Sodium Phosphate Rectal

WHY is this medicine prescribed?

Rectal sodium phosphate is used to treat constipation that happens from time to time. Rectal sodium phosphate should not be given to children younger than 2 years of age. Rectal sodium phosphate is in a class of medications called saline laxatives. It works by drawing water into the large intestine to produce a soft bowel movement.

Are there OTHER USES for this medicine?

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

HOW should this medicine be used?

Rectal sodium phosphate comes as an enema to insert in the rectum. It is usually inserted when a bowel movement is desired. The enema usually causes a bowel movement within 1 to 5 minutes. Follow the directions on the package label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use rectal sodium phosphate exactly as directed. Do not use more or less of it or use it more often than directed on the package label. Do not use more than one enema in 24 hours even if you have not had a bowel movement. Using too much rectal sodium phosphate may cause serious damage to the kidneys or heart and possibly death.

Rectal sodium phosphate is available in a regular- and large-size enema for adults and a small-size enema for children. Do not give the adult-size enema to a child. If you are giving the child-size enema to a child who is 2 to 5 years of age, you should give half of the contents. To prepare this dose, unscrew the cap of the bottle and remove 2 tablespoons of liquid using a measuring spoon. Then replace the bottle cap.

To use the sodium phosphate enema, follow these steps:

1. Remove the protective shield from the tip of the enema.
2. Lie down on your left side and raise your right knee to your chest or kneel and lean forward until the left side of your face is resting on the floor and your left arm is comfortably folded.
3. Gently insert the enema bottle into your rectum with the tip pointing toward your navel. While you insert the enema, bear down as though you are having a bowel movement.
4. Squeeze the bottle gently until the bottle is nearly empty. The bottle contains extra liquid, so it does not have to be completely empty. Remove the enema bottle from your rectum.
5. Hold the enema contents in place until you feel a strong urge to have a bowel movement. This will usually take 1 to 5 minutes, and you should not hold the enema solution for more than 10 minutes. Wash your hands after using the enema.

Ask your pharmacist or doctor for a copy of the manufacturer's information for the patient.

What SPECIAL PRECAUTIONS should I follow?

Before using rectal sodium phosphate,

• tell your doctor and pharmacist if you are allergic to sodium phosphate, any other medications, or any of the ingredients in the enema. Check the label or ask your pharmacist for a list of the ingredients.

• tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention the following: amiodarone (Cordarone); angiotensin converting enzyme (ACE) inhibitors such as benazepril (Lotensin, in Lotrel), captopril (Capoten, in Capozide), enalapril (Vasotec, in Vaseretic), fosinopril, lisinopril (Prinivil, Zestril, in Prinzide, Zestoretic), moexipril (Univasc, in Uniretic), perindopril (Aceon), quinapril (Accupril, in Accuretic, Quinaretic), ramipril (Altace), and trandolapril (Mavik, in Tarka); angiotensin receptor blockers (ARBs) such as candesartan (Atacand, in Atacand HCT), eprosartan (Teveten), irbesartan (Avapro, in Avalide), losartan (Cozaar, in Hyzaar), olmesartan (Benicar, in Azor, Tribenzor), telmisartan (Micardis, in Micardis HCT, Twynsta), or valsartan (Diovan, in Diovan HCT, Exforge, Exforge HCT, Valturna); aspirin and other non-steroidal anti-inflammatory medications such as ibuprofen (Advil, Motrin, others) and naproxen (Aleve, Naprosyn, others); disopyramide (Norpace); diuretics ('water pills'); dofetilide (Tikosyn); lithium (Lithobid); moxifloxacin (Avelox); pimozide (Orap), quinidine (Quinidex, in Nuedexta); sotalol (Betapace); and thioridazine. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.

• do not take any other laxatives or use any other enemas, especially other products that contain sodium phosphate, while you are taking this medication.

• talk to your doctor before using rectal sodium phosphate or any other laxative if you have stomach pain, nausea, or vomiting along with constipation, if you have had a sudden change in bowel habits that has lasted longer than 2 weeks, and if you have already used a laxative for 1 week or longer. Also tell your doctor if you develop rectal bleeding during your treatment with rectal sodium phosphate. These symptoms may be signs that you have a more serious condition that needs medical attention.

• tell your doctor if you are 55 years of age or older, and if you follow a low salt diet. Also tell your doctor if you were born with imperforate anus (a birth defect in which the anus does not form properly and must be repaired with surgery and that may cause ongoing problems with bowel control) and if you have had a colostomy (surgery to create an opening for waste to leave the body). Tell your doctor if you have or ever had heart failure, ascites (build-up of fluid in the stomach area), a blockage or tear in your stomach or intestine, inflammatory bowel disease (IBD; a group of conditions in which the lining of the lining of the intestines is swollen, irritated, or has sores), paralytic ileus (condition in which food does not move through the intestines), toxic megacolon (a serious or life-threatening widening of the intestine), dehydration, low levels of calcium, sodium, magnesium, or potassium in your blood, or kidney disease.

• tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding.

What SPECIAL DIETARY instructions should I follow?

Drink plenty of clear liquids while you are using this medication.

What SIDE EFFECTS can this medicine cause?

Rectal sodium phosphate may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• nausea
• stomach pain
• bloating
• anal discomfort, stinging, or blistering
• chills

Some side effects can be serious. If you experience any of these symptoms, stop using rectal sodium phosphate and call your doctor immediately:

• increased thirst
• dizziness
• urinating less often than usual
• vomiting
• drowsiness
• swelling of the ankles, feet, and legs

Rectal sodium phosphate may cause other side effects. Call your doctor if you have any unusual problems while you are using this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

What should I know about STORAGE and DISPOSAL of this medication?

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom).

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org

What should I do in case of OVERDOSE?

If someone swallows rectal sodium phosphate or if someone uses too much of this medication, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

Symptoms of overdose may include the following:

• increased thirst
• dizziness
• vomiting
• decreased urination
• irregular heartbeat
• fainting
• muscle cramps or spasms

What OTHER INFORMATION should I know?

Ask your pharmacist any questions you have about rectal sodium phosphate.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.