Identification
- Summary
Picosulfuric acid is a stimulant laxative used for cleansing of the colon as a preparation for colonoscopy in adults.
- Brand Names
- Clenpiq, Pico-salax, Picoflo, Purg-odan
- Generic Name
- Picosulfuric acid
- DrugBank Accession Number
- DB09268
- Background
Picosulfuric acid is found in laxative products. Sodium picosulfate is a used to treat constipation or induce colon cleansing to prepare the large bowels before colonoscopy or surgery. The combination product containing sodium picosulfate and magnesium citrate was introduced to the Canadian market in 2005 and has been used in European countries for many years.3
- Type
- Small Molecule
- Groups
- Approved
- Structure
Structure for Picosulfuric acid (DB09268)
- Weight
- Average: 437.44
Monoisotopic: 437.023908795 - Chemical Formula
- C18H15NO8S2
- Synonyms
- Picosulfate
- Picosulphate
Pharmacology
- Indication
Sodium picosulfate, in combination with magnesium oxide and anhydrous citric acid, is indicated for cleansing of the colon as a preparation for colonoscopy in adults and pediatric patients ages 9 years and older.4
Reduce drug development failure ratesBuild, train, & validate machine-learning modelswith evidence-based and structured datasets.Build, train, & validate predictive machine-learning models with structured datasets.- Associated Conditions
Indication Type Indication Combined Product Details Approval Level Age Group Patient Characteristics Dose Form Treatment of Constipation ••• ••• ••••••• •••••••• Treatment of Constipation •••••••••••• ••••• ••••••• •• ••• •••••••••••••••• ••••• ••• Treatment of Constipation •••••••••••• •••• ••••••••• ••• Treatment of Constipation •••••••••••• ••••••••••••• ••• Treatment of Constipation •••••••••••• ••• - Associated Therapies
- Contraindications & Blackbox Warnings
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Sodium picosulfate is a stimulant laxative that in conjunction with magnesium citrate, produces a purgative effect on stools. In a multicentre, observational study comprising of patients undergoing colonoscopy, more than 93.0% of the patients receiving sodium picosulfate-containing preparations reported the colon cleansing effect to be effective.3
- Mechanism of action
Picosulfuric acid, as sodium picosulfate, is a contact laxative. Sodium picosulfate inhibits the absorption of water and electrolytes, and increases their secretion into the intestinal lumen.2 It is hydrolyzed by colonic bacterial enzyme, sulfatase 2, to form an active metabolite bis-(p-hydroxy-phenyl)-pyridyl-2-methane (BHPM), which acts directly on the colonic mucosa to stimulate colonic peristalsis.4
- Absorption
After the first dose of an oral sodium picosulfate, magnesium oxide, and anhydrous citric acid product, healthy volunteers had a picosulfate mean peak plasma concentration (Cmax) of 2.3 ng/mL that was reached at 2 hours (tmax). After the administration of two doses separated by 6 hours, the mean Cmax for picosulfate was 3.2 ng/mL, with a tmax of 7 hours.4,5
- Volume of distribution
Not available.
- Protein binding
Not available.
- Metabolism
Sodium picosulfate is hydrolyzed by colonic bacteria to form an active metabolite bis-(p-hydroxy-phenyl)-pyridyl-2-methane (BHPM).4
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- Route of elimination
Sodium picosulfate and its metabolite bis-(p-hydroxy-phenyl)-pyridyl-2-methane (BHPM) are mainly excreted in urine. The majority of BHPM is excreted as a glucuronide-conjugate. Approximately 0.1% of the sodium picosulfate dose is excreted unchanged in urine.4
- Half-life
The terminal half-life of sodium picosulfate is 7.4 hours in adults and 7 hours in pediatric patients.4
- Clearance
Not available.
- Adverse Effects
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Overdosage of laxative preparations containing sodium picosulfate may lead to severe electrolyte disturbances, in addition to dehydration and hypovolemia, with signs and symptoms of these disturbances. In case of overdose, monitor for fluid and electrolyte disturbances with symptomatic treatment.4 In vitro, 800 and 1600 mg/mL of sodium picosulfate exerted cytotoxic effects on cultured liver cells by inducing dose-dependent vacuolic and fatty change, as well as necrosis combined with a lowered mitotic activity and a slight increase in LDH values of the rapidly growing cultured liver cells of rabbit.1
- Pathways
- Not Available
- Pharmacogenomic Effects/ADRs Browse all" title="About SNP Mediated Effects/ADRs" id="snp-actions-info" class="drug-info-popup" href="javascript:void(0);">
- Not Available
Interactions
- Drug Interactions Learn More" title="About Drug Interactions" id="structured-interactions-info" class="drug-info-popup" href="javascript:void(0);">
- This information should not be interpreted without the help of a healthcare provider. If you believe you are experiencing an interaction, contact a healthcare provider immediately. The absence of an interaction does not necessarily mean no interactions exist.
