Sodium Phosphate Dibasic And Sodium Phosphate Monobasic (Oral Route) Precautions

Description and Brand Names

Drug information provided by: Merative, Micromedex®

US Brand Name

Fleet Phospho-soda EZ-Prep
OsmoPrep
Phospho-Soda
Visicol

Descriptions

Sodium phosphate dibasic and sodium phosphate monobasic combination is used to clean or empty your bowels before an imaging procedure called colonoscopy. This medicine works by cleaning your colon and causing you to have diarrhea. This helps your doctor see the inside of your colon more clearly during the colonoscopy.

This medicine is available only with your doctor's prescription.

This product is available in the following dosage forms:

Tablet
Solution

Before Using

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of OsmoPrep® tablets in the pediatric population. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of OsmoPrep® tablets in the elderly. However, elderly patients may be more sensitive to the effects of OsmoPrep® tablets than younger adults, and are more likely to have age-related kidney problems, which may require caution for patients receiving this medicine.

Breastfeeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Drug Interactions

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

Bepridil
Burosumab-twza
Cisapride
Dronedarone
Levoketoconazole
Mesoridazine
Pimozide
Piperaquine
Saquinavir
Sparfloxacin
Terfenadine
Thioridazine
Ziprasidone

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Adagrasib
Alfuzosin
Amiodarone
Amisulpride
Amitriptyline
Amoxapine
Anagrelide
Apomorphine
Aripiprazole
Aripiprazole Lauroxil
Arsenic Trioxide
Asenapine
Astemizole
Atazanavir
Azithromycin
Bedaquiline
Buprenorphine
Buserelin
Ceritinib
Chloroquine
Chlorpromazine
Ciprofloxacin
Citalopram
Clarithromycin
Clofazimine
Clomipramine
Clothiapine
Clozapine
Crizotinib
Dabrafenib
Dasatinib
Degarelix
Delamanid
Desipramine
Deslorelin
Deutetrabenazine
Dexmedetomidine
Disopyramide
Dofetilide
Dolasetron
Domperidone
Donepezil
Droperidol
Efavirenz
Encorafenib
Entrectinib
Erdafitinib
Erythromycin
Escitalopram
Etrasimod
Fexinidazole
Fingolimod
Flecainide
Fluconazole
Fluoxetine
Formoterol
Foscarnet
Fostemsavir
Gatifloxacin
Gemifloxacin
Gepirone
Glasdegib
Gonadorelin
Goserelin
Granisetron
Halofantrine
Haloperidol
Histrelin
Hydroxychloroquine
Hydroxyzine
Ibutilide
Iloperidone
Imipramine
Inotuzumab Ozogamicin
Ivabradine
Ivosidenib
Ketoconazole
Lapatinib
Lefamulin
Lenvatinib
Leuprolide
Levofloxacin
Lofexidine
Lopinavir
Lumefantrine
Macimorelin
Mefloquine
Methadone
Metronidazole
Mifepristone
Mirtazapine
Mobocertinib
Moxifloxacin
Nafarelin
Nilotinib
Norfloxacin
Nortriptyline
Octreotide
Ofloxacin
Olanzapine
Ondansetron
Osilodrostat
Osimertinib
Oxaliplatin
Ozanimod
Pacritinib
Paliperidone
Panobinostat
Paroxetine
Pasireotide
Pazopanib
Phenobarbital
Pimavanserin
Pitolisant
Ponesimod
Posaconazole
Primidone
Procainamide
Prochlorperazine
Promethazine
Propafenone
Protriptyline
Quetiapine
Quinidine
Quinine
Quizartinib
Ranolazine
Relugolix
Ribociclib
Selpercatinib
Sertraline
Sevoflurane
Siponimod
Solifenacin
Sorafenib
Sotalol
Sulpiride
Sunitinib
Tacrolimus
Telavancin
Telithromycin
Tetrabenazine
Trazodone
Triclabendazole
Trimipramine
Triptorelin
Vandetanib
Vardenafil
Vemurafenib
Venlafaxine
Vilanterol
Vinflunine
Voclosporin
Voriconazole
Zuclopenthixol

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Aluminum Carbonate, Basic
Aluminum Hydroxide
Aluminum Phosphate
Calcium Acetate
Calcium Carbonate
Calcium Citrate
Dihydroxyaluminum Aminoacetate
Dihydroxyaluminum Sodium Carbonate
Magaldrate
Magnesium Carbonate
Magnesium Hydroxide
Magnesium Oxide
Magnesium Trisilicate

Other Interactions

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Proper Use

Take this medicine exactly as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered.

This medicine should come with a Medication Guide. Read and follow these instructions carefully. Ask your doctor if you have any questions.

