Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution is equivalent to one dose. Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution is supplied in two dosage strengths [see Dosage Forms and Strengths ( 3)] . The recommended dosage is:

          Adults: Two 6-ounce doses [see Dosage and Administration ( 2.3)] .
            Pediatric patients 12 years of age and older: Two 4.5-ounce doses [see Dosage and Administration ( 2.4)] .

    2.2 Important Preparation and Administration Instructions

    • Correct fluid and electrolyte abnormalities before treatment with Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution  [see Warnings and Precautions ( 5.1)]
    • Must dilute Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution in water before ingestion.
    • Must consume additional water after each dose of Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution.
    • On the day before colonoscopy, consume only a light breakfast or clear liquids (e.g., water, strained fruit juice without pulp, lemonade, plain coffee or tea, chicken broth, gelatin dessert without fruit). On the day of the colonoscopy only consume clear liquids up to two hours prior to colonoscopy.
    • Do not eat solid food or drink milk or eat or drink anything colored red or purple.
    • Do not drink alcohol.
    • Do not take other laxatives while taking Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution.
    • Do not take oral medications within one hour of starting each dose of Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution.
    • If taking tetracycline or fluoroquinolone antibiotics, iron, digoxin, chlorpromazine, or penicillamine, take these medications at least 2 hours before and not less than 6 hours after administration of Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution  [see Drug Interactions ( 7.2)] .
    • Stop consumption of all fluids at least 2 hours prior to the colonoscopy.

    2.3 Recommended Dosage and Administration for Adults

    The recommended Split-Dose (two-day) regimen for adults consists of two 6-ounce doses of Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution: the first dose during the evening prior to colonoscopy and the second dose the next day, during the morning of the colonoscopy.

    Each dose consists of one bottle of Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution with additional water. The total volume of liquid required for colon cleansing (using two bottles) is 3 quarts. The following are recommended dosage and administration instructions for adults:

    Dose 1 – On the Day Prior to Colonoscopy:

    • May consume a light breakfast, or only clear liquids (no solid food).
    • In the evening before the procedure, pour the contents of one bottle of Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution into the mixing container provided.
    • Add cool drinking water to the 16-ounce fill line on the container, mix, and drink the entire amount.
    • Drink two additional containers filled with water to the 16-ounce fill line over the next hour.

    Dose 2 - Day of Colonoscopy:

    • Continue to consume only clear liquids.
    • In the morning (10 to 12 hours after the evening dose) on the day of the procedure, pour the contents of the second bottle of Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution into the mixing container provided.
    • Add cool drinking water to the 16-ounce fill line on the container, mix, and drink the entire amount.
    • Drink two additional containers filled with water to the 16-ounce fill line over the next hour.
    • Complete all solution of Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution and required water at least two hours prior to colonoscopy.

    2.4 Recommended Dosage and Administration for Pediatric Patients 12 Years of Age and Older

    The recommended Split-Dose (two-day) regimen for pediatric patients 12 years of age and older consists of two 4.5-ounce doses of Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution: the first dose during the evening prior to colonoscopy and the second dose the next day, during the morning of the colonoscopy.

    Each dose consists of one bottle of Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution with additional water. The total volume of liquid required for colon cleansing (using two bottles) is 2.25 quarts. The following are recommended dosage and administration instructions for pediatric patients 12 years of age and older and/or their caregivers:

    Dose 1 – On the Day Prior to Colonoscopy:

        May consume a light breakfast, or only clear liquids (no solid food).
        In the evening before the procedure, pour the contents of one bottle of Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution into the mixing container provided.
        Add cool drinking water to the 12-ounce fill line on the container, mix, and drink the entire amount.
        Drink two additional containers filled with water to the 12-ounce fill line over the next hour.

    Dose 2 – Day of Colonoscopy:

        Continue to consume only clear liquids.
        In the morning (10 to 12 hours after the evening dose) on the day of the procedure, pour the contents of the second bottle of Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution into the mixing container provided.
        Add cool drinking water to the 12-ounce fill line on the container, mix, and drink the entire amount.
        Drink two additional containers filled with water to the 12-ounce fill line over the next hour.
        Complete all solution of Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution and required water at least two hours prior to colonoscopy.

  • 3 DOSAGE FORMS AND STRENGTHS

    • Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution  (for adults): Two bottles each containing 6 ounces of an oral solution of 17.5 grams sodium sulfate, 3.13 grams potassium sulfate, and 1.6 grams magnesium sulfate as a clear to slightly hazy liquid.
    • Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution  (for pediatric patients 12 years of age and older): Two bottles each containing 4.5 ounces of an oral solution of 13.13 grams sodium sulfate, 2.35 grams potassium sulfate, and 1.2 grams magnesium sulfate as a clear to slightly hazy liquid.

    When diluted as directed, the solution is clear and colorless.

  • 4 CONTRAINDICATIONS

    Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution is contraindicated in the following conditions:

    • Gastrointestinal obstruction or ileus  [see Warnings and Precautions ( 5.6)]
    • Bowel perforation [see Warnings and Precaution ( 5.6)]
    • Toxic colitis or toxic megacolon
    • Gastric retention
    • Hypersensitivity to any of the ingredients in Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution
  • 5 WARNINGS AND PRECAUTIONS

    5.1 Serious Fluid and Serum Chemistry Abnormalities

    Advise all patients to hydrate adequately before, during, and after the use of Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution. If a patient develops significant vomiting or signs of dehydration after taking Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution, consider performing post-colonoscopy lab tests (electrolytes, creatinine, and BUN).

