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|K-Phos No. 2

PHOSPHATES (Systemic)

Some commonly used brand names are:

In the U.S.—

• K-Phos M. F. ²
• K-Phos Neutral ²
• K-Phos No. 2 ²
• K-Phos Original ¹
• Neutra-Phos ²
• Neutra-Phos-K ¹
• Uro-KP-Neutral ²

In Canada—

• Uro-KP-Neutral ²

Category

• Acidifier, urinary—Potassium and Sodium Phosphates; Monobasic Potassium Phosphates
• Antiurolithic, calcium calculi—Potassium and Sodium Phosphates; Monobasic Potassium Phosphates
• Electrolyte replenisher—Potassium and Sodium Phosphates; Potassium Phosphates; Sodium Phosphates

Description

Phosphates are used as dietary supplements for patients who are unable to get enough phosphorus in their regular diet, usually because of certain illnesses or diseases. Phosphate is the drug form (salt) of phosphorus. Some phosphates are used to make the urine more acid, which helps treat certain urinary tract infections. Some phosphates are used to prevent the formation of calcium stones in the urinary tract.

Injectable phosphates are to be administered only by or under the supervision of your health care professional. Some of these oral preparations are available only with a prescription. Others are available without a prescription; however, your health care professional may have special instructions on the proper dose of this medicine for your medical condition. You should take phosphates only under the supervision of your health care professional.

Phosphates are available in the following dosage forms:

• Oral
• Potassium Phosphates
  • Capsules for solution (U.S.)
  • Powder for solution (U.S.)
  • Tablets for solution (U.S.)
• Potassium and Sodium Phosphates
  • Capsules for solution (U.S.)
  • Powder for solution (U.S.)
  • Tablets for solution (U.S. and Canada)

• Parenteral
• Potassium Phosphates
  • Injection (U.S. and Canada)
• Sodium Phosphates
  • Injection (U.S.)

Importance of Diet

The best dietary sources of phosphorus include dairy products, meat, poultry, fish, and cereal products.

The daily amount of phosphorus needed is defined in several different ways.

• For U.S.—
• Recommended Dietary Allowances (RDAs) are the amount of vitamins and minerals needed to provide for adequate nutrition in most healthy persons. RDAs for a given nutrient may vary depending on a person"s age, sex, and physical condition (e.g., pregnancy).
• Daily Values (DVs) are used on food and dietary supplement labels to indicate the percent of the recommended daily amount of each nutrient that a serving provides. DV replaces the previous designation of United States Recommended Daily Allowances (USRDAs).

• For Canada—
• Recommended Nutrient Intakes (RNIs) are used to determine the amounts of vitamins, minerals, and protein needed to provide adequate nutrition and lessen the risk of chronic disease.

Normal daily recommended intakes for phosphorus are generally defined as follows:

Before Using This Medicine

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your health care professional will make. For phosphates the following should be considered:

Allergies—Tell your health care professional if you have ever had any unusual or allergic reaction to potassium, sodium, or phosphates. Also, tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy—It is especially important that you are receiving enough vitamins and minerals when you become pregnant and that you continue to receive the right amount of vitamins and minerals throughout your pregnancy. The healthy growth and development of the fetus depend on a steady supply of nutrients from the mother. However, taking large amounts of a dietary supplement in pregnancy may be harmful to the mother and/or fetus and should be avoided.

Breast-feeding—It is especially important that you receive the right amount of vitamins and minerals so that your baby will also get the vitamins and minerals needed to grow properly. However, taking large amounts of a dietary supplement while breast-feeding may be harmful to the mother and/or baby and should be avoided.

Children—Problems in children have not been reported with intake of normal daily recommended amounts. However, use of enemas that contain phosphates in children has resulted in high blood levels of phosphorus.

Older adults—Problems in older adults have not been reported with intake of normal daily recommended amounts.

Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your health care professional may want to change the dose, or other precautions may be necessary. When you are taking phosphates, it is especially important that your health care professional know if you are taking any of the following:

• Amiloride (e.g., Midamor) or
• Angiotensin-converting enzyme (ACE) inhibitors (benazepril [e.g., Lotensin], captopril [e.g., Capoten], enalapril [e.g., Vasotec], fosinopril [e.g., Monopril], lisinopril [e.g., Zestril, Prinivil], quinapril [e.g., Accupril], ramipril [e.g., Altace]) or
• Cyclosporine or
• Digitalis glycosides (heart medicine) or
• Heparin (e.g., Panheprin), with long-term use, or
• Medicine for inflammation or pain (except narcotics) or
• Other potassium-containing medicine or
• Salt substitutes, low-salt foods, or milk or
• Spironolactone (e.g., Aldactone) or
• Triamterene (e.g., Dyrenium)—Use with potassium-containing phosphates may increase the risk of hyperkalemia (too much potassium in the blood), possibly leading to serious side effects

• Antacids—Use with phosphates may prevent the phosphate from working properly

• Calcium-containing medicine, including antacids and calcium supplements—Use with phosphates may prevent the phosphate from working properly; calcium deposits may form in tissues

• Corticosteroids (cortisone-like medicine)—Use with sodium-containing phosphates may increase the risk of swelling

• Phosphate-containing medications, other, including phosphate enemas—Use with sodium or potassium phosphates may cause high blood levels of phosphorus which may increase the chance of side effects

• Sodium-containing medicines (other)—Use with sodium phosphates may cause your body to retain (keep) water

Other medical problems—The presence of other medical problems may affect the use of phosphates. Make sure you tell your health care professional if you have any other medical problems, especially:

• Burns, severe or
• Heart disease or
• Pancreatitis (inflammation of the pancreas) or
• Rickets or
• Softening of bones or
• Underactive parathyroid glands—Sodium- or potassium-containing phosphates may make these conditions worse

• Dehydration or
• Underactive adrenal glands—Potassium-containing phosphates may increase the risk of hyperkalemia (too much potassium in the blood)

• Edema (swelling in feet or lower legs or fluid in lungs) or
• High blood pressure or
• Liver disease or
• Toxemia of pregnancy—Sodium-containing phosphates may make these conditions worse

• High blood levels of phosphate (hyperphosphatemia)—Use of phosphates may make this condition worse

• Infected kidney stones—Phosphates may make this condition worse

• Kidney disease—Sodium-containing phosphates may make this condition worse; potassium-containing phosphates may increase the risk of hyperkalemia (too much potassium in the blood)

• Myotonia congenita—Potassium-containing phosphates may increase the risk of hyperkalemia (too much potassium in the blood), and make this condition worse

Proper Use of This Medicine

For patients taking the tablet form of this medicine:

• Do not swallow the tablet . Before taking, dissolve the tablet in 3/4 to 1 glass (6 to 8 ounces) of water. Let the tablet soak in water for 2 to 5 minutes and then stir until completely dissolved.

For patients using the capsule form of this medicine:

• Do not swallow the capsule . Before taking, mix the contents of 1 capsule in one-third glass (about 21/2 ounces) of water or juice or the contents of 2 capsules in two-thirds glass (about 5 ounces) of water and stir well until dissolved.

For patients using the powder form of this medicine:

• Add the entire contents of 1 bottle (21/4 ounces) to enough warm water to make 1 gallon of solution or the contents of one packet to enough warm water to make 1/3 of a glass (about 2.5 ounces) of solution. Shake the container for 2 or 3 minutes or until all the powder is dissolved.
• Do not dilute solution further.
• This solution may be chilled to improve the flavor; do not allow it to freeze.
• Discard unused solution after 60 days.

Take this medicine immediately after meals or with food to lessen possible stomach upset or laxative action.

To help prevent kidney stones, drink at least a full glass (8 ounces) of water every hour during waking hours , unless otherwise directed by your health care professional.

Take this medicine only as directed . Do not take more of it and do not take it more often than recommended on the label, unless otherwise directed by your health care professional.

Dosing—The dose of these single or combination medicines will be different for different patients. Follow your health care professional"s orders or the directions on the label . The following information includes only the average doses of these medicines. If your dose is different, do not change it unless your health care professional tells you to do so.

The number of teaspoonfuls or ounces of prepared solution that you drink depends on the equivalent amount of phosphorus contained in the product. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are taking the single or combination medicine .

