FDA is notifying healthcare professionals about an association between oral sodium phosphates (osps) for bowel cleansing and a type of acute renal failure called acute phosphate nephropathy. These occurrences, which are rare but serious, have been associated with both OSP liquids such as Fleet Phospho-soda, and OSP tablets such as Visicol. Patients at increased risk of acute phosphate nephropathy include the elderly, those with kidney disease, dehydration or decreased intravascular volume, and those using drugs that affect renal perfusion or function. These include diuretics, ACE inhibitors, angiotensin receptor blockers (arbs), and possibly nsaids. FDA is suggesting several precautions when choosing a bowel cleanser for patients. Here are a few of them: • Avoid using osps in patients with kidney disease, impaired renal function or perfusion, dehydration, or uncorrected electrolyte abnormalities including hyperphosphatemia. • Use osps with caution in patients taking diuretics, ACE inhibitors, arbs, or nsaids. • Instruct patients to take the correct OSP dose and drink sufficient quantities of fluids during bowel cleansing.