    Fluid and electrolyte disturbances can lead to serious adverse events including cardiac arrhythmias, seizures and renal impairment. Correct fluid and electrolyte abnormalities before treatment with Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution. Use Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution with caution in patients with 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)] .

    Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution can cause temporary elevations in uric acid [see Adverse Reactions ( 6.1)] . Uric acid fluctuations in patients with gout may precipitate an acute flare. The potential for uric acid elevation should be considered before administering Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution to patients with gout or other disorders of uric acid metabolism.

    5.2 Cardiac Arrhythmias

    There have been rare reports of serious arrhythmias associated with the use of ionic osmotic laxative products for bowel preparation. Use caution when prescribing Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution 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). Consider pre-dose and post-colonoscopy ECGs in patients at increased risk of serious cardiac arrhythmias.

    5.3 Seizures

    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 Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution 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 [see Drug Interactions ( 7.1)] .

    5.4 Use in Patients with Risk of Renal Injury

    Use Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution with caution in 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) [see Drug Interactions ( 7.1)] . These patients may be at risk for renal injury. Advise these patients of the importance of adequate hydration with Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution and consider performing baseline and post-colonoscopy laboratory tests (electrolytes, creatinine, and BUN) in these patients [see Use in Specific Populations ( 8.6)] .

    5.5 Colonic Mucosal Ulcerations and Ischemic Colitis

    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 Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution may increase these risks [see Drug Interactions ( 7.3)] . Consider the potential for mucosal ulcerations resulting from the bowel preparation when interpreting colonoscopy findings in patients with known or suspect inflammatory bowel disease (IBD).

    5.6 Use in Patients with Significant Gastrointestinal Disease

    If gastrointestinal obstruction or perforation is suspected, perform appropriate diagnostic studies to rule out these conditions before administering Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution   [see Contrandications ( 4)] .

    Use with caution in patients with severe active ulcerative colitis.

    5.7 Aspiration

    Patients with impaired gag reflex or other swallowing abnormalities are at risk for regurgitation or aspiration of Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution. Observe these patients during administration of Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution. Use with caution in these patients.

  • 6 ADVERSE REACTIONS

    The following important adverse reactions for bowel preparations are described elsewhere in the labeling:

    • Serious Fluid and Serum Chemistry Abnormalities [see Warnings and Precautions ( 5.1)]
    • Cardiac Arrhythmias [see Warnings and Precautions ( 5.2)]
    • Seizures [see Warnings and Precautions ( 5.3)]
    • Use in Patients with Risk of Renal Injury [see Warnings and Precautions ( 5.4)]
    • Colonic Mucosal Ulceration and Ischemic Colitis [see Warnings and Precautions ( 5.5)]
    • Patients with Significant Gastrointestinal Disease [see Warnings and Precautions ( 5.6)]
    • Aspiration [see Warnings and Precautions ( 5.7)]

    6.1 Clinical Studies Experience

    Because clinical studies are conducted under widely varying conditions, adverse reaction rates observed in the clinical studies of a drug cannot be directly compared to rates in clinical studies of another drug and may not reflect the rates observed in practice.

    Adults

    The safety of Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution was evaluated in a multi-center, randomized, active controlled trial in 379 adult patients undergoing colonoscopy [see Clinical Studies ( 14)] .

    Most Common Adverse Reactions

    Table 1 shows the most common adverse reactions reported in at least 2% of patients receiving Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution or the control (a bowel prep containing polyethylene glycol and electrolytes (PEG + E)) administered in split-dose (2-day) regimens.

    Table 1: Common Adverse Reactions* in Adult Patients Undergoing Colonoscopy in a Randomized, Active Controlled Trial

    * reported in at least 2% of patients

    SymptomSplit-Dose (2-Day) Regimen

    Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution

    %
    N=190

    PEG + E product

    %
    N=189

    Overall Discomfort5467
    Abdominal Distension4052
    Abdominal Pain3643
    Nausea3633
    Vomiting84

    Laboratory Abnormalities
    Table 2 shows the most common laboratory abnormalities (at least 10% in either treatment group and more than 2% difference between groups) for patients who developed new abnormalities of important electrolytes and uric acid after completing the bowel preparation with either Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution or PEG+E administered as a split-dose (2-day) regimen.

    Table 2: Adult Patients with Normal Baseline Serum Chemistry with A Shift to an Abnormal Value While on the Split-Dose (2-Day) Regimen 1

    1 The study was not designed to support comparative claims for the laboratory abnormalities reported in this table.

    2 Percent (n/N) of patients where N=number of patients with normal baseline who had abnormal values at the timepoint(s) of interest.

    Day of Colonoscopy
    N (%) 2    		Day 30
    N (%) 2
    Bicarbonate (low)Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution20 (13)7 (4)
    PEG + Electrolytes24 (15)4 (3)
    Bilirubin, total (high)Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution14 (9)0 (0)
    PEG + Electrolytes20 (12)3 (2)
    BUN (high)Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution2 (2)14 (11)
    PEG + Electrolytes4 (3)19 (15)
    Calcium (high)Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution16 (10)8 (5)
    PEG + Electrolytes6 (4)6 (4)
    Chloride (high)Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution4 (2)6 (4)
    PEG + Electrolytes20 (12)6 (4)
    Osmolality (high)Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution8 (6)NA
    PEG + Electrolytes19 (13)NA
    Uric acid (high)Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution27 (24)13 (12)
    PEG + Electrolytes12 (10)20 (17)

    Less Common Adverse Reactions

    AV Block (1 case) and CK increase.


