Citramag Bowel Evacuation Powder (magnesium carbonate 11.57mg, citric acid 17.7mg)
Citramag® is a white, lemon-lime flavoured effervescent powder in a sachet, containing magnesium carbonate 11.57g & citric Acid 17.79g.
Citramag® is an oral bowel cleansing preparation for use before radiological endoscopy or colonoscopy examinations requiring a completely evacuated bowel, to minimise faecal contamination.
Citramag® may also be used for colorectal surgery.
Powder for the preparation of magnesium citrate solution 29.5g, (gives 17.7g magnesium citrate in solution, equivalent in alkalinity to 5g MgO).
THIS INFORMATION IS FOR HEALTHCARE PROFESSIONALS ONLY
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Berkelhammer C, Ekambaram A, Silva RG. Low-volume oral colonoscopy bowel preparation: sodium phosphate and magnesium citrate. Gastrointest Endosc. 2002 Jul;56(1):89-94. doi: 10.1067/mge.2002.125361. Erratum in: Gastrointest Endosc 2002 Oct;56(4):612. Silva Rogelia G [corrected to Silva Rogelio G]. PMID: 12085041.
Background: Low-volume oral colonoscopy preparations are easier to tolerate and are gaining popularity at the expense of large-volume lavage solutions. The aims of this two-part study were to compare two oral colonoscopy bowel preparations, sodium phosphate (NaP) and magnesium citrate (Mg), and to assess the effects of timing and dilution of NaP.
Methods: Part 1 included 300 ambulatory patients randomized to receive NaP or Mg on the day before colonoscopy. Patients completed a questionnaire before colonoscopy. The endoscopist, blinded to the type of bowel preparation, rated bowel cleansing and recorded the presence of any rectosigmoid aphthous ulcers. In part 2, a total of 297 patients received NaP diluted into 3 doses 10 minutes apart the evening before and the morning of the day of colonoscopy. This group was compared with the group in part 1 that received NaP in two separate single doses entirely the day before colonoscopy.
Results: NaP and Mg were well tolerated. When preparations were taken the day before colonoscopy, Mg achieved better bowel cleansing (p < 0.001). Taking NaP entirely the day before colonoscopy resulted in poor right colon cleansing (27%). In contrast, taking NaP the evening before and morning of colonoscopy improved cleansing in the right colon (p < 0.001). Vomiting occurred less frequently with dilution of NaP. Rectosigmoid aphthous ulcers occurred more often with NaP (5.5%) than Mg (1%), p < 0.01. For patients who, according to questionnaire, had received a previous bowel preparation, NaP and Mg were both preferred over large-volume lavage solutions, whereas NaP was preferred over Mg.
Conclusions: When taken entirely the day before colonoscopy, Mg is superior to NaP. Taking NaP the evening before and morning of colonoscopy improved bowel cleansing compared with taking it entirely the day before. Dilution of NaP reduces vomiting. NaP induces rectosigmoid aphthous ulcers more often than Mg.
We recommend you consult the appropriate guidelines and associated documents published by the British Society of Gastroenterologists and accredited by NICE, for further references and information.