Take each dose (4 tablets) with 8 ounces of clear liquids. Examples of clear liquids include: water, flavored water, clear broth, herbal tea, black tea, coffee, clear soda, gelatin, popsicles, lemonade (no pulp), ginger ale, white grape juice, or apple juice. Do not eat or drink alcohol, milk, anything colored purple or red, or any foods that have pulp.

Eat or drink only clear liquids after 12:00 PM (noon) on the day before and until after your colonoscopy. Do not eat solid food.

Drink as much extra liquid as you can before, during, and after taking this medicine. This will help replace the fluids you are losing with your bowel movements. This will also keep your kidneys working well and help soften your bowel movements, making them easier to pass.

Do not take any oral medicines within 1 hour before or after each dose of OsmoPrep®.

Do not take this medicine if you have already used it in the last 7 days. Your doctor will tell you if you need to use this medicine again.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

For oral dosage form (tablets):
- For cleansing of the colon:
  - Adults—
    - Evening before the colonoscopy: Four tablets with 8 ounces (oz.) of clear liquids every 15 minutes (for a total of 20 tablets).
    - Day of colonoscopy (starting 3 to 5 hours before the procedure): Four tablets with 8 oz. of clear liquids every 15 minutes (for a total of 12 tablets).
  - Children—Use and dose must be determined by your doctor.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions

It is very important that your doctor check your progress after taking this medicine. This will allow your doctor to see if the medicine is working properly. Blood and urine tests and an electrocardiogram (ECG) may be needed to check for unwanted effects.

Do not take this medicine together with other laxatives or enemas containing sodium phosphate. Doing so may lead to serious unwanted effects.

This medicine may cause serious kidney problems. These are more likely to occur if you are over 55 years of age, dehydrated, have low blood volume, and are taking medicines that could be hard on your kidneys (eg, diuretics or water pills, certain blood pressure medicines, NSAID pain or arthritis medicine). Check with your doctor right away if you have bloody urine, a decrease in the amount or frequency of urine, lower back or side pain, trouble breathing, weight gain, or swelling of the face, fingers, and lower legs.

Taking more than one dose of over-the-counter (OTC) sodium phosphate medicine in 24 hours may cause serious kidney and heart problems. Check with your doctor if you have the following symptoms: confusion, decreased urination, dizziness, dry mouth, fainting, increase in heart rate, rapid breathing, or unusual tiredness or weakness.

Contact your doctor right away if you have any changes to your heart rhythm. You might feel dizzy or faint, or you might have a fast, pounding, or uneven heartbeat. Make sure your doctor knows if you had a heart rhythm problem, such as QT prolongation.

This medicine may cause serious allergic reactions, including anaphylaxis and angioedema, which can be life-threatening and require immediate medical attention. Tell your doctor right away if you have a rash, itching, hoarseness, trouble breathing, trouble swallowing, or any swelling of your hands, face, or mouth after using this medicine.

Call your doctor right away if you have any unusual symptoms that concern you, such as bloating, abdominal or stomach pain, seizures, nausea, vomiting, or headache.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common

Bloating
stomach pain

Incidence not known

Agitation
bloody or cloudy urine
burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
confusion
cough
decrease in the frequency or amount of urine
decreased awareness or responsiveness
depression
difficult or labored breathing
difficult or painful urination
difficulty with swallowing
dizziness
fainting
fast, slow, or irregular heartbeat
headache
hives, itching, skin rash
hostility
increased blood pressure
increased thirst
irritability
large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or genitals
loss of appetite
loss of consciousness
lower back or side pain
muscle twitching
nausea
noisy breathing
puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
rapid weight gain
redness of the skin
seizures
severe sleepiness
sudden decrease in the amount of urine
swelling of the face, ankles, or hands
tightness in the chest
unusual drowsiness, dullness, tiredness, weakness, or feeling of sluggishness
vomiting

Get emergency help immediately if any of the following symptoms of overdose occur:

Symptoms of overdose

Blurred vision
chest pain or discomfort
decreased frequency of urine
dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
dry mouth
increase in heart rate
increased thirst
lightheadedness
loss of appetite
lower back or side pain
muscle cramps in the hands, arms, feet, legs, or face
muscle pain
pounding or rapid pulse
rapid breathing
restlessness
stomach cramps
sunken eyes
sweating
tremor
weakness
weight gain
wrinkled skin

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Portions of this document last updated: April 01, 2024

Original article: https://www.mayoclinic.org/drugs-supplements/sodium-phosphate-dibasic-and-sodium-phosphate-monobasic-oral-route/precautions/DRG-20060675

Sodium Phosphate Dibasic And Sodium Phosphate Monobasic (Oral Route)