    Adverse Reactions with Unapproved Use

    In another study of 408 adult patients, higher rates of the following adverse reactions and laboratory abnormalities were reported in patients treated with Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution as an evening-only (1-day) regimen compared to the split-dose (2-day) regimen.

    • overall discomfort, abdominal distention, nausea, and vomiting
    • total bilirubin (high), BUN (high), creatinine (high), osmolality (high), potassium (high) and uric acid (high)

    Administration of Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution in an evening-only (1-day) dosing regimen is not recommended.


    Pediatrics 12 Years to 16 Years of Age

    The safety of Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution was evaluated in a single dose-ranging clinical trial of 89 pediatric patients aged 12 years to 16 years [see Clinical Studies ( 14)] . In 26 pediatric patients who received Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution (two 4.5-ounce doses), the most common adverse reactions (> 10%) were nausea, abdominal pain, abdominal bloating, and vomiting.

  • 7 DRUG INTERACTIONS

    7.1 Drugs That May Increase Risks of Fluid and Electrolyte Abnormalities

    Use caution when prescribing Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution to patients taking medications that increase the risk of 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 [see Warnings and Precautions ( 5.1, 5.2, 5.3, 5.4)].

    7.2 Potential for Reduced Drug Absorption

    Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution can reduce the absorption of other co-administered drugs [see Dosage and Administration ( 2.1)] .

    • Administer oral medications at least one hour before starting each dose of Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution.
    • Administer tetracycline and fluoroquinolone antibiotics, iron, digoxin, chlorpromazine, and penicillamine at least 2 hours before and not less than 6 hours after administration of Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution to avoid chelation with magnesium.

    7.3 Stimulant Laxatives

    Concurrent use of stimulant laxatives and Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution may increase the risk of mucosal ulceration or ischemic colitis. Avoid use of stimulant laxatives (e.g., bisacodyl, sodium picosulfate) while taking Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution  [see Warnings and Precautions ( 5.5)] .

  • 8 USE IN SPECIFIC POPULATIONS

    8.1 Pregnancy

    Risk Summary
    There are no available data on Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution use in pregnant women to evaluate for a drug-associated risk of major birth defects, miscarriage, or adverse maternal or fetal outcomes. Animal reproductive studies have not been conducted with Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution.

    The estimated background risk of major birth defects and miscarriage for the indicated population is unknown. All pregnancies have a background risk of birth defect, loss, or other adverse outcomes. In the U.S. general population, the estimated background risk of major birth defects and miscarriage in clinically recognized pregnancies is 2% to 4% and 15% to 20%, respectively.

    8.2 Lactation

    Risk Summary
    There are no data available data on the presence of Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution in human or animal milk, the effects on the breastfed child, or the effects on milk production. The developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution and any potential adverse effects on the breastfed child from Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution or from the underlying maternal condition.

    8.4 Pediatric Use

    The safety and effectiveness of Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution (two 4.5-ounce doses) have been established for cleansing of the colon as a preparation for colonoscopy in pediatric patients 12 years of age and older. Use of Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution in this age group is supported by evidence from an adequate and well-controlled trial of Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution in adults and a single, dose-ranging, controlled trial in 89 pediatric patients 12 years to 16 years of age [see Clinical Studies ( 14)] . In the pediatric trial, Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution (two 6-ounce doses) did not demonstrate additional treatment benefit and more patients reported gastrointestinal adverse reactions compared to Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution (two 4.5-ounce doses). Therefore, Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution (two 6-ounce doses) is not recommended for pediatric patients 12 years of age and older [see Dosage and Administration ( 2.3)] . The safety profile of Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution (two 4.5-ounce doses) in this pediatric population was similar to that seen in adults [see Adverse Reactions ( 6.1)] .

    The safety and effectiveness of Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution in pediatric patients less than 12 years of age have not been established.

    8.5 Geriatric Use

    Of the 375 patients who received Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution in clinical trials, 94 (25%) were 65 years of age or older, and 25 (7%) were 75 years of age or older. No overall differences in safety or effectiveness of Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution, administered as the recommended split-dose (2-day) regimen, were observed between geriatric patients and younger patients. Geriatric patients reported more vomiting when Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution was given as a one-day preparation (not a recommended regimen). Elderly patients are more likely to have decreased hepatic, renal or cardiac function and may be more susceptible to adverse reactions resulting from fluid and electrolyte abnormalities [see Warnings and Precautions ( 5.1)] .

    8.6 Renal Impairment

    Use Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution with caution in patients with renal impairment or patients taking concomitant medications that may affect renal function. These patients may be at risk for renal injury. Advise these patients of the importance of adequate hydration before, during and after use of Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution and consider performing baseline and post-colonoscopy laboratory tests (electrolytes, creatinine, and BUN) in these patients [see Warnings and Precautions ( 5.4)] .

  • 10 OVERDOSAGE

    Overdosage of more than the recommended dose of Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution may lead to severe electrolyte disturbances, as well as dehydration and hypovolemia, with signs and symptoms of these disturbances. [see Warnings and Precautions ( 5.1, 5.2, 5.3) ]. Monitor for fluid and electrolyte disturbances and treat symptomatically.

