Monobasic sodium phosphate + Dibasic sodium phosphate


Concise Prescribing Info
Indications/Uses
Listed in Dosage.
Dosage/Direction for Use
Adult : PO Mild osmotic laxative for bowel evacuation and cleansing Each 45 mL soln contains monobasic sodium phosphate 24.4 g/dibasic sodium phosphate 10.8 g: 45 mL soln for 2 doses 12 hr apart. For morning appointment, doses are given at 7am then at 7pm on day before procedure. For afternoon appointment, give 1st dose at 7pm on the night before procedure then at 7am on day of procedure. Each tab contains monobasic sodium phosphate 1.102 g/dibasic sodium phosphate 0.398 g: 4 tab every 15 min for 5 doses the night before the procedure. Then, 4 tab, every 15 min for 3 doses, 3-5 hr before the procedure. Rectal Mild osmotic laxative for bowel evacuation and cleansing; Constipation Each 118 mL enema bottle contains monobasic sodium phosphate (g)/dibasic sodium phosphate (g): 21.4/9.4, 19/7: 1 bottle once daily.
Dosage Details
Oral
Mild osmotic laxative for bowel evacuation and cleansing
Adult: Available preparation:
Each 45 mL soln contains monobasic sodium phosphate 24.4 g and dibasic sodium phosphate 10.8 g.
45 mL soln diluted in 120 mL cold water for 2 doses 12 hr apart. Each dose should be taken w/ 250 mL of water. For morning appointment, doses are given at 7am then at 7pm on day before procedure. For afternoon appointment, give 1st dose at 7pm on the night before procedure then at 7am on day of procedure.

Oral
Mild osmotic laxative for bowel evacuation and cleansing
Adult: Available preparation:
Each tab contains monobasic sodium phosphate 1.102 g and dibasic sodium phosphate 0.398 g.
4 tab taken w/ 250 mL of clear liq, every 15 min for 5 doses the night before the procedure. Then, 4 tab taken w/ 250 mL of clear liq, every 15 min for 3 doses, 3-5 hr before the procedure.

Rectal
Constipation, Mild osmotic laxative for bowel evacuation and cleansing
Adult: Available preparations:
Each 118 mL enema bottle contains monobasic sodium phosphate 21.4 g and dibasic sodium phosphate 9.4 g.
Each 118 mL enema bottle contains monobasic sodium phosphate 19 g and dibasic sodium phosphate 7 g.
1 bottle once daily.
Child: 3-<12 yr ½ bottle once daily; >12 yr Same as adult dose.
Renal Impairment
Severe: Contraindicated.
Contraindications
Hypercalcaemia, acute phosphate nephropathy (biopsy proven), CHF, ascites, GI obstruction, decreased bowel motility, inflammatory bowel disease (e.g. severe active ulcerative colitis), paralytic ileus, anorectal stenosis, imperforate anus, toxic megacolon, toxic colitis, Hirschsprung’s disease, appendicitis, intestinal perforation, rectal bleeding, dehydration, gastric bypass or stapling surgery. Severe renal impairment.
Special Precautions
Patient w/ CV disorder (e.g. heart failure, HTN, heart disease, acute MI, unstable angina, cardiomyopathy, arrhythmias); rectal ulcers/fissures, colostomy; pre-existing electrolyte imbalance, hypovolaemia, severe chronic constipation, gastric retention, impaired gag reflex; history and risk of seizures. Mild to moderate renal impairment. Elderly or debilitated patients, childn. Pregnancy and lactation.
Adverse Reactions
Significant: Electrolyte disorders (e.g. hypernatraemia, hyperphosphataemia, hypophosphataemia, hypokalaemia, hypocalcaemia), dehydration, QT prolongation, seizures, fluid loss, hypovolaemia.
Nervous: Dizziness, headache, asthenia.
CV: Oedema.
GI: Nausea, vomiting, diarrhoea, abdominal pain/distention, bloating (oral); rectal bleeding, irritation, pain, stinging.
Resp: Chest pain.
Others: Chills.
Potentially Fatal: Rarely, acute phosphate nephropathy, nephrocalcinosis, severe electrolyte disorders (oral).
Patient Counseling Information
Drink sufficient liq before, during and after therapy. This drug may cause dizziness due to dehydration, if affected, do not drive or operate machinery.
MonitoringParameters
Monitor electrolyte balance and renal function, ECG prior and during therapy.
Overdosage
Symptoms: Dehydration, hypotension, tachycardia, bradycardia, tachypnoea, cardiac arrest, shock, resp failure, dyspnoea, paralytic ileus, anxiety, pain, hypernatraemia, hyperphosphataemia, hypokalaemia, hypocalcaemia, acidosis. Management: Symptomatic treatment. Initiate electrolyte correction and fluid replacement therapy immediately. Admin of Ca gluconate may be necessary.
Drug Interactions
Reduced absorption w/ Ca, Fe, Mg salts, sucralfate. Increased risk of seizures w/ TCA. Increased risk for hyperphosphataemia w/ vit D. Reduced therapeutic effect w/ lithium. Increased risk of ectopic calcification w/ Ca supplements or Ca-containing antacids. Increased risk of hyperkalaemia w/ K phosphates.
Potentially Fatal: Enhanced nephrotoxicity w/ diuretics, ACE inhibitors, NSAIDs.
Action
Description: Monobasic sodium phosphate and dibasic sodium phosphate are osmotic laxatives. They exert osmotic effect in the small intestine by drawing water into the lumen of the gut producing distention and peristalsis and eventually, evacuation of bowel.
Onset: W/in 30 min to 6 hr (oral); w/in 2-5 min (rectal).
Pharmacokinetics:
Absorption: Approx 1-20% is absorbed from GI tract (oral).
Excretion: Via faeces.
Storage
Store below 25°C.
References
Anon. Saline Laxatives. AHFS Clinical Drug Information [online]. Bethesda, MD. American Society of Health-System Pharmacists, Inc. https://www.ahfscdi.com. Accessed 14/09/2017.

Anon. Sodium Phosphates. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 14/09/2017.

Buckingham R (ed). Phosphate. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 14/09/2017.

Osmoprep Tablet (Salix Pharmaceuticals, Inc.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 14/09/2017.

Ready-To-Use Enema (Rugby Laboratories, Inc.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 15/09/2017.

Disclaimer: This information is independently developed by MIMS based on Monobasic sodium phosphate + Dibasic sodium phosphate from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 MIMS. All rights reserved. Powered by MIMS.com
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