Drug Interaction Integrate drug-drug
interactions in your softwareAbacavir Abacavir may decrease the excretion rate of Picosulfuric acid which could result in a higher serum level. Aceclofenac Aceclofenac may decrease the excretion rate of Picosulfuric acid which could result in a higher serum level. Acemetacin Acemetacin may decrease the excretion rate of Picosulfuric acid which could result in a higher serum level. Acetaminophen Acetaminophen may decrease the excretion rate of Picosulfuric acid which could result in a higher serum level. Acetazolamide The risk or severity of dehydration can be increased when Acetazolamide is combined with Picosulfuric acid. - Food Interactions
- Avoid alcohol.
- Avoid solid foods. When using picosulfuric acid in preparation for a colonoscopy, only consume clear fluids the day before the procedure.
Products
Drug product information from 10+ global regionsOur datasets provide approved product information including:dosage, form, labeller, route of administration, and marketing period.Access drug product information from over 10 global regions.- Product Ingredients
Ingredient UNII CAS InChI Key Sodium picosulfate monohydrate LR57574HN8 1307301-38-7 FHYUVJHZGPGDSP-UHFFFAOYSA-L Sodium picosulphate anhydrous VW106606Y8 10040-45-6 GOZDTZWAMGHLDY-UHFFFAOYSA-L - Active Moieties
Name Kind UNII CAS InChI Key Deacetylbisacodyl unknown R09078E41Y 603-41-8 LJROKJGQSPMTKB-UHFFFAOYSA-N - International/Other Brands
- Guttalax / Laxoberal / Laxoberon / Picolax / Picoprep
- Over the Counter Products
Name Dosage Strength Route Labeller Marketing Start Marketing End Region Image Skilax Drops 7.5mg/ml Solution / drops Oral MILRIN PHARMACEUTICAL CO. (M) SDN BHD 2020-09-08 Not applicable Malaysia 
- Mixture Products
Name Ingredients Dosage Route Labeller Marketing Start Marketing End Region Image AGAROL Sodium picosulfate monohydrate (33.34 mg) + Mineral oil (28.22 mg) Emulsion Oral COASPHARMA S.A.S. 2018-06-22 Not applicable Colombia 
Citracleen Sodium picosulfate monohydrate (10 mg / 15.08 g) + Citric acid (10.97 g / 15.08 g) + Magnesium oxide (3.5 g / 15.08 g) Powder, for solution Oral Laboratorios Casen Fleet, S.L.U. Not applicable Not applicable Canada 
CITRAFLEET Sodium picosulfate monohydrate (10 mg/15.08g) + Citric acid (10.97 mg/15.08g) + Magnesium oxide (3.5 g/15.08g) Powder, for solution Oral Casen Recordati Sl 2014-07-08 Not applicable Italy 
CITRAFLEET Sodium picosulfate monohydrate (10 mg/15.08g) + Citric acid (10.97 mg/15.08g) + Magnesium oxide (3.5 g/15.08g) Powder, for solution Oral Casen Recordati Sl 2014-07-08 Not applicable Italy CITRAFLEET 0.01 G/ 3.50 G/ 10.97 G ORAL ÇÖZELTI HAZIRLAMAK IÇIN TOZ IÇEREN SAŞE , 2 ADET Sodium picosulfate monohydrate (0.01 g) + Citric acid (10.97 g) + Magnesium oxide (3.5 g) Powder, for solution Oral RECORDATİ İLAÇ SAN. VE TİC. A.Ş. 2017-06-04 Not applicable Turkey 
Categories
- ATC Codes
- A06AB08 — Sodium picosulfate
- A06AB — Contact laxatives
- A06A — DRUGS FOR CONSTIPATION
- A06 — DRUGS FOR CONSTIPATION
- A — ALIMENTARY TRACT AND METABOLISM
- Drug Categories
- Chemical TaxonomyProvided by Classyfire
- Description
- This compound belongs to the class of organic compounds known as diphenylmethanes. These are compounds containing a diphenylmethane moiety, which consists of a methane wherein two hydrogen atoms are replaced by two phenyl groups.