  • 11 DESCRIPTION

    Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution (for adults) is an osmotic laxative and is provided as two bottles each containing 6 ounces of solution. Each bottle contains: 17.5 grams sodium sulfate, 3.13 grams potassium sulfate, and 1.6 grams magnesium sulfate. Inactive ingredients include: citric acid USP, flavoring ingredients, malic acid FCC, sodium benzoate, NF, sucralose, purified water, USP.

    Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution  (for pediatric patients 12 years of age and older) is an osmotic laxative and is provided as two bottles each containing 4.5 ounces of solution. Each bottle contains: 13.13 grams sodium sulfate, 2.35 grams potassium sulfate, and 1.2 grams magnesium sulfate. Inactive ingredients include: citric acid USP, flavoring ingredients, malic acid FCC, sodium benzoate, NF, sucralose, purified water, USP.

    Sodium Sulfate, USP

    The chemical name is Na 2SO 4. The average Molecular Weight is 142.04. The structural formula is:

    Sodium Sulfate

    Potassium Sulfate, FCC, purified

    The chemical name is K 2SO 4. The average Molecular Weight is 174.26. The structural formula is:

    Potassium Sulfate

    Magnesium Sulfate, USP

    The chemical name is MgSO 4. The average Molecular Weight: 120.37. The structural formula is:

    Magnesium Sulfate

    Each Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution also contains a polypropylene mixing container.

  • 12 CLINICAL PHARMACOLOGY

    12.1 Mechanism of Action

    Sulfate salts provide sulfate anions, which are poorly absorbed. The osmotic effect of unabsorbed sulfate anions and the associated cations causes water to be retained within the gastrointestinal tract.

    12.2 Pharmacodynamics

    No formal pharmacodynamic studies have been conducted with Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution.

    12.3 Pharmacokinetics

    Absorption and Elimination

    After administration of Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution in six healthy subjects, the time at which serum sulfate reached its highest point (T max) was approximately 17 hours after the first dose or approximately 5 hours after the second dose, and then declined with a half-life of 8.5 hours.

    Excretion

    Fecal excretion was the primary route of sulfate elimination.

    Specific Populations

    Patients with Renal Impairment

    The disposition of sulfate after ingestion of Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution was studied in patients (N=6) with moderate renal impairment (creatinine clearance of 30 to 49 mL/min). In patients with moderate renal impairment, mean AUC was 54% higher and mean C max was 44% higher, than healthy subjects.

    The mean sulfate concentrations in healthy subjects and in patients with moderate renal impairment returned to their respective baselines by Day 6 after dose initiation. Urinary excretion of sulfate over 30 hours after the first dose was approximately 16% lower in patients with moderate renal impairment than in healthy subjects. These differences are not considered clinically meaningful.

    Patients with Hepatic Impairment

    The disposition of sulfate after ingestion of Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution was studied in patients (N=6) with mild to moderate hepatic impairment (Child-Pugh grades A and B). Systemic exposure of serum sulfate (AUC and C max) was similar between healthy subjects and patients with hepatic impairment. The mean sulfate concentrations in healthy subjects and in patients with mild to moderate hepatic impairment returned to their respective baselines by Day 6 after dose initiation. Urinary excretion of sulfate over 30 hours after the first dose was similar between patients with hepatic impairment and healthy subjects.

  • 13 NONCLINICAL TOXICOLOGY

    13.2 Animal Toxicology and/or Pharmacology

    The sulfate salts of sodium, potassium, and magnesium contained in Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution were administered orally (gavage) to rats and dogs up to 28 days up to a maximum daily dose of 5 grams/kg/day (approximately 0.9 and 3 times for rats and dogs, respectively, the recommended human dose of 44 grams/day or 0.89 grams/kg based on the body surface area). In rats, the sulfate salts caused diarrhea and electrolyte and metabolic changes, including hypochloremia, hypokalemia, hyponatremia, lower serum osmolality, and high serum bicarbonate. Significant renal changes included increased fractional sodium excretion, increased urinary sodium and potassium excretion, and alkaline urine in both males and  females. In addition, creatinine clearance was significantly decreased in females at the highest dose. No microscopic renal changes were seen. In dogs, the sulfate salts caused emesis, excessive salivation, excessive drinking of water, and abnormal excreta (soft and/or mucoid feces and/or diarrhea) and increased urine pH and sodium excretion.

  • 14 CLINICAL STUDIES

    Adults

    The colon cleansing efficacy of Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution was evaluated in a randomized, single-blind, active-controlled, multicenter study in adult patients scheduled to have a colonoscopy. There were 363 adult patients included in the efficacy analysis. Patients ranged in age from 20 to 84 years (mean age 55 years) and 54% were female. Race distribution was 86% Caucasian, 9% African-American, and 5% other.

    Patients were randomized to one of the following two colon preparation regimens: Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution or a marketed polyethylene glycol (PEG) plus electrolytes bowel preparation. In the Study Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution was administered as a split-dose (two-day) regimen. The PEG bowel prep was also given as a split-dose preparation according to its labeled instructions. Patients receiving Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution were limited to a light breakfast followed by clear liquids on the day prior to the day of colonoscopy; patients receiving the PEG bowel prep were allowed to have a normal breakfast and a light lunch, followed by clear liquids.

