Is anyone else's office banning Fleets Phosophosoda?? - page 2

I work in an Endoscopy unit where the prep of choice is between OsmoPrep and Fleets Phosphosoda. Well today we had a email from head honcho doc that the Fleets Phosphosoda was dangerous and it has... Read More

  1. by   RNiel
    Our Doc used to use Fleets Phospho more than anything else until the recent study came out. He now uses GoLytely more than anything else. Previously he reserved the GoLytely for people with history of cardiac, renal or electrolye problems and gave the Fleets to everyone else. Now in addition to pts w/ those problems he includes those over the age of 60. Our patients are told to take 30 ml of MOM the night before the prep when they go to bed. The next day it's nothing but clear liquids and the prep. On the morning of the colonoscopy they are mostly all pretty well cleaned out. If the pt has a hx of constipation the doc with increase the MOM to 30 ml for two nights before the day of the prep.
  2. by   CrohnieToo
    I ABSOLUTELY can NOT do the Lytely preps or ANY prep that requires drinking a huge amount of liquid w/in a short time period. And I REFUSE to do them.

    I have a partial obstruction and I just can NOT do a large volume of food OR LIQUID w/in a short period of time. Since I have minimal symptoms I am not ready to submit to surgery.

    I do the PhosphoSoda prep w/no problems. There is less sewer water to drink and I can spread out the time period in which to drink sufficient liquids to prevent dehydration and to thoroughly rinse and flush the colon.

    I do think that too many people do not drink sufficient fluids between downing the PhosphoSoda and the time they must go NPO. I start earlier than recommended and use a 20 oz water bottle for my subsequent liquids so that I KNOW I am getting sufficient fluids down before NPO time.

    I've found too many of these doctors script "overkill" for scope prepping rather than making it clear to patients the need to drink sufficient fluids to maintain hydration and flush the colon when using PhosphoSoda or Magnesium Citrate. I've also found that they are too rigid in their time table. I was once given instructions and a time table for a morning scope that wasn't scheduled until 12 noon by a gastro who is ALWAYS late, even in starting the first scope of the day. Fortunately, I've gone thru enough colonoscopies I can figure out the timing myself.
    Last edit by CrohnieToo on Apr 20, '08
  3. by   porterc
    Here's what you do and it worked for me! Dont take the day before for liquid diet only - take two days a pill crusher and crush the tablet and down with lime gatorade. Works perfectly. Manufacturer wont tell you this because it hasnt been 'tested yet'. Worked for me, but I'm not a doctor, but I did tell him.
  4. by   hvhc
    My brother-in-law was just admitted to the hospital in acute renal failure for dialysis after using this prep for his colonscopy. Would appreciate any information anyone may have on this issue.
  5. by   NRSKarenRN
    Mechanism of action of this medication is to draw water into the intestine, increasing peristalsis and the urge to defecate ---this may cause electrolyte imbalances due to high sodium content. Patients with undiagnosed electolyte problems, bordeline kidney functioning and heart conditions may have serious side effects. This is well known as med been around about 100 years.

    What should I discuss with my healthcare provider before using Fleet Phospho Soda (sodium biphosphate and sodium phosphate)?

    Do not use this medication if you have:
    • ascites (fluid around your liver);
    • congestive heart failure;
    • unstable angina (chest pain);
    • a perforated bowel;
    • a bowel obstruction or severe constipation or
    • colitis or toxic megacolon.
    If you have any these conditions, you could have dangerous or life-threatening side effects from sodium biphosphate and sodium phosphate.

    People with eating disorders (such as anorexia or bulimia) should not use this medication without the advice of a doctor.
    Talk with your doctor before using sodium biphosphate and sodium phosphate if you have:
    • nausea, vomiting, or stomach pain;
    • trouble swallowing;
    • a heart rhythm disorder (such as "Long-QT syndrome");
    • a history heart attack, heart surgery, or bypass surgery within the past 3 months;
    • kidney disease;
    • underactive thyroid;
    • an electrolyte imbalance (such as high or low levels of potassium, sodium, phosphorous, or magnesium in your blood);
    • a sudden change in bowel habits lasting more than 2 weeks;
    • if you take a diuretic (a water pill) such as furosemide (Lasix), hydrochlorothiazide (HCTZ, HydroDiuril, Hyzaar, Lopressor, Vasoretic, Zestoretic), spironolactone (Aldactazide, Aldactone), triamterene (Dyrenium, Maxzide, Dyazide), and others;
    • if you are on a salt-restricted diet; or
    • if you have used a laxative for longer than 1 week.
    If you have any of these conditions, you may not be able to use sodium biphosphate and sodium phosphate, or you may need a dosage adjustment or special tests during treatment.

    Adverse Reactions

    Frequency not defined.
    Cardiovascular: Edema, hypotension
    Central nervous system: Dizziness, headache
    Endocrine & metabolic: Hypocalcemia, hypernatremia, hyperphosphatemia, calcium phosphate precipitation
    Gastrointestinal: Nausea, vomiting, diarrhea, abdominal bloating, abdominal pain, mucosal bleeding, superficial mucosal ulcerations
    Renal: Acute renal failure
    Postmarketing and/or case reports: Tablet: Atrial fibrillation following severe vomiting


    Use with caution in patients with impaired renal function (oral solution contraindicated), pre-existing electrolyte imbalances (including patients on diuretics which may effect electrolyte levels or dehydration); risk of hypocalcemia, hyperphosphatemia, hypernatremia, and acidosis. If using as a bowel evacuant, correct electrolyte abnormalities before treatment; inadequate fluid intake may lead to excessive fluid loss and hypovolemia. May cause colonic mucosal aphthous ulcerations; use with caution in patients with an acute exacerbation of chronic inflammatory bowel disease, absorption may be enhanced. Use with caution in debilitated patients. Enemas and oral solution are available in pediatric and adult sizes; prescribe by "volume" not "by bottle".

    Oral solution: Patients receiving >45 mL of oral solution may develop severe electrolyte shifts, even in the absence of medical contraindications.

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