Treat hypophosphatemia or prevent hypophosphatemia

Electrolyte Supplement, Parenteral
Phosphorus is involved in many significant metabolic and enzymatic reactions in almost all organs and tissues. It 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.
Potassium is the major cation of intracellular fluid and is essential for the conduction of nerve impulses in heart, brain, and skeletal muscle; contraction of cardiac, skeletal and smooth muscles; maintenance of normal renal function, acid-base balance, carbohydrate metabolism, and gastric secretion.

1.Distribution: Enters cells via active transport from extracellular fluid; ~85% of serum phosphates is free and ultra-filterable. 2.Protein binding: 15%. 3.3Excretion: Primarily urine (>80% to 90% of dose reabsorbed by the kidney); skin and feces (small amounts).

Hyperphosphatemia and hyperkalemia; severe renal impairment (eGFR <30 mL/minute/1.73 m2) and end-stage renal disease.

Fetal risk cannot be ruled out.
Available evidence is inconclusive or inadequate for determining fetal risk when used in pregnant women.

1.Cardiovascular: Bradycardia, cardiac arrhythmia, chest pain, ECG changes, edema, heart block, hypotension, localized phlebitis (IV), prolonged QT interval on ECG.
2.Endocrine & metabolic: Decreased serum magnesium, hyperkalemia, hyperphosphatemia, hypocalcemia
3.Gastrointestinal: Diarrhea, nausea, stomach pain, vomiting
4.Genitourinary: Decreased urine output
5.Nervous system: Confusion, lethargy, paralysis, paresthesia, seizures
6.Neuromuscular & skeletal: Asthenia, tetany (with large doses of phosphate)
7.Renal: Acute renal failure
8.Respiratory: Dyspnea

Hypophosphatemia, acute treatment:General replacement guidelines
IV:
1.Low dose, serum phosphate level 2.3 to 2.7 mg/dL: Initial: 0.08 to 0.16 mmol/kg over 4 to 6 hours.
2.Intermediate dose, serum phosphate level 1.5 to 2.2 mg/dL: Initial: 0.16 to 0.32 mmol/kg over 4 to 6 hours.
3.High dose, serum phosphate level <1.5 mg/dL: Initial: 0.32 to 0.64 mmol/kg over 4 to 6 hours.
4.Obesity: May use adjusted body weight for patients weighing >130% of IBW
Parenteral nutrition:10 to 15 mmol/1,000 kcal or 20 to 40 mmol/24 hours.