    The primary efficacy endpoint was the proportion of patients with successful colon cleansing as assessed by the colonoscopists, who were not informed about the type of preparation received, as shown in Table 3. In the study, no clinically or statistically significant differences were seen between the group treated with Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution and the group treated with the PEG bowel prep.

    Table 3: Proportion of Adult Patients with Successful Colon Cleansing Response Rates

    1 Responders were patients whose colon preparations were graded excellent (no more than small bits of adherent feces/fluid) or good (small amounts of feces or fluid not interfering with the exam) by the colonoscopist.

    2 Does not equal difference in tabled responder rates due to rounding effects.

    Treatment GroupRegimenNResponders1
    %
    (95% C. I.)    		Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution–PEG
    Difference
    (95% CI)
    Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution (with light breakfast)Split-Dose18097%
    (94%, 99%)

    2%2

    (-2%, 5%)
    PEG bowel prep
    (with normal breakfast & light lunch)     		Split-Dose18396%
    (92%, 98%)

    Pediatric Patients 12 Years to 16 Years of Age

    Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution was evaluated for colon cleansing in a randomized, single-blind, multicenter, doseranging, active-controlled study in 89 pediatric patients 12 years to 16 years of age. The majority of patients were female (57%), white (78%), and of non-Hispanic or non-Latino ethnicity (91%). The mean age was 14 years. The median body weight was 60 kg (range 32 to 155 kg).

    Patients were randomized to Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution (two 6-ounce doses), Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution (two 4.5-ounce doses) or oral PEG solution. Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution (two 6-ounce doses) did not demonstrate additional treatment benefit and more patients reported gastrointestinal adverse reactions compared to Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution (two 4.5-ounce doses); therefore, Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution (two 6-ounce doses) is not recommended for pediatric patients 12 years of age and older [see Dosage and Administration ( 2.4)] .

    Patients in the Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution (two 4.5-ounce doses) group took the preparation in a “split-dose” regimen, where the first dose was taken the evening before colonoscopy, with the second dose taken the morning of the exam. Patients in the control group took the preparation according to its approved labeling on the evening before colonoscopy.

    Patients in the Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution (two 4.5-ounce doses) were allowed to have a light breakfast on the day before colonoscopy, followed by clear liquids until the colonoscopy is completed the following day. Patients in the control group subjects were permitted only clear liquids on the day prior to colonoscopy until completion of the colonoscopy the following day.

    The primary efficacy endpoint was the proportion of patients with successful colon cleansing as assessed by the colonoscopists, who were not informed about the type of preparation received.

    The percentage of responders and the associated 95% confidence intervals for the Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution (two 4.5-ounce doses) and Oral PEG solution are shown in Table 4. Efficacy was similar between patients who weighed 65 kg or more (n=12) and those patients who weighed less than 65 kg (n=15) in the Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution (two 4.5-ounce doses) arm.

    Table 4: Proportion of Pediatric Patients 12 Years to 16 Years of Age with Successful Colon Cleansing Response Rates

    1 Responders were patients whose colon preparations were graded excellent (no more than small bits of adherent feces/fluid) or good (small amounts of feces or fluid not interfering with the exam) by the colonoscopist.

    2 Does not equal difference in tabled responder rates due to rounding effects.

    Treatment GroupRegimenNResponders1
    %
    (95% C. I.)    		Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution–PEG
    Difference
    (95% CI)

    Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution

    4.5 ounces per dose
    (with light breakfast)

    		Split-Dose2685%
    (71%, 99%)

    25%2

    (3%, 47%)
    Oral PEG Solution
    (with clear liquids only)

    Evening

    Dosing

    		3259%
    (42%, 76%)

  • 16 HOW SUPPLIED/STORAGE AND HANDLING

    Each Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution  (for adults) (NDC: 10572-012-01) contains:

    • Two bottles (NDC: 10572-011-01) each containing 6-ounces of an oral solution of 17.5 grams sodium sulfate, 3.13 grams potassium sulfate, and 1.6 grams magnesium sulfate as a clear to slightly hazy liquid. When diluted as directed, the solution is clear and colorless.
    • One (1) mixing container with a 16-ounce fill line.

    Each Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution  (for pediatric patients 12 years of age and older) (NDC: 10572-112-01) contains:

    • Two bottles (NDC: 10572-111-01) each containing 4.5-ounces of an oral solution of 13.13 grams sodium sulfate, 2.35 grams potassium sulfate, and 1.2 grams magnesium sulfate as a clear to slightly hazy liquid. When diluted as directed, the solution is clear and colorless.
    • One (1) mixing container with a 12-ounce fill line.

    Store at 20° to 25°C (68° to 77°F). Excursions permitted between 15° to 30°C (59° to 86°F). See USP controlled room temperature.

  • 17 PATIENT COUNSELING INFORMATION

    Advise the patient and/or caregiver to read the FDA-approved patient labeling (Medication Guide).

