sodium biphosphate and sodium phosphate (oral)

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Pronunciation: SOE dee um bye FOS foe nate and SOE dee um FOS fate

Brand: OsmoPrep, Phosphate Laxative, Visicol

What is the most important information I should know about oral sodium biphosphate and sodium phosphate?

You should not take sodium biphosphate and sodium phosphate if you have kidney disease, a bowel obstruction, a perforated bowel, colitis or toxic megacolon, or a history of gastric bypass surgery or stomach stapling.

Do not use more than 1 dose in any 24-hour period. If you do not get any results within 30 minutes after using this medicine, call your doctor before using another dose.

Using too much of this medicine can cause rare but life-threatening side effects on your kidneys and heart.

Kidney failure may be more likely if you have: kidney disease, congestive heart failure, severe constipation or stomach pain, inflammatory bowel disease, if you are over 55, or if you are dehydrated. Using certain other medicines can also increase your risk of kidney problems.

What is oral sodium biphosphate and sodium phosphate?

Sodium biphosphate and sodium phosphate are forms of phosphorus, which is a naturally occurring substance that is important in every cell in the body.

Sodium biphosphate and sodium phosphate is a combination medicine used in adults to treat constipation and to clean the bowel before a colonoscopy.

Sodium biphosphate and sodium phosphate may also be used for purposes not listed in this medication guide.

What should I discuss with my healthcare provider before taking oral sodium biphosphate and sodium phosphate?

In rare cases, this medicine can cause kidney failure. This effect may be more likely if you have:

  • kidney disease;
  • congestive heart failure;
  • severe constipation or stomach pain, inflammatory bowel disease;
  • if you take certain medicines to treat high blood pressure or heart disease;
  • if you take an NSAID (nonsteroidal anti-inflammatory drug);
  • if you are older than 55; or
  • if you are dehydrated.

You should not use oral sodium biphosphate and sodium phosphate if you are allergic to it, or if you have:

  • kidney disease (or if you have ever had a biopsy showing a kidney problem caused by too much phosphate);
  • a bowel obstruction;
  • a perforated bowel;
  • colitis or toxic megacolon; or
  • a history of gastric bypass surgery or stomach stapling.

To make sure this medicine is safe for you, tell your doctor if you have:

  • inflammatory bowel disease;
  • trouble swallowing, gastroesophageal reflux disease (GERD);
  • heart disease, heart rhythm disorder, recent heart attack or heart surgery;
  • a seizure disorder;
  • recent withdrawal from drug or alcohol addiction;
  • an electrolyte imbalance (such as high or low levels of potassium, sodium, phosphorous, or magnesium in your blood);
  • if you have ongoing vomiting or diarrhea, or if you are sweating more than usual;
  • if you take certain medicines to treat depression, seizures, or kidney problems;
  • if you are on a low-salt diet; or
  • if you have used any laxative within the past 7 days.

FDA pregnancy category C. It is not known whether sodium biphosphate and sodium phosphate will harm an unborn baby. Tell your doctor if you are pregnant.

It is not known whether sodium biphosphate and sodium phosphate passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

Do not give this medicine to anyone under 5 years old without medical advice.

How should I take oral sodium biphosphate and sodium phosphate?

Use exactly as directed on the label, or as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended.

To keep from getting dehydrated, drink a full glass (8 ounces) of water or other clear liquid each time you use this medicine. This includes water, flavored water, lemonade (no pulp), ginger ale, or apple juice, but nothing colored red or purple. Follow your doctor's instructions about the type and amount of liquids to drink for 24 hours after taking sodium biphosphate and sodium phosphate.

If you take the tablet form of this medicine, you will most likely start taking it the evening before your colonoscopy, and finish taking it on the day of your colonoscopy.

Measure the oral liquid and mix it with a full glass (8 ounces) of cool water. Stir and drink this mixture right away. Then drink another full glass of cool water.

Do not use more than 1 dose in any 24-hour period. If you do not get any results within 30 minutes after using this medicine, call your doctor before using another dose.

Using too much of this medicine can cause rare but life-threatening side effects on your kidneys and heart.

Do not use sodium biphosphate and sodium phosphate for longer than 1 week unless your doctor has told you to.

Call your doctor if you are sick with vomiting or diarrhea, or if you are sweating more than usual. You may need blood tests to check your electrolyte levels.

Store at room temperature away from moisture and heat. Throw away any leftover medicine after your treatment ends.

What happens if I miss a dose?

Call your doctor for instructions if you miss a dose or do not finish all doses required before your colonoscopy.

Do not use more than the recommended dose of this medicine in any 24-hour period.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while using oral sodium biphosphate and sodium phosphate?

This medicine can make it harder for your body to absorb other medicines you take by mouth. Avoid taking other oral medicines within 2 hours before or after you take sodium biphosphate and sodium phosphate.

Avoid using other laxatives or enemas that contain sodium phosphate.

What are the possible side effects of oral sodium biphosphate and sodium phosphate?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Stop using this medicine and call your doctor at once if you have:

  • headache, dizziness, vomiting, little or no urinating;
  • fever, sudden or severe stomach pain, severe diarrhea, rectal bleeding or bright red bowel movements;
  • fast, slow, or uneven heart rate;
  • seizure (black-out or convulsions); or
  • no bowel movement after use.

Common side effects may include:

  • bloating, nausea, or mild stomach discomfort.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect oral sodium biphosphate and sodium phosphate?

Ask a doctor or pharmacist if it is safe for you to use this medicine if you are also using any of the following drugs:

  • a diuretic or "water pill";
  • NSAIDs (nonsteroidal anti-inflammatory drugs) --aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others; or
  • an antibiotic --azithromycin, clarithromycin, erythromycin, moxifloxacin, pentamidine; an antidepressant --citalopram, escitalopram; anti-malaria medicine --chloroquine, halofantrine; cancer medicine --arsenic trioxide, vandetanib; heart rhythm medicine --amiodarone, disopyramide, dofetilide, flecainide, ibutilide, procainamide, quinidine, sotalol; medicine to treat a psychiatric disorder --chlorpromazine, haloperidol, lithium, pimozide, ziprasidone, others.

This list is not complete. Other drugs may interact with sodium biphosphate and sodium phosphate, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Where can I get more information?

Your doctor or pharmacist can provide more information about sodium biphosphate and sodium phosphate.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

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