Phosphate Supplement (Oral, Parenteral)

People who don't get enough phosphorous in their diets have the option of making up for that deficiency by taking phosphate supplements, either orally or parenterally.

Overview

Phosphate is the medicinal form of the nutrient phosphorous, which is important in people's diets because it works with calcium to help build strong bones and teeth. Since roughly 85% of all phosphorous in the human body is found in bones and teeth, it highlights the significance of having a sufficient level of that mineral available in the body.

Phosphate supplements can be delivered via two distinct routes, either orally or parenterally. If taken orally, phosphates are available as an over-the-counter drug and may not require the prescription or supervision of a medical professional. When delivered intravenously, phosphate supplements must be injected by a qualified professional or your family doctor.

People who have a deficiency of phosphorous have generally been experiencing some kind of illness, and have been unable to ingest the needed daily requirement of this mineral. In some cases, phosphate supplements are delivered to patients in order to treat infections in the urinary tract, and in other cases it is used to prevent the formation of calcium stones in the urinary tract.

To include phosphorous naturally in a person's diet, the best food sources are fish, dairy products, meats, poultry, and some kinds of cereals. The recommended daily amounts for people of various ages to include in their diets are as follows:

  • Infants to 3 yrs between 300 and 800 mg
  • Children between 4 and 6 800 mg
  • Children between 7 and 10 to 800 mg
  • Adolescent and adult males 800 to 1200 mg
  • Adolescent and adult females 800 to 1200 mg
  • Pregnant females 800 mg
  • Breastfeeding females 800 mg

Condition Treated

Type Of Medicine

  • Mineral supplement

Side Effects

Phosphate supplements supply some very beneficial effects to persons using them, but some patients will also experience some unwanted side effects, to a greater or lesser degree. Many patients have reported experiencing some relatively mild symptoms which last for only a day or two and subside of their own accord, without the need for any kind of medical treatment. If side effects in the following group should occur in your own case after taking phosphate supplements, it may be necessary to alert your family doctor, in the event that they become severe enough to cause you discomfort.

  • Persistent diarrhea
  • Nausea and/or vomiting
  • Stomach pain or cramping
  • Abdominal pain or cramping

There's another grouping of side effects which are experienced by some patients, although the incidence of their occurrence is relatively low, and can be considered unlikely for most patients.

  • Sudden weight gain
  • Confusion or disorientation
  • Difficulty with breathing, such as shortness of breath
  • Muscle cramps
  • Decrease in urination frequency or in the amount of urine passed
  • Convulsions or seizures
  • Heaviness in the legs
  • Unexplained weakness or fatigue
  • Tremors and shaking
  • Increasing thirst
  • Headaches
  • Dizziness or disorientation
  • Weakness, numbness, or tingling in the hands or the feet
  • Swelling in the lower legs, ankles, or feet
  • Unusual anxiety or irritability
  • Irregular heartbeat, faster or slower than normal
  • Tingling sensation or numbness in the lips.

Dosage

Since phosphate supplements are available in several forms, there are varying dosages which will apply to different age groups, and it is necessary to observe these proper dosing strategies in order to appropriately make up for the deficiency of phosphorous in the body. When dosing at home, the following usage guidelines should be observed:

  • For patients ingesting the capsule form of phosphate supplements, the capsule itself should not be swallowed, but the contents of the capsule should be mixed with about two and half ounces of water. If two capsules are being ingested at the same time, these should be broken open and mixed with 5 ounces of water.
  • For patients using the medication in its tablet form, the tablet itself should not be swallowed, but should instead be dissolved in about 6 ounces of water. It will be necessary to allow the tablet to dissolve for up to five minutes, before stirring and ingesting.
  • For patients who use the powder form of this supplement, the entire 2 1/4 ounces of a bottle containing the powder should be added to 1 gallon of water. If the powder comes in a packet, the packet contents should be added to warm water and then shaken or stirred until all powder is dissolved. If a large batch of this is mixed up at one time, it must be used within 60 days or else discarded.

In all cases, the phosphate supplement should be taken with a meal so as to reduce the possibility of laxative action or an upset stomach. It should also be remembered that it will be necessary to drink lots of water, preferably every hour or so, in order to avoid the possibility of developing kidney stones.

The actual dosing for an individual patient will depend on a number of factors, including the strength of the medication itself, your own medical condition, and the frequency with which it is ingested or injected.

  • When using the solution form of phosphates, both adults and teenagers should receive 228 mg of phosphorous (the equivalent of two tablets), dissolved in at least 6 ounces of water, as many as four times daily, to be accompanied by a meal, and ideally administered at bedtime. For children above the age of four, a recommended dosage of 228 mg of phosphorous (equating to two tablets), dissolved in up to 8 ounces of water, to be taken as many as four times daily, in accompaniment with a meal, and preferably at bedtime. Children below the age of four years must have dosage determined by a family doctor, per their specific medical condition.
  • When using the oral dosage in capsule form, children over the age of four, teenagers, and adults should be given the equivalent of 250 mg of phosphate supplement (equating to one capsule), to be dissolved in 2 1/2 ounces of water, as many as four times daily, in accompaniment with a meal, and preferably at bedtime. Children up to the age of four should have their dosage determined by a family doctor, in accordance with their particular medical condition.
  • When using the oral dosage form of the powder, children up to the age of four, teenagers, and adults should be given 250 mg of phosphate supplement which is dissolved in 2 1/2 ounces of water, up to four times daily, in accompaniment with a meal, and ideally at bedtime. Children who are aged four or below must have their dosage determined by a family doctor, taking into account their specific medical condition.

