IntravenousSevere hypophosphataemiaAdult: As monobasic potassium phosphate: Up to 9 mmol of phosphate given over 12 hours, repeat every 12 hours if needed. Alternatively, 0.2-0.5 mmol/kg phosphate (max: 50 mmol) may be given over 6-12 hours.
OralHypophosphataemiaAdult: Up to 100 mmol of phosphate daily.
RectalMild osmotic laxative for bowel evacuation and cleansingAdult: Usually contains monobasic and dibasic sodium phosphates but the composition and dosage may vary. Phosphate enemas work within 2-5 minutes. Use as directed.
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Oral:
Dose reduction may be necessary.
Rectal:
Dose reduction may be necessary.
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Oral:
Incompatible with calcium salts.
Rectal:
Incompatible with calcium salts.
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Severe renal function, congestive heart failure, ascites, unstable angina pectoris, gastric retention, ileus or acute obstruction or pseudo-obstruction, severe chronic constipation, bowel perforation, acute colitis, toxic megacolon or hypomotility syndrome, hypertension, hyperkalaemia, oedema, low serum-calcium concentrations, infected phosphate renal calculi.
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Chronic renal disease, pre-existing electrolyte disturbances. Concurrent admin with drugs that may affect electrolyte levels. Correct electrolyte abnormalities before initiating therapy. Monitor renal function, serum calcium, serum phosphorus, serum potassium, and serum sodium at periodic intervals during therapy. Caution in patients taking drugs that may prolong QT interval. Ensure adequate hydration. Pregnancy. Elderly or debilitated patients.
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Abdominal discomfort or pain, diarrhoea, nausea, vomiting, hypernatraemia, dehydration (with high doses). Convulsions, drowsiness, mood change, trembling, malaise, loss of appetite, muscle spasm (with long-term use). Less frequently, headaches, dizziness, mental confusion, seizures, weakness or heaviness of legs, muscle cramps, numbness, tingling, pain, arrhythmia; shortness of breath or troubled breathing; swelling of lower legs or feet; unusual weight gain, low urine output; unusual thirst; bone and joint pain.
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May lead to severe electrolyte disturbances, including hyperphosphataemia, hypocalcaemia, hypernatraemia, or hypokalaemia, as well as dehydration and hypovolaemia. May also lead to cardiac arrhythmias, seizure, renal failure and death. Monitor carefully and treat symptomatically until stable.
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Concurrent use with aluminium, calcium, or magnesium salts will reduce absorption of phosphates. Vitamin D increases the GI absorption of phosphates and risk of hyperphosphataemia. Increased risk of hyperphosphataemia, hypocalcaemia, and hypernatraemia when used in patients receiving diuretics or drugs that may affect serum electrolytes. Increased risk of ectopic calcification when used concurrently with calcium supplements or calcium-containing antacids.
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Decreased effects with milk or dairy products due to their calcium content.
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Description:
Mechanism of Action: Sodium phosphate can be used in the management of hypophosphataemia. It also acts as a mild osmotic laxative when given orally as dilute solutions or by the rectal route. Phosphate enemas or concentrated oral solutions are used for bowel cleansing before surgery or endoscopy procedures.
Pharmacokinetics:
Absorption: About 66% of an oral dose is absorbed from the GI tract.
Excretion: Mainly excreted in the urine with the remaining dose via the faeces.
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Oral:
Store at 15-30°C.
Rectal:
Store at 15-30°C.
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