Polyethylene Glycol 3350 and electrolytes - Unflavored, Polyethylene Glycol 3350 and electrolytes with Lemon Flavor, Polyethylene Glycol 3350 and electrolyteswith Orange Flavor
- Manufacturer
- Braintree Laboratories, Inc.
- ICD-10 indication
- Z12.11
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About Polyethylene Glycol 3350 and electrolytes - Unflavored, Polyethylene Glycol 3350 and electrolytes with Lemon Flavor, Polyethylene Glycol 3350 and electrolyteswith Orange Flavor
GoLYTELY is a prescription osmotic laxative indicated for bowel cleansing prior to colonoscopy. It contains polyethylene glycol 3350 and electrolytes (sodium sulfate, sodium bicarbonate, sodium chloride, and potassium chloride) to induce diarrhea and cleanse the colon. It is supplied as a powder to be reconstituted with water and is available unflavored or with a pineapple flavor pack.
Copay & patient assistance
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Conditions we've indexed resources for
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Prior authorization & coverage
| Payer | PA | Step therapy | Copay tier |
|---|---|---|---|
— Medicare Part D | — | — | — |
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How this page is sourced
- Drug identity verified against openFDA NDC Directory.
- Label text (when shown) originates from NLM DailyMed.
- Copay and assistance URLs verified periodically; if you hit a broken link, tell us.