Potassium phosphate Side Effects

For the Consumer

Applies to potassium phosphate: intravenous solution

As well as its needed effects, potassium phosphate may cause unwanted side effects that require medical attention.

If any of the following side effects occur while taking potassium phosphate, check with your doctor or nurse immediately:

• Burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
• chest pain or discomfort
• confusion
• dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
• fast, slow, or irregular heartbeat
• muscle cramps in the hands, arms, feet, legs, or face
• no muscle tone or movement
• numbness and tingling around the mouth, fingertips, or feet
• pounding or rapid pulse
• shortness of breath
• unusual tiredness or weakness
• weakness and heaviness of the legs

For Healthcare Professionals

Applies to potassium phosphate: intravenous solution, oral powder for reconstitution

Metabolic

Signs of hyperkalemia include muscle weakness, frank skeletal muscle and diaphragm paralysis, peaked T waves on the ECG, and cardiac arrhythmias. If toxicity is suspected or documented, potassium should be stopped immediately. While monitoring the ECG, a combination of dextrose and insulin in a ratio of 3 g of dextrose for every 1 unit of insulin may be administered. Sodium bicarbonate 50 to 100 mEq and calcium gluconate 10% intravenously may be helpful if acidosis is present. Potassium-binding resins or dialysis may be necessary in serious cases.

Hyperkalemia is significantly more likely in elderly patients with uremia who receive high doses.

In patients with renal failure, other factors that may cause hyperkalemia include defects in the renin-angiotensin-aldosterone axis, tubular defects in potassium secretion, intra- to extracellular potassium shifts due to metabolic acidosis, and possible high potassium loads from underlying disease states (such as rhabdomyolysis, hemolysis, gastrointestinal bleeding, etc.).

Renal failure is the most common cause of hyperphosphatemia. Other factors that may contribute to hyperphosphatemia in patients with renal insufficiency include high phosphorus intake, and rarely, hypoparathyroidism or acromegaly.

When severe, hyperphosphatemia may reduce the extracellular concentration of ionized calcium (increasing the risk of tetany) and increase the risk of extraosseous calcification.^[Ref]

Metabolic side effects have been reported the most frequently and have usually resulted from hyperkalemia and/or hyperphosphatemia. They have included muscle weakness, frank skeletal muscle and diaphragm paralysis, peaked T waves on the ECG, life-threatening cardiac arrhythmias and an increased risk of extraosseous calcification.

While the most common cause of hypokalemia in patients with liver cirrhosis is diuretic therapy, other causes include low dietary intake, enhanced renal loss due to hyperaldosteronism, magnesium deficiency, and accelerated gastrointestinal losses. Hypophosphatemia may be associated with malnutrition in some patients with alcoholic liver disease.^[Ref]

Gastrointestinal

Gastrointestinal side effects have included diarrhea, nausea, stomach pains, and vomiting.^[Ref]

Cardiovascular

Cardiovascular side effects have included fast or irregular heartbeat, dyspnea, lower extremity edema, and unusual weight gain.^[Ref]

Nervous system

Nervous system side effects have included headaches, dizziness, thirst, mental confusion, seizures, weakness or heaviness of the legs, muscle cramps, numbness, tingling, and perioral tingling.^[Ref]

It is possible that some side effects of potassium phosphate may not have been reported. These can be reported to the FDA here. Always consult a healthcare professional for medical advice.

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