stop before colonoscopy

Medications and food may affect your bowel preparation for colonoscopy. Some medications may cause you to bleed more during or after colonoscopy. This is particularly true if some form of therapeutic procedures (biopsies, dilation, polypectomy) are performed during colonoscopy.

Some medication and food may affect the cleanliness of your colon. Certain medications and food can slow your gut causing constipation and therefore poor bowel prep. You need to stop before colonoscopy certain medications and foods.

Medications to stop before colonoscopy 

Anti-platelet medications 

Anti-platelet medications are used to prevent stroke and heart attack. In addition, they can prevent any artery from getting blocked like arteries in the leg.

You do not need to stop aspirin before colonoscopy. On the other hand, some people need to stop their plavix before colonoscopy. Talk to your doctor if you take any of these medications and ask if you need to stop or continue them.

Examples of anti-platelet medications
  •  Aspirin
  • Clopidrogel (Plavix)
  • Ticlopidine (Ticlid)
  • Prasugrel (Effient)
  • Ticagrelor (Brillinta)
  • Dipyridamole (Persantine)
  • Aggrenox (dipyridamole plus aspirin)
  • Abciximab (ReoPro)

Anti-coagulation medications

Anticoagulants are blood thinners that are used to prevent or treat blood clots. They are used in patients with arrhythmia such as atrial fibrillation, deep vein thrombosis, pulmonary embolism, mechanical heart valves, heart attack and stroke.

You need to stop your anti-coagulation medications before your colonoscopy. Heparin has to be stopped 4-6 hours before your colonoscopy. Lovenox is usually stopped about 12 hours before colonoscopy.  Warfarin (Coumadin) is usually stopped 5-7 days before your colonoscopy. Other oral anticoagulation medications like Eliquis and Xarelto can be stopped 2-3 days before colonoscopy.

Examples of anticoagulation medications
  • Heparin
  • Coumadin (Warfarin)
  • Rivaroxaban (Xarelto)
  • Apixaban (Eliquis)
  • Dabigatran (Pradaxa)
  • Bivalirudin (Angiomax)
  • Argatroban
  • Enoxaprin (Lovenox)
  • Dalteparin (Fragmin)
  • Tinzaparin (Innoprin)
  • Fondaparinux (Arixtra)

Diabetic medications

There are 2 types of diabetes mellitus. Insulin-dependent and non-insulin dependent diabetes mellitus. There are 2 main types of medications-insulin and non-insulin medications. Take only half the usual dose of your pills or insulin the day before your colonoscopy while you’re on clear liquid diet. Do not take oral diabetic medications or short-acting insulin on the day of your colonoscopy. Read Diabetes and colonoscopy. How to take your medications before colonoscopy.

Examples of diabetic medications

Click list of medications for diabetes mellitus. 

Anti-diarrhea medications

Some people with diarrhea take medications that can reduce their stool counts. Medications like  Imodium®, Lomotil®, and Pecto Bismol® should be stopped about 1 week before your colonoscopy. You want to be cleaned out therefore anything that will make you hold on to your stool should be avoided.

Non-steroidal anti-inflammatory agents (NSAIDS)

These medications include aspirin, ibuprofen, naproxen, meloxicam, indomethacin, diclofenac, and sulindac. There are others. Aspirin is mostly used for heart conditions while the others are mainly pain medications. In general, these medications may be used in the days before colonoscopy. You do not need to stop any of these medications before colonoscopy particularly aspirin. However, follow the specific instruction of your physician because these medications may affect some of your colonoscopy findings. 

Fiber and supplements

Fiber supplements include psyllium, glucomannan, methylcellulose, flaxseed, wheat dextrin, calcium polycarbophil, and inulin. They are found in products such as Metamucil®, Citrucel®, and Benefiber®. They should be stopped 1 week before your colonoscopy.

Food to stop before colonoscopy 

Food affects bowel prep. Avoid high fiber diet starting 3 days before your colonoscopy. A day before your colonoscopy, your physician will put you on either a clear liquid diet or a low fiber diet. Most people are placed on a clear liquid diet a day before colonoscopy. Read What food can I eat before colonoscopy.


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