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All about: OsmoPrep

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Generic Name: sodium biphosphate and sodium phosphate ( SOE dee um bye FOS foe nate and SOE dee um FOS fate)
Brand Names: Fleet Enema, Fleet Enema for Children, Fleet Phospho Soda, OsmoPrep, Visicol

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 other than those listed in this medication guide.

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

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

When using this medication in a child, use only the forms that are specially made for children. Do not use sodium biphosphate and sodium phosphate without first talking to your doctor if you have kidney disease, have congestive heart failure, have an electrolyte imbalance; or are on a sodium restricted diet. Dangerous, even life-threatening, toxicity may occur while using sodium biphosphate and sodium phosphate if you have any of these conditions.

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

Do not use this medication if you have:
  • ascites (fluid around your liver);

  • congestive heart failure;

  • unstable angina (chest pain);

  • a perforated bowel;

  • a bowel obstruction or severe constipation or

  • colitis or toxic megacolon.

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

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

Talk with your doctor before using sodium biphosphate and sodium phosphate if you have:

  • nausea, vomiting, or stomach pain;

  • trouble swallowing;

  • a heart rhythm disorder (such as "Long-QT syndrome");

  • a history heart attack, heart surgery, or bypass surgery within the past 3 months;

  • kidney disease;

  • underactive thyroid;

  • an electrolyte imbalance (such as high or low levels of potassium, sodium, phosphorous, or magnesium in your blood);

  • a sudden change in bowel habits lasting more than 2 weeks;

  • if you take a diuretic (a water pill) such as furosemide (Lasix), hydrochlorothiazide (HCTZ, HydroDiuril, Hyzaar, Lopressor, Vasoretic, Zestoretic), spironolactone (Aldactazide, Aldactone), triamterene (Dyrenium, Maxzide, Dyazide), and others;

  • if you are on a salt-restricted diet; or

  • if you have used a laxative for longer than 1 week.

If you have any of these conditions, you may not be able to use sodium biphosphate and sodium phosphate, or you may need a dosage adjustment or special tests during treatment.

FDA pregnancy category C. This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. It is also not known whether sodium biphosphate and sodium phosphate will harm a nursing infant. Do not use sodium biphosphate and sodium phosphate without telling your doctor if you are breast-feeding baby.

How should I use sodium biphosphate and sodium phosphate?

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

To keep from getting dehydrated, drink a full glass of water 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. 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.

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.

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.

If you do not get any results from using this medication, 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. Store sodium biphosphate and sodium phosphate at room temperature away from moisture and heat. Throw away any leftover medicine after your treatment ends.

What happens if I miss a dose?

Since sodium biphosphate and sodium phosphate is used as needed, you are not likely to be on a dosing schedule. Do not use more than the recommended dose of this medication in any 24-hour period.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine.

Symptoms of a sodium biphosphate and sodium phosphate overdose may include diarrhea, dry mouth, increased thirst, drowsiness, restless feeling, confusion, nausea, vomiting, increased urination, muscle pain or weakness, fast heart rate, feeling light-headed, fainting, or seizure (convulsions).

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

Do not use other laxatives while using sodium biphosphate and sodium phosphate unless your doctor has told you to.

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

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. Stop using this medication and call your doctor at once if you have any of these serious side effects:
  • rectal bleeding;

  • no bowel movement after use;

  • sores or ulcers around your rectum;

Less serious side effects may be more likely to occur, such as:

  • bloating, stomach pain;

  • nausea, vomiting, tightness in your throat;

  • dizziness; or

  • headache.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect sodium biphosphate and sodium phosphate?

Before using this medication, tell your doctor if you are using any of the following drugs:

  • arsenic trioxide (Trisenox);

  • bepridil (Vascor);

  • cisapride (Propulsid);

  • chloroquine (Arelan) or halofantrine (Halfan);

  • droperidol (Inapsine);

  • narcotic medication such as fentanyl (Actiq, Duragesic, Ionsys), hydrocodone (Vicodin), hydromorphone (Dilaudid), methadone (Methadose), morphine (Kadian, MS Contin), oxycodone (OxyContin, Percocet), propoxyphene (Darvocet, Darvon), and others;

  • antibiotics such as azithromycin (Zithromax), clarithromycin (Biaxin), dirithromycin (Dynabac), erythromycin (E-Mycin, E.E.S., Erythrocin, Ery-Tab), pentamidine (NebuPent, Pentam), sparfloxacin (Zagam), or telithromycin (Ketek);

  • antidepressants such as amitriptyline (Elavil, Etrafon), clomipramine (Anafranil), imipramine (Janimine, Tofranil), and others;

  • medicines to treat psychiatric disorders, such as chlorpromazine (Thorazine), haloperidol (Haldol), mesoridazine (Serentil), pimozide (Orap), or thioridazine (Mellaril); or

  • heart rhythm medicine such as amiodarone (Cordarone, Pacerone), dofetilide (Tikosyn), disopyramide (Norpace), procainamide (Procan, Pronestyl), quinidine (Cardioquin, Quinaglute), or sotalol (Betapace).

There may be other drugs that can affect sodium biphosphate and sodium phosphate. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

  • Your pharmacist has information about sodium biphosphate and sodium phosphate written for health professionals that you may read.

  • 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.
  • Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.
Copyright 1996-2006 Cerner Multum, Inc. Version: 3.04. Revision Date: 2/14/07 2:30:53 PM.

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