• For potassium phosphates
• For tablets for oral solution dosage form:
  • To replace phosphorus lost by the body or to make the urine more acid or to prevent the formation of kidney stones in the urinary tract:
    • Adults and teenagers—The equivalent of 228 milligrams (mg) of phosphorus (2 tablets) dissolved in six to eight ounces of water four times a day, with meals and at bedtime.
  • To replace phosphorus lost by the body:
    • Children over 4 years of age—The equivalent of 228 mg of phosphorus (2 tablets) dissolved in six to eight ounces of water four times a day, with meals and at bedtime.
    • Children up to 4 years of age—The dose must be determined by your doctor.
• For capsules for oral solution dosage form:
  • To replace phosphorus lost by the body:
    • Adults, teenagers, and children over 4 years of age—The equivalent of 250 mg of phosphorus (contents of 1 capsule) dissolved in two and one-half ounces of water or juice four times a day, after meals and at bedtime.
    • Children up to 4 years of age—Dose must be determined by your doctor.
• For powder for oral solution dosage form:
  • To replace phosphorus lost by the body:
    • Adults, teenagers, and children over 4 years of age—The equivalent of 250 mg of phosphorus dissolved in two and one-half ounces of water four times a day, after meals and at bedtime.
    • Children up to 4 years of age—Dose must be determined by your doctor.

• For potassium and sodium phosphates
• For tablets for oral solution dosage form:
  • To replace phosphorus lost by the body or to make the urine more acid or to prevent the formation of kidney stones in the urinary tract:
    • Adults and teenagers—The equivalent of 250 milligrams (mg) of phosphorus dissolved in eight ounces of water four times a day, after meals and at bedtime.
  • To replace phosphorus lost by the body:
    • Children over 4 years of age—The equivalent of 250 mg of phosphorus dissolved in eight ounces of water four times a day, after meals and at bedtime.
    • Children up to 4 years of age—Dose must be determined by your doctor.
• For capsules for oral solution dosage form:
  • To replace phosphorus lost by the body:
    • Adults, teenagers, and children over 4 years of age—The equivalent of 250 mg of phosphorus (the contents of 1 capsule) dissolved in two and one-half ounces of water or juice four times a day, after meals and at bedtime.
    • Children up to 4 years of age—Dose must be determined by your doctor.
• For powder for oral solution dosage form:
  • To replace phosphorus lost by the body:
    • Adults, teenagers, and children over 4 years of age—The equivalent of 250 mg of phosphorus dissolved in two and one-half ounces of water four times a day, after meals and at bedtime.
    • Children up to 4 years of age—Dose must be determined by your doctor.
• For tablets for oral solution dosage form:
  • To replace phosphorus lost by the body:
    • Adults, teenagers, and children over 4 years of age—The equivalent of 250 mg of phosphorus (1 tablet) dissolved in eight ounces of water four times a day.
    • Children up to 4 years of age—Dose must be determined by your doctor.

Missed dose—If you miss a dose of this medicine, take it as soon as possible. However, if it is within 1 or 2 hours of your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage—To store this medicine:

• Keep out of the reach of children.
• Store away from heat and direct light.
• Do not store the capsule, tablet, or powder form of this medicine in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down.
• Keep the liquid form of this medicine from freezing.
• Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.

Precautions While Using This Medicine

Your health care professional should check your progress at regular visits to make sure that this medicine does not cause unwanted effects.

Do not take iron supplements within 1 to 2 hours of taking this medicine . To do so may keep the iron from working properly.

For patients taking potassium phosphate-containing medicines :

• Check with your health care professional before starting any strenuous physical exercise, especially if you are out of condition and are taking other medication. Exercise and certain medicines may increase the amount of potassium in the blood.

For patients on a potassium-restricted diet :

• This medicine may contain a large amount of potassium. If you have any questions about this, check with your health care professional.
• Do not use salt substitutes and low-salt milk unless told to do so by your health care professional. They may contain potassium.

For patients on a sodium-restricted diet :

• This medicine may contain a large amount of sodium. If you have any questions about this, check with your health care professional.

Side Effects of This Medicine

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your health care professional as soon as possible if any of the following side effects occur:

Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. However, check with your health care professional if any of the following side effects continue or are bothersome:

Diarrhea; nausea or vomiting; stomach pain

Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your health care professional.

Revised: 08/18/2000

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