Dosing considerations in the use of sodium phosphate bowel preparations for colonoscopy

Douglas Rex

Research output: Contribution to journalArticle

36 Citations (Scopus)

Abstract

OBJECTIVE: To review dosing considerations and other treatment recommendations to maximize the efficacy, tolerability, and safety of sodium phosphate (NaP) preparations. DATA SOURCES: Literature was accessed through PubMed (1990-May 2007) and abstracts from scientific meetings. STUDY SELECTION AND DATA EXTRACTION: English-language publications including clinical trials and case reports were evaluated. Recent reports assessing newer bowel preparations containing reduced doses of NaP were reviewed to evaluate efficacy, tolerability, and safety. DATA SYNTHESIS: Among commonly administered bowel preparations for colonoscopy, NaP preparations are generally more effective and better tolerated compared with polyethylene glycol electrolyte lavage solution regimens. However, NaP preparations are contraindicated in specific patient populations, and clinicians must use effective screening mechanisms to select proper patients to receive NaP preparation for colonoscopy. Recently, cases of renal failure in patients with previously normal renal function have been reported after NaP preparation for colonoscopy, heightening concerns about the safety of these agents. Newer products contain reduced doses of NaP and may improve the safety and tolerability of NaP purgatives without compromising efficacy of colon cleansing. In addition, accumulating clinical data and/or rationale support split dosing of NaP products, wide intervals between doses, and aggressive hydration before and during bowel preparation and after the colonoscopy procedure. CONCLUSIONS: Safe administration of NaP products requires rigorous attention to dosing considerations and other treatment recommendations, including administration of minimally effective doses of NaP, split-dosing schedules, and aggressive hydration.

Original languageEnglish
Pages (from-to)1466-1475
Number of pages10
JournalAnnals of Pharmacotherapy
Volume41
Issue number9
DOIs
StatePublished - Sep 2007

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Colonoscopy
Safety
Cathartics
Therapeutic Irrigation
PubMed
Electrolytes
Renal Insufficiency
Publications
Appointments and Schedules
Colon
Language
Clinical Trials
Kidney
sodium phosphate
Therapeutics
Population

Keywords

  • Bowel purgatives
  • Sodium phosphate

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Pharmacology, Toxicology and Pharmaceutics(all)

Cite this

Dosing considerations in the use of sodium phosphate bowel preparations for colonoscopy. / Rex, Douglas.

In: Annals of Pharmacotherapy, Vol. 41, No. 9, 09.2007, p. 1466-1475.

Research output: Contribution to journalArticle

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