    Instruct patients or caregivers:

    • Must dilute Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution before ingestion.
    • Must consume additional water after each dose of Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution.
    • On the day before colonoscopy, consume only a light breakfast or clear liquids (e.g., water, apple or orange juice without pulp, lemonade, coffee, tea, or chicken broth). On the day of the colonoscopy only consume clear liquids up to two hours prior to colonoscopy.
    • Two doses of Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution are required for a complete preparation for colonoscopy. One bottle of Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution is equivalent to one dose.
    • Do not to take other laxatives while taking Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution.
    • Do not eat solid food or drink milk or eat or drink anything colored red or purple.
    • Do not drink alcohol.
    • Do not take oral medications within one hour of starting each dose of Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution.
    • If taking tetracycline or fluoroquinolone antibiotics, iron, digoxin, chlorpromazine, or penicillamine, take these medications at least 2 hours before and not less than 6 hours after administration of Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution  [see Drug Interactions ( 7.2)] .
    • Stop consumption of all fluids at least 2 hours prior to colonoscopy.
    • Contact their healthcare provider if they develop significant vomiting or signs of dehydration after taking Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution or if they experience cardiac arrhythmias or seizures [see Warnings and Precautions ( 5.1, 5.2, 5.3)] .

    Distributed by Affordable Pharmaceuticals, LLC

    Braintree, MA 02185
    U.S. Patent 6,946,149

  • MEDICATION GUIDE

    MEDICATION GUIDE

    Sodium Sulfate, Potassium Sulfate and Magnesium
    Sulfate Oral Solution (so-DEE-um sul-fate, po-TASS
    ee-um sul-fate and mag-NEE-see-um sul-fate)

    Read and understand this Medication Guide instructions at least 2 days before your colonoscopy and again before you start taking Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution.

    What is the most important information I should know about Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution?

    Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution and other 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:
      abnormal heartbeats that can cause death
      seizures. This can happen even if you have never had a seizure.
      kidney problems

    Your chance of having fluid loss and changes in body salts with Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution is higher if you:

        have heart problems

        have kidney problems

        take water pills or non-steroidal anti-inflammatory drugs (NSAIDS)

    Tell your healthcare provider right away if you have any of these symptoms of a loss of too much body fluid (dehydration) while taking Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution:

         o vomiting                                                            o urinating less often than normal
         o dizziness                                                            o headache


    See "What are the possible side effects of Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution?" for more information about side effects.

    What is Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution?

    Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution is a prescription medicine used by adults and children 12 years of age and older to clean the colon before a colonoscopy. Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution 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.


    It is not known if Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution is safe and effective in children under 12 years of age.

    Do not take Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution if your healthcare provider has told you that you have:
        a blockage in your intestine (bowel obstruction)
        an opening in the wall of your stomach or intestine (bowel perforation)
        a very dilated intestine (toxic megacolon)
        problems with the emptying of food and fluid from your stomach (gastric retention)
        an allergy to any of the ingredients in Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution See the end of this Medication Guide for a complete list of ingredients in Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution.

    Before taking Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution, tell your healthcare provider about all of your medical conditions, including if you:

        have problems with serious loss of body fluid (dehydration) and changes in blood salts (electrolytes).
        have gout
        have heart problems including an irregular heartbeat, especially a condition called "QT prolongation".
        have a history of seizures or take medicines for seizures.
        are withdrawing from drinking alcohol or from taking benzodiazepines.
        have a low blood salt (sodium) level.
        have kidney problems or take medicines for kidney problems.
        have stomach or bowel problems including ulcerative colitis.
        have problems with swallowing or gastric reflux.
        are pregnant or plan to become pregnant. It is not known if Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution will harm your unborn baby. Talk to your healthcare provider if you are pregnant.

        are breastfeeding or plan to breastfeed. It is not known if Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution passes into your breast milk. You and your healthcare provider should decide if you will take Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution while breastfeeding.


    Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.


    Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution may affect how other medicines work. Medicines taken by mouth may not be absorbed properly when taken within 1 hour before the start of each dose of Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution.


    Especially tell your healthcare provider if you take:
        medicines for blood pressure or heart problems.
        medicines for kidney problems.
        medicines for seizures.
        water pills (diuretics).
        non-steroidal anti-inflammatory medicines (pain medicines).
        medicines for depression or mental health problems.
        laxatives. Do not take other laxatives while taking Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution.

    The following medicines should be taken at least 2 hours before starting Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution and not less than 6 hours after taking Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution:
        tetracycline
        fluoroquinolone antibiotics
        iron
        digoxin (Lanoxin)
        chloropromazine
        penicillamine (Cuprimine. Depen)

    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 Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution?

    See the Instructions for Use in the Patient Instructions for Use Booklet for dosing instructions. You must read, understand, and follow these instructions to take Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution the right way.

        Take Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution exactly as your healthcare provider tells you to take it.
        Each bottle of Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution must be mixed with water (diluted) before drinking.
        It is important for you to drink the additional prescribed amount of water listed in the Instructions for Use to prevent fluid loss
          (dehydration).
        One bottle of Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution is equal to one dose.
        Two doses of Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution are required for complete colonoscopy preparation.
        All people taking Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution should follow these general instructions starting 1 day before your colonoscopy:
              eat only a light breakfast or clear liquids (for example: water, strained fruit juice without pulp, lemonade, plain coffee or tea, chicken
                broth, gelatin dessert without fruit) on the day before your procedure.
              only drink clear liquids the rest of the day and the next day until 2 hours before your colonoscopy. Stop drinking all fluids at least 2
                hours before your colonoscopy.
              after taking Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution if you have any bloating or feeling like your stomach is upset, wait to take your second dose until your stomach feels better.

    While taking Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution, do not:

              take any other laxatives.
              take any medicines by mouth (oral) within 1 hour of starting Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution.
              eat solid foods, drink dairy (such as milk), or drink alcohol while taking Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution and until after your colonoscopy
              eat or drink anything colored red or purple.


