sodium phosphates (sodium phosphate and sodium biphosphate) Fleet Phospho-soda
Pharmacologic classification: acid salt Therapeutic classification: saline laxative Pregnancy risk category C
Available forms Available without a prescription Solution: 2.4 g monobasic sodium phosphate and 9 g dibasic sodium phosphate/5 ml
Indications and dosages Constipation. Adults and children age 12 and older: 20 to 45 ml daily. Children ages 10 to 11: 10 to 20 ml daily. Children ages 5 to 9: 5 to 10 ml daily.
Pharmacodynamics Laxative action: Sodium phosphate and sodium biphosphate exert an osmotic effect in the small intestine by drawing water into the intestinal
lumen, producing distention that promotes peristalsis and bowel evacuation.
Pharmacokinetics Absorption: The extent of phosphate and sodium absorption from oral phosphate laxatives is unknown. The extent of phosphate absorption
from rectally administered phosphate enemas is unknown, but about 1% to 20% of the sodium and phosphate in such preparations
is reportedly absorbed. Distribution: Unknown. Metabolism: Unknown. Excretion: Unknown; probably in feces and urine.
Route |
Onset |
Peak |
Duration |
P.O. |
3-6 hr |
Variable |
Variable |
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Contraindications and precautions Contraindicated in patients on sodium-restricted diets and patients with abdominal pain, nausea, vomiting, or other symptoms
of appendicitis or acute surgical abdomen; intestinal obstruction or perforation; edema; heart failure; megacolon; or impaired
renal function. Use cautiously in patients with large hemorrhoids or anal excoriations.
Interactions Drug-drug. Antacids: May cause inactivation of both drugs. Don’t use together.
Adverse reactions GI: abdominal cramping. Metabolic: fluid and electrolyte disturbances (hypernatremia, hyperphosphatemia) with daily use. Other: laxative dependence with long-term or excessive use.
Effects on lab test results May increase sodium and phosphate levels. May decrease electrolyte levels (with prolonged use).
Overdose and treatment No information available. Probable clinical effects include abdominal pain and diarrhea.
Special considerations Dilute drug with water before giving orally (as directed by manufacturer). Follow drug administration with full glass of water.
Drug isn’t routinely used to treat constipation but is commonly used to evacuate the bowel. Monitor serum electrolyte levels; when drug is given as saline laxative, up to 10% of sodium content may be absorbed. Breast-feeding patients It isn’t known if drug appears in breast milk. Use cautiously in breast-feeding women.
Patient education Teach patient how to mix drug. Instruct patient about dose schedule. Warn patient that frequent or prolonged use of drug may lead to laxative dependence. Teach patient about dietary sources of bulk, which include bran and other cereals, fresh fruit, and vegetables. Tell patient to drink 8 oz (240 ml) of cool water after taking Fleet Phospho-soda. Caution patient that rectal forms aren’t intended for oral use. For children younger than age 5, tell parent to call before use.
Reactions may be common, uncommon, life-threatening, or
COMMON AND LIFE THREATENING.
◆ Canada only
◇ Unlabeled clinical use
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