Sodium Phosphate (Dibasic Sodium Phosphate + Monobasic Sodium Phosphate)
Also sold as: Phosphate saline, Bowel prep solutions
Pregnancy
Cat C
Lactation
Safe
Schedule
OTC
Forms
Oral solution (Fleet, Visicol) +2
Indications
- Hypophosphatemia correction
- Bowel preparation for colonoscopy
- Phosphate supplementation (renal disease)
- Hyperaluminemia prevention
Adult Dosing
Hypophosphatemia (oral)
250-500 mg (1-2 tablets Visicol) BID
Until normalized
Bowel prep (colonoscopy)
per protocol (Fleet: 45mL solution + hydration)
Single evening dose
IV phosphate (hospital)
10-15 mmol (phosphate) daily in divided doses
Until corrected
Pediatric Dosing
Use with caution; dehydration risk from osmotic effect
Renal Dose Adjustment
| CrCl / eGFR | Dose Adjustment |
|---|---|
| CrCl > 60 mL/min | No adjustment |
| CrCl 30-60 mL/min | Reduce dose; monitor phosphate |
| CrCl < 30 mL/min | Avoid; risk of hyperphosphatemia |
Hepatic Adjustment
No adjustment required
Pregnancy & Lactation
Pregnancy: Category C
Safe for phosphate correction; avoid enema use in pregnancy.
Lactation: Safe
Safe; minimal excretion in breast milk.
Top Drug Interactions
| Interacting Drug | Effect | Severity |
|---|---|---|
| Calcium supplements | Reduced phosphate absorption if taken together; separate by 2+ hours | Moderate |
| Aluminum antacids | Formation of insoluble complexes | Moderate |
| Iron supplements | Reduced iron absorption | Minor |
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Side Effects
Common
- Diarrhea (osmotic effect)
- Nausea
- Abdominal cramping
- Hypernatremia (high sodium content)
- Electrolyte imbalance
Serious / Discontinue If
- Hypernatremia (excessive sodium intake)
- Hyperphosphatemia (over-correction)
- Acute renal failure (in dehydrated patients)
- Hypocalcemia
- Arrhythmias (electrolyte imbalance)
Contraindications
- Hyperphosphatemia
- Severe dehydration
- Acute renal failure
- Bowel obstruction (enema use)
Available Indian Brands
| Brand | Manufacturer | Price (approx) |
|---|---|---|
| Sodium phosphate solution | Various | Variable (not commonly stocked) |
Monitoring Required
- Serum phosphate at baseline and 3-5 days after initiation
- Serum sodium (hypernatremia risk)
- Renal function
- Calcium levels (hypocalcemia risk)
Patient Counseling Points
- Drink plenty of water to maintain hydration
- Expect diarrhea (osmotic effect)
- Take 2+ hours away from calcium supplements
- Report weakness, irregular heartbeat, or severe cramping
- For bowel prep: follow specific protocol; fasting required
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Clinically reviewed by: Dr. Suresh Kumar, MD (Nephrology), Electrolyte Specialist
Last reviewed: 2026-04-12
References
- BNF — Sodium Phosphate
- ASGE Bowel Prep Guidelines
- Kidney Disease Outcomes