Bowel preparation with oral sodium phosphate and renal disease

Mishra et al. [1] described two cases of severe hyperphosphatemia following ingestion of Fleet Phospho-Soda. One of the affected patients was a 51-year-old woman with end-stage renal disease, and the other was a 57-year-old man with chronic renal insufficiency. The authors failed to note that current professional Fleet Phospho-Soda labeling includes the warning, ”Do not use in patients with clinically significant impairment of renal function“ [2].

Fleet Laboratories is concerned that Fleet Phospho-Soda should be used only in patients who do not have contraindications to the drug product.

Competing Interests: Dr Caswell is employed by Fleet Laboratories, manufacturers of Fleet Phospho-soda.

References

• 1 Mishra R, Kaufman D, Mattern III J, Dutta S K. Severe hyperphosphatemia and hypocalcemia caused by bowel preparation for colonoscopy using oral sodium phosphate in end-stage renal disease.  Endoscopy. 2005;  37 1259-1260
• 2 Murray L, senior editor. Physicians’ Desk Reference, 60th ed.  Montvale, NJ; Thompson Healthcare, Inc. 2006: 1170-1172