Formulary
Phosphate: Indications, Dosing, Side Effects and Interactions
Phosphate clinical drug profile including indications, dosing, side effects, cautions and interactions.
MedNext Academy | 3 min read
Phosphate: Indications, Dosing, Side Effects and Interactions
Phosphate clinical drug profile including indications, dosing, side effects, cautions and interactions.
Indications and dose
**Treatment of moderate to severe hypophosphataemia**
- **Adult** (By Intravenous Infusion): (consult product literature).
**Established hypophosphataemia (with monobasic potassium phosphate)**
- **Adult** (By Intravenous Infusion): 9 mmol every 12 hours, increased if necessary up to 0.5 mmol/kg (max. per dose 50 mmol), increased dose to be used in critically ill patients; dose to be infused over 6-12 hours, according to severity.
**Vitamin D-resistant hypophosphataemic osteomalacia**
- **Adult** (By Mouth Using Effervescent Tablets): 4-6 tablets daily, using Phosphate Sandoz .
**Hypophosphataemia, Hypophosphataemic rickets, Osteomalacia for phosphate**
- **Neonate** (By mouth using effervescent tablets): 1 mmol/kg daily in 1-2 divided doses, dose can be taken as a supplement in breast milk-caution advised as solubility in breast milk is limited to 1.2 mmol in 100 mL if calcium also added, contact pharmacy department for details.
- **Child 1 month-4 years** (By mouth using effervescent tablets): 2-3 mmol/kg daily in 2-4 divided doses, dose to be adjusted as necessary, dose can be taken as a supplement in breast milk-caution advised as solubility in breast milk is limited to 1.2 mmol in 100 mL if calcium also added, contact pharmacy department for details; maximum 48 mmol per day.
- **Child 5-17 years** (By mouth using effervescent tablets): 2-3 mmol/kg daily in 2-4 divided doses, dose to be adjusted as necessary; maximum 97 mmol per day.
- **Neonate** (By intravenous infusion): 1 mmol/kg daily, dose to be adjusted as necessary.
- **Child 1 month-1 year** (By intravenous infusion): 0.7 mmol/kg daily, dose to be adjusted as necessary.
- **Child 2-17 years** (By intravenous infusion): 0.4 mmol/kg daily, dose to be adjusted as necessary.
Cautions
General cautions: Cardiac disease; dehydration; diabetes mellitus; sodium and potassium concentrations of preparations Specific cautions: With intravenous use Avoid extravasation; severe tissue necrosis
Side effects
Frequency not known With intravenous use Electrolyte imbalance With oral use Abdominal distress; diarrhoea; nausea Side-effects, further information Diarrhoea is a common side-effect and should prompt a reduction in dosage.
Interactions
**Severe interactions:**
- Staggered administration of phosphate binders (at least 1 hour apart) had no clinically significant effect on roxadustat exposure in patients with CKD.
**Other interactions (26):**
- Antimuscarinics: codeine phosphate may increase the risk of antimuscarinic side effects such as dry mouth, urine retention and constipation (but this does not generally apply to antimuscarinics...
- As an opioid analgesic, codeine phosphate may potentiate the effects of tranquillisers such as barbiturates, general anaesthetics, anxiolytics and hypnotics, sedatives and alcohol.
- Chlorocresol has long been recognised to be incompatible with a range of compounds including calcium chloride, codeine phosphate, diamorphine hydrochloride, papaveretum, quinine hydrochloride,...
- This specifically applies to: Cellulose sodium phosphate; edetate disodium : concurrent use with magnesium supplements may result in binding of magnesium; patients should be advised not to take...
- There are no data on mycophenolate mofetil with phosphate binders other than sevelamer.
- Using other types of laxatives or at least spacing doses is recommended.
Renal impairment
Dose adjustments Reduce dose. Monitoring Monitor closely in renal impairment.
Medicinal forms
Solution,Tablet,Solution
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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