Indications
Dibasic Sodium Phosphate, usually combined with Monobasic Sodium Phosphate, is used as a rectal enema for the short-term relief of occasional constipation and to empty the lower bowel before examinations such as sigmoidoscopy, before surgery, or before childbirth when advised.
How It Works
The phosphate salts are poorly absorbed and act as an osmotic laxative: they draw water into the lower bowel. This softens and increases the volume of the stool and stimulates the bowel to empty, usually within 2 to 5 minutes and at most about 30 minutes after use.
Dosage and Administration
Use as directed on the label. Adults and children aged 12 and over usually use the contents of one adult-size enema rectally once in 24 hours. Lie on your left side with knees bent, gently insert the lubricated tip into the rectum, squeeze the bottle until most of the liquid is used, and hold it in until the urge to empty is strong. Children aged 2 to 11 need a smaller paediatric enema, only as advised by a doctor. Do not use more than one enema in 24 hours or for more than 3 days without medical advice.
Interactions
Use with care if you take diuretics (water tablets), ACE inhibitors such as Enalapril, angiotensin receptor blockers such as Losartan, NSAIDs such as Ibuprofen, or Lithium, as the risk of dehydration, salt imbalance and kidney injury is higher. Do not use with other phosphate bowel preparations.
Contraindications
Do not use in children under 2 years, in suspected bowel blockage, perforation or toxic megacolon, inflammatory bowel disease flare, Hirschsprung disease, imperforate anus, severe dehydration, congestive heart failure, or significant kidney disease, or if you have nausea, vomiting or stomach pain of unknown cause.
Side Effects
Mild effects include stomach cramps, a feeling of fullness, nausea and local irritation or discomfort around the anus. Using it too often or holding it in too long can cause dehydration and changes in blood salts (high phosphate, low calcium, low potassium, high or low sodium).
Get urgent medical help if there is no bowel movement or the liquid does not come out within 30 minutes, if you have rectal bleeding, severe stomach pain, vomiting, dizziness, confusion, muscle cramps or twitching, very reduced urine or an irregular heartbeat.
Pregnancy and Lactation
Occasional use is generally considered acceptable during pregnancy and breastfeeding when advised by a doctor or midwife. Avoid repeated use and speak to your doctor first.
Precautions and Warnings
Older people, people with kidney or heart disease, and those who are dehydrated are at higher risk of serious salt imbalance and should use it only under medical advice. Drink plenty of clear fluids. Do not use as a regular laxative. Stop and seek advice if constipation lasts more than a week.
Overdose
Using too much or retaining the enema can cause dangerous phosphate poisoning with low calcium, dehydration, fits, irregular heartbeat and kidney failure, especially in young children and older adults. Seek emergency medical help.
Therapeutic Class
Osmotic laxative (phosphate enema)
Storage
Store below 30°C, do not freeze, away from light and out of the reach of children.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.