Yes

Electrolyte Supplement, Oral; Laxative

Source of phosphate in large volume I.V. fluids; short-term treatment of constipation (oral/rectal) and to evacuate the colon for rectal and bowel exams; treatment and prevention of hypophosphatemia

C

1% to 10%:

Endocrine & metabolic: Hypocalcemia, hypernatremia, hyperphosphatemia, calcium phosphate precipitation

Gastrointestinal: Nausea, vomiting, diarrhea

Renal: Acute renal failure

Do not give with magnesium- and aluminum-containing antacids or sucralfate which can bind with phosphate

Phosphate salts may precipitate when mixed with calcium salts; solubility is improved in amino acid parenteral nutrition solutions; check with a pharmacist to determine compatibility

As a laxative, exerts osmotic effect in the small intestine by drawing water into the lumen of the gut, producing distention and promoting peristalsis and evacuation of the bowel; phosphorous participates in bone deposition, calcium metabolism, utilization of B complex vitamins, and as a buffer in acid-base equilibrium

Onset of action:

Cathartic: 3-6 hours

Rectal: 2-5 minutes

Absorption: Oral: ~1% to 20%

Normal requirements elemental phosphorus: Oral:

0-6 months: 240 mg

6-12 months: 360 mg

1-10 years: 800 mg

>10 years: 1200 mg

Pregnancy lactation: Additional 400 mg/day

Adults RDA: 800 mg

I.V. doses should be incorporated into the patient's maintenance I.V. fluids whenever possible; intermittent I.V. infusion should be reserved for severe depletion situations and requires continuous EKG monitoring. It is difficult to determine total body phosphorus deficit due to redistribution into intracellular compartment or bone tissue; (it is recommended that repletion of severe hypophosphatemia (<1 mg/dL in adults) be done via I.V. route since large dose of oral phosphate may cause diarrhea and intestinal absorption may be unreliable). The following dosages are empiric guidelines. Note: Doses listed as mmol of phosphate.

Severe hypophosphatemia: I.V.:

Children:

Low dose: 0.08 mmol/kg over 6 hours; use if recent losses and uncomplicated

Intermediate dose: 0.16-0.24 mmol/kg over 4-6 hours; use if phosphorus level 0.5-1 mg/dL

High dose: 0.36 mmol/kg over 6 hours; use if serum phosphorus <0.5 mg/dL

Adults: 0.15-0.3 mmol/kg/dose over 12 hours, may repeat as needed to achieve desired serum level

Maintenance:

Children: 0.5-1.5 mmol/kg/24 hours I.V. or 2-3 mmol/kg/24 hours orally in divided doses

Adults: 50-70 mmol/24 hours I.V. or 50-150 mmol/24 hours orally in divided doses

Phosphate maintenance electrolyte requirement in parenteral nutrition: 2 mmol/kg/24 hours or 35 mmol/kcal/24 hours; maximum: 15-30 mmol/24 hours

Laxative (Fleet®): Rectal:

Children 2-12 years: Contents of one 2.25 oz pediatric enema, may repeat

Children greater than or equal to 12 years and Adults: Contents of one 4.5 oz enema as a single dose, may repeat

Laxative (Fleet® Phospho®-Soda): Oral:

Children 5-9 years: 5 mL as a single dose

Children 10-12 years: 10 mL as a single dose

Children greater than or equal to 12 years and Adults: 20-30 mL as a single dose

Should be administered on an empty stomach with water

For intermittent I.V. infusion, dilute at a maximum concentration of 0.12 mmol/mL and infuse over 4-6 hours; maximum, rate of infusion: 0.06 mmol/kg/hour

No information available to require special precautions

No effects or complications reported

May cause diarrhea with the oral preparation; excessive or prolonged use as a laxative may cause dependence

Contents of one packet should be diluted in 75 mL water before administration; maintain adequate fluid intake; for intermittent I.V. infusion, dilute at a maximum concentration of 0.12 mmol/mL and infuse over 4-6 hours; maximum, rate of infusion: 0.06 mmol/kg/hour

Monitor serum sodium and phosphorous levels

Enema: Sodium phosphate 6 g and sodium biphosphate 16 g/100 mL (67.5 mL pediatric enema unit, 135 mL adult enema unit)

Injection: Phosphate 3 mmol and sodium 4 mEq per mL (5 mL, 10 mL, 15 mL, 30 mL, 50 mL)

Solution, oral: Sodium phosphate 18 g and sodium biphosphate 48 g/100 mL (45 mL, 90 mL, 273 mL)

Oral:

Whole cow's milk: 0.29 mmol/mL phosphate; 0.025 mEq/mL sodium; 0.035 mEq/mL potassium

Fleet® Phospho®-Soda: 4.15 mmol/mL phosphate; 4.8 mEq/mL sodium

Intravenous:

Sodium phosphate: 3 mmol/mL phosphate; 4 mEq/mL sodium