    Contact your healthcare provider right away if after taking Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution you have severe vomiting, signs of dehydration, changes in consciousness such as feeling confused, delirious or fainting (loss of consciousness) or seizures after taking Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution.

    What are the possible side effects of Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution?

    Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution can cause serious side effects, including:

        See " What is the most important information I should know about Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution?"
    Changes in certain blood tests. Your healthcare provider may do blood tests after you takeSodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution  to check your blood for changes. Tell your healthcare provider if you have any symptoms of too much fluid loss, including:
      o vomiting                                         o nausea                                                        o bloating
      o dizziness                                         o stomach area (abdomen) cramping           o headache
      o urinate less than usual                    o trouble drinking clear liquid                      o trouble swallowing
      o seizures                                           o heart problems                                          o worsening gout
      Ulcers of the bowel or bowel problems (ischemic colitis). Tell your healthcare provider right away if you have severe stomach-area
          (abdomen) pain or rectal bleeding.


    The most common side effects of Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution in adults include:

      o overall discomfort                                                                o stomach bloating
      o stomach pain                                                                        o nausea
      o vomiting


    The most common side effects of Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution in children 12 to 16 years of age include:
      o nausea                                                                                 o stomach pain
      o stomach bloating                                                                 o vomiting


    These are not all the possible side effects of Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution.

    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 Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution?

        Store Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution at room temperature, between 68°F to 77°F (20°C to 25°C).

    Keep Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution and all medicines out of the reach of children.

    General information about the safe and effective use of Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution.


    Medicines are sometimes prescribed for purposes other than those listed in a Medication Guide. Do not use Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution for a condition for which it was not prescribed. Do not give Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution to other people, even if they are going to have the same procedure you are. It may harm them. You can ask your pharmacist or healthcare provider for information about Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution that is written for healthcare professionals.

    What are the ingredients in Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution?

    Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution is supplied in two dosage strengths. Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Oral Solution comes in a carton containing two 6-ounce bottles, along with a 16-ounce polypropylene mixing container. Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate Pediatric Oral Solution comes in a carton containing two bottles containing 4.5 ounces of oral solution, along with a 12-ounce polypropylene mixing container.

    Each bottle contains:
    Active ingredients: sodium sulfate, potassium sulfate and magnesium sulfate.
    Inactive ingredients: citric acid, USP, flavoring ingredients, malic acid, FCC, sodium benzoate, NF, sucralose, purified water, USP.

    Distributed by Affordable Pharmacuticals, LLC
    Braintree, MA 02185, USA
    For more information go to www.affordablepharma.com or call 1-800-514-5617.

    This Medication Guide has been approved by the U.S. Food and Drug Administration.                                                                Revised 08/2020

  • PRINCIPAL DISPLAY PANEL

    Principal Display Panel – Adult Carton Label

    NDC: 10572-012-01 U.S. Patent 6,946,149

    Dispense the enclosed Medication Guide to each patient.

    Sodium Sulfate, PotassiumSulfate and Magnesium Sulfate
    Oral Solution

    For Adults
    (17.5g/3.13g/1.6g) per 6 ounces

    This carton contains:

    2 6-ounce (177 mL) bottles of liquid bowel prep
    1 16-ounce mixing container
    1 Patient booklet. Booklet includes:
       1- Medication Guide
       2- Patient Instructions
       3- Full Prescribing Information

    Recommended Dosage:
    See prescribing information

    Dilute the solution concentrate as
    directed prior to use.

    Both 6-ounce bottles are required for
    a complete prep.

    Rx only

    Affordable Pharmaceuticals, LLC

    Adult Carton Label

  • PRINCIPAL DISPLAY PANEL

    Principal Display Panel – Adult Bottle Label

    NDC: 10572-011-01

    Sodium Sulfate, Potassium
    Sulfate and Magnesium Sulfate
    Oral Solution
    For Adults
    (17.5g/3.13g/1.6g) per 6 ounces

    Dispense the enclosed Medication Guide to each patient.

    This bottle contains 6 ounces (177 mL) of liquid bowel prep

    Directions:
    Dilute the solution concentrate prior to use. See enclosed booklet for
    complete dosage and administration instructions. Both 6-ounce
    bottles are required for a complete prep.

    Keep this and other drugs out of reach of children.
    Store at 25°C (77°F); excursions permitted to 15-30°C (59-86°F).

    Distributed by Affordable Pharmaceuticals, LLC, Braintree, MA Rx only Rev June ‘22

    Adult Bottle Label

  • PRINCIPAL DISPLAY PANEL

    Principal Display Panel – Pediatric Carton Label

    NDC: 10572-112-01 U.S. Patent 6,946,149

    Dispense the enclosed Medication Guide to each patient.

    Sodium Sulfate, Potassium
    Sulfate and Magnesium Sulfate
    Oral Solution
    For pediatric patients 12 years of age and older
    (13.13g/2.35g/1.2g) per 4.5 ounces

    This carton contains:

    2 Bottles containing 4.5 ounces
    of liquid bowel prep
    1 12-ounce mixing container
    1 Patient booklet. Booklet includes:
       1- Medication Guide
       2- Patient Instructions
       3- Full Prescribing Information

    Recommended Dosage:
    See prescribing information

    Dilute the solution concentrate as
    directed prior to use.

