sodium biphosphate and sodium phosphate

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

Brand: Fleet Enema, Fleet Enema for Children, OsmoPrep, Visicol

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

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You should not use this medication if you have used it within the past 7 days, or if you have kidney disease, dehydration, or an electrolyte imbalance (such as high or low levels of potassium, sodium, phosphorous, or magnesium in your blood).

If you have any these conditions, you could have dangerous or life-threatening side effects on your kidneys from taking sodium biphosphate and sodium phosphate.

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People with eating disorders (such as anorexia or bulimia) should not use this medication without the advice of a doctor.

Before using sodium biphosphate and sodium phosphate, tell your doctor about all of your medical conditions, especially heart disease, liver disease, recent stomach surgery, a bowel perforation or obstruction, colitis or inflammatory bowel disease, seizures, if you are older than 56 years, if you are on a low-salt diet, or if you have recently had a heart attack or recovered from drug or alcohol addiction.

Use this medication exactly as directed on the label, or as it has been prescribed by your doctor. Never use the medication in larger amounts, or for longer than recommended.

When using this medication in a child, use only the forms that are specially made for children.

What is 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 used to treat constipation and to clean the bowel before surgery, x-rays, endoscopy, or other intestinal procedures. Sodium biphosphate and sodium phosphate enemas are also used for general care after surgery and to help relieve impacted bowels.

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 using sodium biphosphate and sodium phosphate?

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You should not use this medication if you have used it within the past 7 days, or if you have:

  • kidney disease (or if you are on dialysis);
  • dehydration; or
  • an electrolyte imbalance (such as high or low levels of potassium, sodium, phosphorous, or magnesium in your blood).

If you have any these conditions, you could have dangerous or life-threatening side effects on your kidneys from taking sodium biphosphate and sodium phosphate.

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People with eating disorders (such as anorexia or bulimia) should not use this medication without the advice of a doctor.

To make sure you can safely use sodium biphosphate and sodium phosphate, tell your doctor if you have any of these other conditions:

  • congestive heart failure;
  • liver problems such as cirrhosis, or ascites (fluid around your liver);
  • unstable angina (chest pain);
  • a heart rhythm disorder (such as "Long-QT syndrome");
  • a history of recent heart attack, heart surgery, or bypass surgery;
  • a history of gastric bypass surgery or stomach stapling;
  • a bowel obstruction or severe constipation;
  • trouble swallowing;
  • a perforated bowel;
  • inflammatory bowel disease, colitis or toxic megacolon;
  • epilepsy or other seizure disorder;
  • a recent history of drug or alcohol addiction withdrawal.
  • if you have ongoing vomiting or diarrhea, or if you are sweating more than usual;
  • if you are older than 56 years; or
  • if you are on a low-salt diet.
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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 or plan to become pregnant while using this medication.

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It is not known whether sodium biphosphate and sodium phosphate passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

How should I use sodium biphosphate and sodium phosphate?

Use exactly as directed on the label, or as prescribed by your doctor. Never use this medication in larger or smaller amounts or for longer than recommended.

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To keep from getting dehydrated, drink a full glass (8 ounces) of water or other clear liquid each time you use this medication. You may be instructed not to drink or eat anything before your medical test. Follow your doctor's instructions about the type and amount of liquids you should drink for at least 24 hours after using this medicine.

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.

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For best results, take the oral liquid on an empty stomach when you first get out of bed, at least 30 minutes before eating. You may also take the medicine at bedtime. In most cases, it will work overnight.

Measure the oral liquid and mix it with one-half glass (4 oz) of cool water. Stir this mixture and drink all of it right away. To make sure you get the entire dose, add a little more water to the same glass, swirl gently and drink right away.

When using this medication in a child, use only the forms that are specially made for children.

  • Fleet Enema For Children can be used in children from 2 to 11 years old.
  • Never use an adult-strength sodium biphosphate and sodium phosphate enema in a child younger than 12 years old.
  • Do not use the enema to treat a child younger than 2 years of age without the advice of a doctor.
  • Fleet Phospho-Soda oral liquid can be given to children who are at least 5 years old.
  • Do not give the oral solution to a child younger than 5 years of age without the advice of a doctor.
  • Do not give the oral tablet (Visicol) to a child younger than 18 years old.
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Do not take the rectal enema by mouth. It is for use only in your rectum.

