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.

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

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.

Usual Adult Dose for Bowel Preparation:

For colon cleansing prior to colonoscopy procedure:
Visicol(R):
The evening before the procedure: Take 3 Visicol(R) tablets (the last dose will be 2 tablets) with 240 mL of clear liquids every 15 minutes for a total of 20 tablets.

On the day of the procedure: Starting 3 to 5 hours before the procedure, take 3 Visicol(R) tablets (the last dose will be 2 tablets) with 240 mL of clear liquids every 15 minutes for a total of 20 tablets.

OsmoPrep(R):
The evening before the procedure: Take 4 OsmoPrep(R) tablets with 240 mL of clear liquids every 15 minutes for a total of 20 tablets.

On the day of the procedure: Starting 3 to 5 hours before the procedure, take 4 OsmoPrep(R) tablets with 240 mL of clear liquids every 15 minutes for a total of 12 tablets.

For bowel cleansing prior to surgery, X-rays, or other intestinal procedures, and for general care after surgery:
Enema: Sodium biphosphate-sodium phosphate 7 g-19 g (118 mL or 197 mL depending upon the size enema used) rectally once

Usual Adult Dose for Constipation:

Enema: Sodium biphosphate-sodium phosphate 7 g-19 g (118 mL or 197 mL depending upon the size enema used) rectally once

Oral solution: 15 mL (diluted in 240 mL of cool water) orally as a single dose; dose should be followed with at least an additional 240 mL of cool water
Maximum single daily dose: 30 or 45 mL

Usual Pediatric Dose for Bowel Preparation:

For bowel cleansing prior to surgery, X-rays, or other intestinal procedures, and for general care after surgery:
Enema:
2 to less than 5 years: Sodium biphosphate-sodium phosphate 1.75 g-4.75 g (29 mL or one-half enema) rectally once

5 to 11 years: Sodium biphosphate-sodium phosphate 3.5 g-9.5 g (59 mL or one enema) rectally once

12 years or older: Sodium biphosphate-sodium phosphate 7 g-19 g (118 mL or 197 mL depending upon the size enema used) rectally once

Usual Pediatric Dose for Constipation:

Enema:
2 to less than 5 years: Sodium biphosphate-sodium phosphate 1.75 g-4.75 g (29 mL or one-half enema) rectally once

5 to 11 years: Sodium biphosphate-sodium phosphate 3.5 g-9.5 g (59 mL or one enema) rectally once

12 years or older: Sodium biphosphate-sodium phosphate 7 g-19 g (118 mL or 197 mL depending upon the size enema used) rectally once

Oral solution:
5 to 9 years: 7.5 mL (diluted in 240 mL of cool water) orally as a single dose
Maximum single daily dose: 7.5 mL

10 to 11 years: 15 mL (diluted in 240 mL of cool water) orally as a single dose
Maximum single daily dose: 15 mL

12 years or older: 15 mL (diluted in 240 mL of cool water) orally as a single dose
Maximum single daily dose: 30 or 45 mL

The oral dose should be followed with at least an additional 240 mL of cool water.

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.