Sodium Phosphates

Table of contents

  • Brand Names
  • Drug Combinations
  • Chemistry
  • Pharmacologic Category
  • Mechanism of Action
  • Therapeutic Use
  • Pregnancy and Lactation Implications
  • Contraindications
  • Warnings and Precautions
  • Adverse Reactions
  • Drug Interactions
  • Nutrition/Nutraceutical Interactions
  • Dosage
  • Pharmacokinetics and Pharmacodynamics
  • Special Considerations

Brand Names

Europe

Austria: Clysmol, Fleet Phospho-Soda; Belgium: Fleet Phospho-Soda, Fleet-Enema, Lavement au Phosphate, Colexklysma; Denmark: Fleet Klar-til-brug; France: Fleetphosphosoda, Normacol Lavement, Oligogranul Phosphore; Germany: Fleet Phospho-Soda, Natriumphosphat; Greece: Bioklysm, Dulox, Enema Cooper, Enter-Out, Fleelaxat, Fleet Phospho-Soda, Fosfolax, Kathargon, Klysmol, Mineralin, Odrinol, Phosphoclean, Phospholaxat, Phosphates, Trifalac; Ireland: Fleet Phospho-Soda, Fleet-Enema; Italy: Clisma Fleet, Enemac; Luxembourg: Fleet Enema, Lavement Au Phosphate; Malta: Sodium Acid Phosphate Enema, Fleet Enema; Netherlands: Colex Klysma, Fleet, Phosphoral; Poland: Enema, Feet Phospho Soda, Phospho Laxative, Rectanal; Portugal: Enema Fleet, Fleet Phospho Soda, Preclint; Spain: Enema, Fosfoevac, Fosfosoda, Foslainco, Lainema; Sweden: Phosphoral; UK: Fleet Enema, Fleet Phospho-Soda.

North America

Canada: Natrum Phosphoricum, Nat Phos Schuessler Cell Salt Homaccord, Phosphate; USA: OsmoPrep, Sodium Phosphates, Visicol.

Latin America

Argentina: Colonil, Denverlax, Dicofán, Enemol, Fosfacol, Fosfalax, Fosfo-Adital, Fosfobarigraf, Fosfo-Dom, Gadolax, Kritel Enema, Prontonema, Silaxa, Tekfema; Brazil: Fleet Enema, Phosfoenema; Mexico: Fleet Enema Fosf-Sodio, Fleet PS Fosfosoda.

Drug combinations

Sodium Phosphate and Betamethasone

Sodium Phosphate and Bisacodyl

Sodium Phosphate and Dexamethasone

Sodium Phosphate and Potassium Phosphate

Sodium Phosphate and Prednisolone

Sodium Phosphate, Dextrose, and Zinc Acetate

Sodium Phosphate, Prednisolone, and Sulfacetamide

Other Sodium Phosphate combinations: Acetylcysteine; Alanine; Arginine; Asparagine; Aspartic Acid; Calcium Chloride; Dextrose; Glutamic Acid; Glutathione Disulfide; Glycine; Histidine; Isoleucine; Leucine; L-Lysine; L-Malic Acid; Magnesium Acetate; Magnesium Chloride; Methionine; N-Acetyltyrosin; Ornithine; Phenylalanine; Potassium Acetate; Potassium Chloride; Potassium Phosphate; Proline; Serine; Sodium Acetate; Sodium Bicarbonate; Sodium Chloride; Sodium Gluconate; Sodium; Threonine; Tryptophan; Tyrosine; Valine; Xylitol; Zinc Acetate

Chemistry

Sodium Phosphate, Monobasic: NaH~2~PO~4~ xH~2~O. Mw: 119.98 (anhydrous). Phosphoric acid, monosodium salt, dihydrate. CAS-7558-80-7 (anhydrous); CAS-10049-21-5 (monohydrate); CAS-13472-35-0 (dihydrate).

Sodium Phosphate, Dibasic: Na~2~HPO~4~ xH~2~O. Mw: 141.96 (anhydrous). Phosphoric acid, disodium salt, dodecahydrate. CAS-10140-65-5; CAS-10039-32-4 (dodecahydrate); CAS-7782-85-6 (heptahydrate); CAS-10028-24-7 (dihydrate); CAS-118830-14-1 (monohydrate); CAS-7558-79-4 (anhydrous).

Sodium Phosphate, Tribasic: Na~3~PO~4~. Mw: 163.94 (anhydrous). Phosphoric acid, trisodium salt, dodecahydrate. CAS-7601-54-9 (anhydrous); CAS-10101-89-0 (dodecahydrate).

Pharmacologic Category

Cathartics and Laxatives; Hyperosmotic Laxatives. Replacement Preparations; Electrolyte Solutions. Homeopathic Products. (ATC-Code: A06AG).

Mechanism of action

An essential mineral usually found in nature combined with oxygen as phosphate. Participates in bone deposition, calcium metabolism, as part of molecules which regulate many coenzymes, steps in clotting cascade, and functions of immune system. A component of lipid bilayer of cell membranes and of other intracellular compounds such as nucleic acids and nucleoproteins. Acts as buffer for maintenance of plasma and urinary pH. When administered orally or rectally as laxative, exerts osmotic effect in small intestine by drawing water into lumen of the gut, producing distension, promoting peristalsis, and bowel evacuation.

Therapeutic use

To evacuate colon for rectal and bowel exams. Source of phosphate in large volume I.V. fluids and parenteral nutrition. Hypophosphatemia.

Pregnancy and lactiation implications

Reproduction studies not conducted. Use with caution in pregnant and nursing women.

Unlabeled use

Contraindications

Hypersensitivity to sodium phosphate salts or any component of the formulation. Congestive heart failure, hyperparathyroidism, ascites. If enema, imperforate anus. If intravenous preparation, diseases with hyperphosphatemia, hypocalcemia, or hypernatremia. If oral preparation, acute colitis, acute phosphate nephropathy (biopsy-proven), bowel obstruction, bowel perforation, congenital megacolon, gastric retention, hypomotility syndromes, ileus, pseudo-obstruction, severe chronic constipation, toxic megacolon, unstable angina.

Warnings and precautions

Acute phosphate nephropathy reported with use as colon cleanser prior to colonoscopy (risk factors for acute phosphate nephropathy may include increased age (>55 years of age), pre-existing renal dysfunction, bowel obstruction, active colitis, or dehydration, and use of medicines which affect renal perfusion or function). Prolongation of QT interval reported (caution in patients with or at risk for arrhythmias or with concurrent use of other QT-prolonging medications). Use with caution in pre-existing electrolyte imbalances, dehydration, or risk of electrolyte disturbance; also in chronic inflammatory bowel disease (colitis associated with acute phosphate nephropathy). Caution in renal impairment (risk for acute phosphate nephropathy). Caution in history of seizures. Laxatives and purgatives have potential for abuse by bulimia nervosa patients. Use with caution in debilitated patients, in the elderly, and in gastric bypass or stapling surgery. If using as bowel evacuant, correct electrolyte abnormalities before administration. Other oral medications may not be well absorbed when given during bowel evacuation due to rapid intestinal peristalsis.

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