Oral Sodium Phosphate/NSAIDs
This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.
Medical warning:
Serious. These medicines may interact and cause very harmful effects. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.
How the interaction occurs:
When oral sodium phosphate is used to cleanse the bowel (generally done before certain medical procedures such as a colonoscopy) and you are taking an NSAID, it may increase your risk of kidney damage.
What might happen:
You may develop a condition called acute phosphate nephropathy, which may decrease your kidney function. Symptoms include malaise, lethargy, drowsiness, decreased urine production, and swelling of the ankles, feet, and legs.
What you should do about this interaction:
Make sure your healthcare professionals (e.g. doctor or pharmacist) know that you are taking these medicines together. Prior to using oral sodium phosphate to prepare for your procedure, let your doctor know if you have a history of kidney problems; have used a laxative for constipation in the previous week; use diuretics, angiotensin converting enzyme (ACE) inhibitors or angiotensin converting enzyme (ARBs, medicines for blood pressure), or NSAIDs; or have active colitis or delayed bowel emptying. Drink lots of clear liquids before, during, and after your procedure. After your procedure, let your doctor know if you develop malaise, lethargy, drowsiness, decreased urine production, and swelling of the ankles, feet, and legs.Your healthcare professionals may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.
References:
1.Anonymous. Food and Drug Administration Science Background Paper: Acute Phosphate Nephropathy and Renal Failure Associated With the Use of Oral Sodium Phosphate Bowel Cleansing Products. Available at: http://www.fda.gov/cder/drug/infopage/OSP_solution/science_background.pdf. Downloaded December 15, 2008..
2.Anonymous. Information for Healthcare Professionals: Oral Sodium Phosphate (OSP) Products for Bowel Cleansing (marketed as Visicol and OsmoPrep, and oral sodium phosphate products available without a prescription). Available at: http://www.fda.gov/cder/drug/InfoSheets/HCP/OSP_solution2008HCP.htm Accessed December 15, 2008..
3.Anonymous. Oral Sodium Phosphate (OSP) Actions. Questions and Answers. Available at: http://www.fda.gov/cder/drug/infopage/OSP_solution/QA.htm Accessed December 15, 2008..
4.Barclay RL, Depew WT, Vanner SJ. Carbohydrate-electrolyte rehydration protects against intravascular volume contraction during colonic cleansing with orally administered sodium phosphate. Gastrointest Endosc 2002 Nov; 56(5):633-8.
5.Tjandra JJ, Tagkalidis P. Carbohydrate-electrolyte (E-Lyte) solution enhances bowel preparation with oral fleet phospho-soda. Dis Colon Rectum 2004 Jul;47(7):1181-6.
6.Brunelli SM, Lewis JD, Gupta M, Latif SM, Weiner MG, Feldman HI. Risk of kidney injury following oral phosphosoda bowel preparations. J Am Soc Nephrol 2007 Dec;18(12):3199-205.
7.Markowitz GS, Stokes MB, Radhakrishnan J, D'Agati VD. Acute phosphate nephropathy following oral sodium phosphate bowel purgative: an underrecognized cause of chronic renal failure. J Am Soc Nephrol 2005 Nov; 16(11):3389-96.
