Sodium Phosphate

Pronunciation: SOE-dee-um FOS-fate
Class: Mineral

Trade Names

Sodium Phosphate
- Injection, solution, concentrate phosphate 3 mmol and sodium 4 mEq/mL

Pharmacology

Exerts a modifying influence on the steady state of calcium levels, a buffering effect on acid-base equilibrium, and a primary role in the renal excretion of hydrogen ion. Plays a significant intracellular role in the synthesis of high-energy organic phosphates. Essential to maintain red cell glucose utilization, lactate production, and the concentration of both erythrocyte adenosine triphosphate (ATP) and 2,3-diphosphoglycerate (DPG).

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Pharmacokinetics

Elimination

IV-infused phosphorus not taken up by the tissues is excreted almost entirely in the urine.

Indications and Usage

Treatment of hypophosphatemia; as an additive for preparing specific parenteral fluid formulas.

Contraindications

High phosphorus or low calcium levels; hypernatremia.

Dosage and Administration

Hypophosphatemia
Adults and Children

IV Dose and rate of administration dependent upon the individual needs of the patient.

Adults

TPN phosphorus 10 to 15 mmol/L of TPN solution containing dextrose 250 g.

Infants

TPN 1.5 to 2 mmol/kg/day.

Off-label dosing
Hypophosphatemia Adults

IV

Mild hypophosphatemia (serum phosphorus 2.3 to 3 mg/dL)

0.16 mmol/kg. Administer at a rate no faster than 7.5 mmol/h.

Moderate hypophosphatemia (serum phosphorus 1.6 to 2.2 mg/dL)

0.32 mmol/kg. Administer at a rate no faster than 7.5 mmol/h.

Severe hypophosphatemia (serum phosphorus less than 1.6 mg/dL)

0.64 mmol/kg. Administer at a rate no faster than 7.5 mmol/h.

Children

IV

Acute

0.16 to 0.32 mmol/kg per dose IV over 6 h.

Maintenance dosage

0.5 to 1.5 mmol/kg per dose IV over 24 h.

TPN Adults

IV 20 to 40 mmol/day.

Children

IV

Preterm neonates

1 to 2 mmol/kg/day.

Infants/children

0.5 to 2 mmol/kg/day.

Adolescents and children weighing more than 50 kg

10 to 40 mmol/day.

General Advice

  • Must be diluted and thoroughly mixed before use.
  • To avoid phosphorus intoxication, infuse solutions containing sodium phosphate slowly.
  • The concomitant amount of sodium (4 mEq/mL) must be calculated into total electrolyte dose of prepared solutions.
  • phosphate 1 mmol = phosphorus 31 mg.

Storage/Stability

Store between 59° and 86°F.

Drug Interactions

Corticosteroids/Corticotropin

Caution must be exercised in the administration of parenteral fluids, especially those containing sodium ion, to patients receiving corticosteroids or corticotropin.

Thiazides

Concurrent use with thiazides may cause renal damage.

Laboratory Test Interactions

None well documented.

Adverse Reactions

Musculoskeletal

Hypocalcemic tetany.

Precautions

Monitor

Frequent monitoring of serum sodium, phosphorus, and calcium levels, as well as renal function, is recommended.


Pregnancy

Category C .

Lactation

Undetermined.

Children

Safety and efficacy have been established in children (neonates, infants, children, and adolescents).

Elderly

Dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy.

Renal Function

In patients with diminished renal function, administration of solutions containing sodium ions may result in sodium retention.

Special Risk Patients

Use with caution in patients with cirrhosis or cardiac failure, or in conjunction with other edematous medications. Do not use with sodium-retaining medications.

Aluminum toxicity

May contain aluminum. Aluminum may reach toxic levels with parenteral administration if kidney function is impaired.

Parenteral administration

Infusing high concentrations of phosphorus may result in a reduction of serum calcium and symptoms of hypocalcemic tetany.

Sodium retention

Use solutions containing sodium ion with great care in patients with CHF or severe renal insufficiency, and in clinical states in which edema with sodium retention exists.

Overdosage

Symptoms

Hypocalcemic tetany.

Patient Information

  • Advise patient or caregiver that medication will be prepared and administered by health care provider in a health care setting.

Copyright © 2009 Wolters Kluwer Health.

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