To use the enema, lie down on your left side with your knees bent.

Remove the cap from the applicator tip and gently insert the tip into your rectum. Slowly squeeze the bottle to empty the contents into the rectum.

For best results, stay lying down until you feel the urge to have a bowel movement. This should occur within 2 to 15 minutes in most cases.

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If you do not get any results after using sodium biphosphate and sodium phosphate, call your doctor before using another dose. Using too much of this medication in 24 hours can be harmful. Do not use sodium biphosphate and sodium phosphate for longer than 1 week unless your doctor has told you to.

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

To be sure this medication has not caused harmful effects, your doctor may want to test your blood and check your kidney function in the days after your colonoscopy. Do not miss any follow-up visits to your doctor.

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 medication in any 24-hour period.

What happens if I overdose?

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

Overdose may cause dry mouth, increased thirst, drowsiness, restless feeling, confusion, nausea, vomiting, increased urination, muscle pain or weakness, fast heart rate, feeling light-headed, or fainting.

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

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Do not use other laxatives while using this medication, unless your doctor has told you to.

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

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

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Stop using sodium biphosphate and sodium phosphate and call your doctor at once if you have a serious side effect such as:

  • rectal bleeding;
  • no bowel movement after use;
  • sores or ulcers around your rectum;
  • seizure (black-out or convulsions);
  • fast, slow, or uneven heart rate;
  • urinating less than usual or not at all;
  • drowsiness, confusion, mood changes, increased thirst, loss of appetite, nausea and vomiting; or
  • swelling, weight gain, feeling short of breath.

Less serious side effects may include:

  • bloating, stomach pain;
  • tightness in your throat;
  • dizziness; or
  • headache.

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 sodium biphosphate and sodium phosphate?

Tell your doctor about all other medications you use, especially:

  • arsenic trioxide (Trisenox);
  • a diuretic (water pill);
  • droperidol (Inapsine);
  • narcotic medication such as fentanyl (Actiq, Duragesic, Ionsys), hydrocodone (Vicodin), hydromorphone (Dilaudid), levomethadyl (Orlaam), methadone (Dolophine, Methadose) methadone (Methadose), morphine (Kadian, MS Contin), oxycodone (OxyContin, Percocet), propoxyphene (Darvocet, Darvon), and others;
  • an antibiotic such as clarithromycin (Biaxin), erythromycin (E.E.S., EryPed, Ery-Tab, Erythrocin), levofloxacin (Levaquin), moxifloxacin (Avelox), or pentamidine (NebuPent, Pentam);
  • an antidepressant such as amitriptylline (Elavil, Vanatrip), clomipramine (Anafranil), or desipramine (Norpramin);
  • anti-malaria medications such as chloroquine (Arelan), or mefloquine (Lariam);
  • an NSAID (non-steroidal anti-inflammatory drug) such as ibuprofen (Motrin, Advil), naproxen (Aleve, Naprosyn), diclofenac (Cataflam, Voltaren), etodolac (Lodine), indomethacin (Indocin), ketoprofen (Orudis), and others;
  • medicines to treat psychiatric disorders, such as chlorpromazine (Thorazine), clozapine (FazaClo, Clozaril), haloperidol (Haldol), pimozide (Orap), thioridazine (Mellaril), or ziprasidone (Geodon);
  • medicine to prevent or treat nausea and vomiting, such as dolasetron (Anzemet) or ondansetron (Zofran);
  • migraine headache medicine such as sumatriptan (Imitrex) or zolmitriptan (Zomig);
  • heart or blood pressure medication such as benazepril (Lotensin), candesartan (Atacand), captopril (Capoten), eprosartan (Teveten), fosinopril (Monopril), enalapril (Vasotec), irbesartan (Avapro, Avalide), lisinopril (Prinivil, Zestril), losartan (Cozaar, Hyzaar), olmesartan (Benicar); quinapril (Accupril), telmisartan (Micardis), valsartan (Diovan), and others; or
  • heart rhythm medicine such as amiodarone (Cordarone, Pacerone), dofetilide (Tikosyn), disopyramide (Norpace), procainamide (Procan, Pronestyl), quinidine (Cardioquin, Quinaglute), or sotalol (Betapace).

This list is not complete and other drugs may interact with sodium biphosphate and sodium phosphate. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

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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