05/19 PREP1S/1P-002

DAY-BEFOREINSTRUCTIONS:

Priortoyourprocedure,purchaseTriLyteand10mgDulcolaxfromyourpharmacy.

Onthedaybeforeyourprocedure,completesteps1and2—andstep3fortheOmethatdescribesyourprocedure:

Step1: Takeone10mgDulcolaxtabletat

12:00noonwithwater.DONOTcrushorchew.

NOTE:DonottakeDulcolaxwithinonehourof

takinganantacid.

Step2: MixTriLytesoluGon,recap,andshake

todissolvethepowder,andrefrigerate.(Note:If

youaretakingTriLyteLemon-Lime,simplyopen

theboPle.IfyouaretakingTriLytewithFlavor

Packs,openaflavorpackandaddittothe

TriLyteboPle).Adddrinkingwatertothetop

lineontheTriLyteboPle,recap,andshaketo

mix.ThereconsGtutedsoluGonwillbeclearand

colorless.Usewithin48hours.NoaddiGonal

ingredientsshouldbeaddedtothesoluGon.

Ifyourprocedureisbefore10:00am:

Step3: At5:00pm,drinkone8ozglassof

soluGonevery10-15minutes.Drinkeachglass

quicklyinsteadoftakingmanysips.

TRILYTE&DULCOLAXPREPINSTRUCTIONS AMDoctor:__________________________________ DateofColonoscopy:___________ ArrivalTime:_______PM

LocaGon: ☐SCEndoscopyCenterWC,131SummerplaceDrive,WestColumbia,SC29169

☐SCEndoscopyCenterNE,11GatewayCornersPark,Columbia,SC29203

☐Other:____________________________________________________________________________

1. Onthedaybeforeyourprocedure,ONLYconsumeclearliquids,suchas:

• Water

• Clearbroth

• Applejuice

• Whitecranberryjuice

• Whitegrapejuice

• Gingerale

• PlaingelaGn

• Frozenjuicebars

2. Onthedaybeforeyourprocedure,DONOTdrinkanyofthefollowing:

• NORed/Purpleliquids

• NOLiquidsyoucan’tseethrough

• NOAlcoholicbeverages

3.Stayhydrated.

4.Applyadabofpetroleumjelly aroundanusbeforeandafereach bowelmovementforaddedease andcomfort.

5.IMPORTANT:DONOTeatordrinkanythingaftermidnight.

PHYSICIANREMINDERS: TRILYTE&DULCOLAX

IMPORTANT

Donoteatordrinkanythingafermidnight.Failuretodosomayresultinthe

needtorescheduleyour

procedure.