This is a stable, clear, colorless, buffered aqueous oral solution with ginger-lemon flavor. It is used for the relief of occasional constipation and for bowel cleansing before surgical procedures, X-ray, or endoscopic examinations.

Sodium Phosphate is used in the management of hypophosphataemia. It also acts as a mild osmotic laxative when administered orally in diluted form or via the rectal route. Phosphate-containing enemas or concentrated oral solutions are commonly used for bowel preparation prior to surgery or endoscopic procedures.

Dose for bowel preparation

Adults and children 5 years of age & over: The recommended dosage for adults and children 5 years of age & over is 45 ml and repeated 10 to 12 hours later. The intake of clear liquids is an essential part of this regimen. On the day before the procedure, the patient should only take clear liquids for breakfast, lunch and dinner and between doses. No solid food, milk or milk products should be taken on the day before the procedure. The patient should not drink anything colored red or purple. Medical procedure is intended to be performed at early morning, mid-morning or later, by two alternative dosage regimens.

Early morning procedure: The first dose is taken at 7 a.m. on the morning before the procedure. The second dose is taken at 7 p.m. on the evening before the procedure.

Mid-morning (or later) procedure: The first dose is taken at 7 p.m. on the evening before the procedure. The second dose is taken at 7 a.m. (or at least 3 hours before leaving for the appointment) on the morning before the procedure.

• First dose: Mix 15 ml (one third of the bottle) of This into a full glass (approximately 250 ml) of clear liquids and drink. Repeat two more times within the next 20 minutes.
• Between Doses: Between the first and second doses, the patient should drink at least three more glasses (approximately 250 ml each) of clear liquids or more if desired to prevent dehydration and to ensure that their bowel remains easily examinable for the procedure.
• Second Dose: Mix 15 ml of This into a full glass of clear liquid and drink. Repeat two more times within the next 20 minutes.
• Please refer to clear liquids list below. Beverages, water, tea or coffee (no milk or non dairy creamer), sweeteners are acceptable, carbonated or non carbonated soft drinks (not colored red or purple), fruit flavored cordials (not colored red or purple) and strained fruit juices without pulp. Do not drink any alcoholic beverage.

Dose for occasional constipation

Adult/child over

• 12 years old: 20-45 ml
• 10-11 years old child: 10-20 ml
• 5-9 years old child: 5-10 ml

Use cautiously with medicines that may alter electrolyte balance, including calcium channel blockers, diuretics, ACE inhibitors, ARBs, NSAIDs, lithium, and similar agents. These combinations may increase the risk of hyperphosphataemia, hypocalcaemia, hypernatraemic dehydration, and metabolic acidosis. Concurrent use with polyethylene glycol bowel-cleansing preparations is not recommended due to potential safety concerns.

Contraindicated in patients with congestive heart failure (CHF), renal failure or significant renal impairment, congenital or acquired megacolon, gastrointestinal obstruction, ascites, ileus or bowel perforation, and active inflammatory bowel disease.

Common gastrointestinal effects include bloating, nausea, abdominal pain, and vomiting. Nervous system effects may include dizziness, headache, and rarely seizures. Renal-related adverse effects may include increased blood urea nitrogen (BUN), elevated creatinine, renal impairment, acute renal failure, phosphate nephropathy, nephrocalcinosis, and renal tubular necrosis. Hypersensitivity reactions such as rash, itching, urticaria, throat tightness, bronchospasm, dyspnea, and rarely anaphylaxis may occur.

Use in pregnancy: Not recommended unless the potential benefit justifies the possible risk to the fetus due to phosphate absorption across the placenta.

Use in lactation: Not recommended during breastfeeding unless clearly necessary, as phosphate may pass into breast milk and affect the infant.

Use with extreme caution in elderly, weak, or debilitated patients, those with colostomy, or patients on a low-sodium diet. Adequate fluid intake before and after administration is essential to prevent dehydration. Patients undergoing major bowel procedures and remaining nil by mouth should have electrolyte levels monitored and may require IV fluids containing potassium and calcium. Use cautiously in patients taking diuretics or drugs that prolong QT interval. Avoid concurrent use with polyethylene glycol bowel preparations. Do not use in patients experiencing nausea, vomiting, or abdominal pain unless advised by a physician.

Children: Not recommended for children under 5 years of age.

Diabetic patients: Liquid diet during bowel preparation may affect blood glucose levels; adjustment of insulin or oral antidiabetic drugs may be necessary.

Enema & bowel cleansing solution

Store in a cool, dry place, protected from light. Keep out of reach of children.