    Both bottles containing 4.5 ounces of oral
    solutions are required for a complete prep.

    Rx only

    Affordable Pharmaceuticals, LLC

    Pediatric Carton

  • PRINCIPAL DISPLAY PANEL

    Principal Display Panel – Pediatric Bottle Label

    NDC: 10572-111-01

    Sodium Sulfate, Potassium
    Sulfate and Magnesium Sulfate)
    Oral Solution
    For pediatric patients 12 years of age and older
    (13.13g/2.35g/1.2g) per 4.5 ounces

    Dispense the enclosed Medication Guide to each patient.

    This bottle contains 4.5 ounces of liquid bowel prep

    Directions:
    Dilute the solution concentrate prior to use. See enclosed booklet for
    complete dosage and administration instructions. Both 6 bottles
    containing 4.5 ounces of oral soultion are required for a complete prep.

    Keep this and other drugs out of reach of children.
    Store at 25°C (77°F); excursions permitted to 15-30°C (59-86°F).

    Distributed by Affordable Pharmaceuticals, LLC, Braintree, MA Rx only June 2022

    Pediatric Bottle Label

  • INGREDIENTS AND APPEARANCE
    SODIUM SULFATE, POTASSIUM SULFATE AND MAGNESIUM SULFATE 
    sodium sulfate, potassium sulfate, magnesium sulfate solution, concentrate
    Product Information
    Product TypeHUMAN PRESCRIPTION DRUGItem Code (Source)NDC: 10572-012
    Route of AdministrationORAL
    Active Ingredient/Active Moiety
    Ingredient NameBasis of StrengthStrength
    SODIUM SULFATE (UNII: 0YPR65R21J) (SODIUM CATION - UNII:LYR4M0NH37) SODIUM SULFATE17.5 g  in 1 mL
    POTASSIUM SULFATE (UNII: 1K573LC5TV) (POTASSIUM CATION - UNII:295O53K152) POTASSIUM SULFATE3.13 g  in 1 mL
    MAGNESIUM SULFATE, UNSPECIFIED FORM (UNII: DE08037SAB) (MAGNESIUM CATION - UNII:T6V3LHY838) MAGNESIUM SULFATE, UNSPECIFIED FORM1.6 g  in 1 mL
    Inactive Ingredients
    Ingredient NameStrength
    SODIUM BENZOATE (UNII: OJ245FE5EU)  
    SUCRALOSE (UNII: 96K6UQ3ZD4)  
    MALIC ACID (UNII: 817L1N4CKP)  
    CITRIC ACID MONOHYDRATE (UNII: 2968PHW8QP)  
    Product Characteristics
    Color    Score    
    ShapeSize
    FlavorBERRY (BERRY) Imprint Code
    Contains    
    Packaging
    #Item CodePackage DescriptionMarketing Start DateMarketing End Date
    1NDC: 10572-012-012 in 1 CARTON08/05/2010
    1177.4 mL in 1 BOTTLE, PLASTIC; Type 0: Not a Combination Product
    Marketing Information
    Marketing CategoryApplication Number or Monograph CitationMarketing Start DateMarketing End Date
    NDANDA02237208/05/2010
    SODIUM SULFATE, POTASSIUM SULFATE AND MAGNESIUM SULFATE 
    sodium sulfate, potassium sulfate, magnesium sulfate solution, concentrate
    Product Information
    Product TypeHUMAN PRESCRIPTION DRUGItem Code (Source)NDC: 10572-112
    Route of AdministrationORAL
    Active Ingredient/Active Moiety
    Ingredient NameBasis of StrengthStrength
    SODIUM SULFATE (UNII: 0YPR65R21J) (SODIUM CATION - UNII:LYR4M0NH37) SODIUM SULFATE13.13 g  in 133.1 mL
    POTASSIUM SULFATE (UNII: 1K573LC5TV) (POTASSIUM CATION - UNII:295O53K152) POTASSIUM SULFATE2.35 g  in 133.1 mL
    MAGNESIUM SULFATE, UNSPECIFIED FORM (UNII: DE08037SAB) (MAGNESIUM CATION - UNII:T6V3LHY838) MAGNESIUM SULFATE, UNSPECIFIED FORM1.2 g  in 133.1 mL
    Inactive Ingredients
    Ingredient NameStrength
    SODIUM BENZOATE (UNII: OJ245FE5EU)  
    SUCRALOSE (UNII: 96K6UQ3ZD4)  
    MALIC ACID (UNII: 817L1N4CKP)  
    CITRIC ACID MONOHYDRATE (UNII: 2968PHW8QP)  
    Product Characteristics
    Color    Score    
    ShapeSize
    FlavorBERRY (BERRY) Imprint Code
    Contains    
    Packaging
    #Item CodePackage DescriptionMarketing Start DateMarketing End Date
    1NDC: 10572-112-012 in 1 CARTON01/05/2021
    1133.1 mL in 1 BOTTLE, PLASTIC; Type 0: Not a Combination Product
    Marketing Information
    Marketing CategoryApplication Number or Monograph CitationMarketing Start DateMarketing End Date
    NDANDA02237208/05/2010
    Labeler - Affordable Pharmaceuticals, LLC (182815311)
    Establishment
    NameAddressID/FEIBusiness Operations
    Braintree Laboratories, Inc.617357954manufacture(10572-012, 10572-112) , analysis(10572-012, 10572-112)
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