- Kingdom
- Organic compounds
- Super Class
- Benzenoids
- Class
- Benzene and substituted derivatives
- Sub Class
- Diphenylmethanes
- Direct Parent
- Diphenylmethanes
- Alternative Parents
- Phenylsulfates / Phenoxy compounds / Sulfuric acid monoesters / Pyridines and derivatives / Heteroaromatic compounds / Azacyclic compounds / Organopnictogen compounds / Organooxygen compounds / Organonitrogen compounds / Organic oxides show 1 more
- Substituents
- Aromatic heteromonocyclic compound / Arylsulfate / Azacycle / Diphenylmethane / Heteroaromatic compound / Hydrocarbon derivative / Organic nitrogen compound / Organic oxide / Organic oxygen compound / Organic sulfuric acid or derivatives show 10 more
- Molecular Framework
- Aromatic heteromonocyclic compounds
- External Descriptors
- Not Available
- Affected organisms
- Humans and other mammals
Chemical Identifiers
- UNII
- 95D580798S
- CAS number
- 10040-34-3
- InChI Key
- UJIDKYTZIQTXPM-UHFFFAOYSA-N
- InChI
- InChI=1S/C18H15NO8S2/c20-28(21,22)26-15-8-4-13(5-9-15)18(17-3-1-2-12-19-17)14-6-10-16(11-7-14)27-29(23,24)25/h1-12,18H,(H,20,21,22)(H,23,24,25)
- IUPAC Name
- {4-[(pyridin-2-yl)[4-(sulfooxy)phenyl]methyl]phenyl}oxidanesulfonic acid
- SMILES
- OS(=O)(=O)OC1=CC=C(C=C1)C(C1=CC=C(OS(O)(=O)=O)C=C1)C1=CC=CC=N1
References
- General References
- Nishikawa J, Kast A: Toxicity study with sodium picosulfate in cultured liver cells of rabbit, rat and man. Arzneimittelforschung. 1981;31(2):321-5. [Article]
- Kim DH, Hyun SH, Shim SB, Kobashi K: The role of intestinal bacteria in the transformation of sodium picosulfate. Jpn J Pharmacol. 1992 May;59(1):1-5. [Article]
- Love J, Bernard EJ, Cockeram A, Cohen L, Fishman M, Gray J, Morgan D: A multicentre, observational study of sodium picosulfate and magnesium citrate as a precolonoscopy bowel preparation. Can J Gastroenterol. 2009 Oct;23(10):706-10. [Article]
- FDA Approved Drug Products: CLENPIQ (sodium picosulfate, magnesium oxide, and anhydrous citric acid) oral solution [Link]
- FDA Clinical Pharmacology and Biopharmaceutical Review(s) on PICOPREP [File]
- External Links
- Human Metabolome Database
- HMDB0256534
- PubChem Compound
- 5243
- PubChem Substance
- 310265163
- ChemSpider
- 5053
- 1546457
- ChEMBL
- CHEMBL1741134
- ZINC
- ZINC000003873921
- Wikipedia
- Sodium_picosulfate
Clinical Trials
- Clinical Trials Learn More" title="About Clinical Trials" id="clinical-trials-info" class="drug-info-popup" href="javascript:void(0);">
Phase Status Purpose Conditions Count 4 Active Not Recruiting Treatment Patients Undergoing Elective Colonoscopy 1 4 Completed Not Available Bowel preparation therapy 1 4 Completed Not Available Bowel preparation therapy / Colonoscopy 1 4 Completed Diagnostic Colonoscopy 2 4 Completed Diagnostic Hemodynamics / Hyponatremia 1
Pharmacoeconomics
- Manufacturers
- Not Available
- Packagers
- Not Available
- Dosage Forms
Form Route Strength Gel Oral 36 mg/100ml Emulsion Oral Suspension Oral Liquid Oral Capsule, liquid filled Oral 2.5 mg Capsule, gelatin coated Capsule, gelatin coated 2.5 mg Solution / drops Oral 750 MG/100ML Tablet, chewable Oral 3.5 MG Tablet, chewable Oral Tablet, effervescent Solution / drops Oral Solution / drops Oral 7.5 MG/ML Solution / drops; suspension / drops Solution Oral 750.000 mg Tablet Oral 5.00 mg Capsule 2.5 mg Powder, for solution Oral Powder, for solution Oral 12 g Powder, metered Oral Capsule Powder - Prices
