Indications
Dibasic sodium phosphate, combined with monobasic sodium phosphate, is used as a ready-to-use rectal enema for quick relief of occasional constipation and to empty the lower bowel before bowel examinations, surgery or childbirth.
How It Works
Sodium phosphate is a saline (salt) laxative. In the rectum it draws water into the bowel, which softens the stool and increases the volume, stretching the bowel wall and triggering a bowel movement, usually within 1 to 5 minutes.
Dosage and Administration
Adults and children 12 years and over: one adult-size enema inserted gently into the rectum, once in 24 hours, or as directed on the label. Children aged 2 to 11 years need a smaller paediatric enema, only as directed by a doctor. Lie on your left side with knees bent, insert the lubricated tip slowly, squeeze the bottle until most of the liquid is used, then remove it. Hold the liquid in until you feel a strong urge, usually 1 to 5 minutes. Do not use more than one enema in 24 hours, and do not use for more than 3 days in a row unless a doctor advises. Stop if you feel resistance; do not force the tip.
Interactions
- Diuretics, ACE inhibitors such as Enalapril, angiotensin receptor blockers such as Losartan, and NSAIDs: higher risk of kidney injury and salt imbalance.
- Lithium: blood levels may change.
- Medicines that prolong the QT interval: low calcium or potassium may add to heart rhythm risk.
- Other phosphate laxatives: do not use together.
Contraindications
- Bowel obstruction, perforation, active inflammatory bowel disease, megacolon or Hirschsprung’s disease.
- Unexplained stomach pain, nausea, vomiting or rectal bleeding.
- Congestive heart failure, kidney failure or dehydration.
- Children under 2 years.
- Imperforate anus.
Side Effects
Common effects include stomach cramps, a feeling of fullness, nausea and mild rectal discomfort or irritation. Overuse, holding the enema too long, or use in people with kidney or heart problems can cause dangerous changes in salts in the blood, such as high phosphate, low calcium and dehydration.
Get urgent medical help if there is no bowel movement and the liquid does not come out within 30 minutes, or if you have rectal bleeding, severe stomach pain, dizziness, confusion, muscle cramps or spasms, a fast or irregular heartbeat, or much less urine.
Pregnancy and Lactation
Occasional short-term use is generally considered acceptable in pregnancy and breastfeeding, but ask your doctor or midwife first, especially if you have high blood pressure or swelling.
Precautions and Warnings
- Use with caution in older people and in those with kidney disease, heart disease, high blood pressure or a salt-restricted diet.
- Drink plenty of fluids before and after use.
- Not for long-term use; see a doctor if constipation lasts more than a week.
Overdose
Using too much, or retaining the enema, can cause serious salt imbalance with fits, irregular heartbeat and kidney damage. Seek emergency medical help.
Therapeutic Class
Osmotic (saline) laxative, rectal enema.
Storage
Store below 30°C, away from light and out of the reach of children. Do not freeze.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.