- Not Available
- Patents
Patent Number Pediatric Extension Approved Expires (estimated) Region US8450338 No 2013-05-28 2028-10-10 US 
US8481083 No 2013-07-09 2028-10-10 US US9827231 No 2017-11-28 2034-06-23 US US10624879 No 2020-04-21 2034-06-23 US US11191753 No 2021-12-07 2034-06-23 US
Properties
- State
- Solid
- Experimental Properties
- Not Available
- Predicted Properties
Property Value Source Water Solubility 0.0185 mg/mL ALOGPS logP -0.05 ALOGPS logP -1.5 Chemaxon logS -4.4 ALOGPS pKa (Strongest Acidic) -2.5 Chemaxon pKa (Strongest Basic) 4.08 Chemaxon Physiological Charge -2 Chemaxon Hydrogen Acceptor Count 7 Chemaxon Hydrogen Donor Count 2 Chemaxon Polar Surface Area 140.09 Å2 Chemaxon Rotatable Bond Count 7 Chemaxon Refractivity 101.83 m3·mol-1 Chemaxon Polarizability 40.3 Å3 Chemaxon Number of Rings 3 Chemaxon Bioavailability 1 Chemaxon Rule of Five Yes Chemaxon Ghose Filter No Chemaxon Veber's Rule No Chemaxon MDDR-like Rule Yes Chemaxon - Predicted ADMET Features
- Not Available
Spectra
- Mass Spec (NIST)
- Not Available
- Spectra
Spectrum Spectrum Type Splash Key Predicted MS/MS Spectrum - 10V, Negative (Annotated) Predicted LC-MS/MS splash10-000i-1000900000-290835f734b1513174c6 Predicted MS/MS Spectrum - 10V, Positive (Annotated) Predicted LC-MS/MS splash10-000i-0001900000-f22ec8b31d22b339fe91 Predicted MS/MS Spectrum - 20V, Negative (Annotated) Predicted LC-MS/MS splash10-000i-3000900000-f3953bd89219b6546c81 Predicted MS/MS Spectrum - 20V, Positive (Annotated) Predicted LC-MS/MS splash10-059f-0029800000-6730344d48e522ae4caf Predicted MS/MS Spectrum - 40V, Negative (Annotated) Predicted LC-MS/MS splash10-0002-9000000000-e8a96f42272b50398b41 Predicted MS/MS Spectrum - 40V, Positive (Annotated) Predicted LC-MS/MS splash10-004i-0195000000-805be934072f6e0f85b5 Predicted 1H NMR Spectrum 1D NMR Not Applicable Predicted 13C NMR Spectrum 1D NMR Not Applicable - Chromatographic Properties
Collision Cross Sections (CCS)
Adduct CCS Value (Å2) Source type Source [M-H]- 222.3631149 predictedDarkChem Lite v0.1.0 [M-H]- 189.58849 predictedDeepCCS 1.0 (2019) [M+H]+ 222.5293149 predictedDarkChem Lite v0.1.0 [M+H]+ 191.94647 predictedDeepCCS 1.0 (2019) [M+Na]+ 222.6128149 predictedDarkChem Lite v0.1.0 [M+Na]+ 198.03963 predictedDeepCCS 1.0 (2019)
Enzymes
- Kind
- Protein
- Organism
- Escherichia coli O1:K1 / APEC
- Pharmacological action
- Unknown
- Actions
- Substrate
- General Function
- Catalyzes the transfer of sulfuryl groups between phenolic compounds.
- Specific Function
- Aryl sulfotransferase activity
- Gene Name
- assT
- Uniprot ID
- A0A0H2Z368
- Uniprot Name
- Arylsulfate sulfotransferase AssT
- Molecular Weight
- 66545.805 Da
References
- Kim DH, Hyun SH, Shim SB, Kobashi K: The role of intestinal bacteria in the transformation of sodium picosulfate. Jpn J Pharmacol. 1992 May;59(1):1-5. [Article]
Drug created at October 28, 2015 03:06 / Updated at November 08, 2022 23:43