Patients who are receiving phosphate supplement intravenously will have the dosage determined by their doctor in a clinical setting, and the delivery procedure will be there in a doctor's office or hospital, under the direct supervision of medical personnel. Since injectables will not be taken home by a patient for self-administration, it is not necessary to be concerned about the dosage level at home.

Interactions

There are a number of interactions which are possible for patients who are given phosphate supplements, some of which relate to your existing medical condition, and some which relate to interactions with other drugs you may be taking.

To avoid the possibility of interactions with other drugs, it's a good idea to prepare a list of all the prescription medications, over-the-counter drugs, vitamins, and herbal supplements which you may be taking. Your doctor can review this list and ensure that there are no conflicts between drugs you're taking, and if necessary he/she will recommend that you discontinue certain other drugs while you are being given phosphate supplements. This same list may come in very handy if you should have a need to visit an emergency room or a healthcare clinic where your primary care doctor is not in residence. Any doctor or medical professional at a clinic can review your medications list and then safely prescribe a program of treatment for the medical condition which brought you to the emergency room.

The specific medical conditions which may have an impact on your usage of phosphate supplements, and which should be fully discussed with your doctor, are as follows:

  • Swelling in the feet or lower legs
  • Fluid in the lungs
  • High blood pressure
  • Liver disease
  • Severe burns
  • Heart disease
  • Inflammation of the pancreas
  • Rickets
  • Kidney disease
  • Infected kidney stones
  • High blood levels of phosphate
  • Toxemia of pregnancy
  • Dehydration
  • Underactive adrenal glands
  • Softening of bones
  • Myotonia congenital
  • Underactive parathyroid glands.

Usage of phosphate supplements or any other kind of dietary supplement is generally discouraged when you are taking any of the medications listed below, and if you know that you are taking any of these drugs, you should discuss it with your doctor before treatment with phosphate supplements.

  • Ziprasidone
  • Trospium
  • Trihexyphenidyl
  • Amantadine
  • Amisulpride
  • Belladonna alkaloids
  • Benztropine
  • Amifampridine
  • Atropine
  • Bepridil
  • Solifenacin
  • Sparfloxacin
  • Scopolamine
  • Dicyclomine
  • Darifenacin
  • Clidinium
  • Cisapride
  • Biperiden
  • Oxybutynin
  • Methscopolamine
  • Hyoscyamine
  • Fesoterodine
  • Dronedarone
  • Saquinavir
  • Piperaquine
  • Glycopyrrolate.

Another whole class of medications which are strongly advised to be discontinued while taking phosphate supplements include all of the following:

  • Delamanid
  • Dasatinib
  • Alacepril
  • Alfuzosin
  • Amitriptyline
  • Amiodarone
  • Azithromycin
  • Efavirenz
  • Droperidol
  • Donepezil
  • Cilazapril
  • Ciprofloxacin
  • Citalopram
  • Clozapine
  • Delaminid
  • Desipramine
  • Amoxapine
  • Apomorphine
  • Aripiprazole
  • Arsenic trioxide
  • Chloroquine
  • Captopril
  • Canrenoate
  • Astemizole
  • Asenipene
  • Anagrelide
  • Clozapine
  • Crizotinib
  • Cyclobenzaprine
  • Deslorelin
  • Disopyrmaide
  • Dofetilide
  • Domperidone
  • Enalapril maleate
  • Erythromycin
  • Escitalopram
  • Ondansetron
  • Nafarelin
  • Moxifloxacin
  • Moexipril
  • Norfloxacin
  • Hydroxyzine
  • Histrelin
  • Haloperidol
  • Goserelin
  • Fingolimod
  • Flecainide
  • Fluconazole
  • Mifepristone
  • Nilotinib
  • Nortriptyline
  • Octreotide
  • Lapatinib
  • Ketoconazole
  • Indomethacin
  • Imipramine
  • Imidrapil
  • Fosinopril
  • Fluoxetine
  • Ivabradine
  • Leuprolide
  • Lapatinib
  • Lisinopril
  • Lopinavir
  • Lumefantrine
  • Methadone
  • Mefloquine
  • Paliperidone
  • Moexipril
  • Sulpiride
  • Spironolactone
  • Spirapril
  • Sotalol
  • Pitolisant
  • Triptorelin
  • Triamterene
  • Trazodone
  • Pentopril
  • Perindopril
  • Quinapril
  • Quetiapine
  • Quinine
  • Quinidine
  • Ranolazine
  • Salmeterol
  • Sorafenib
  • Sotalol
  • Telavancin
  • Tacrolimus
  • Sunitinib
  • Toremifene
  • Tizanidine
  • Trimipramine
  • Frifluoperazine
  • Triptorelin
  • Posaconazole
  • Procainimide
  • Prochlorperazine
  • Propafenone
  • Perflutren lipid microsphere
  • Promethazine
  • Trazodone
  • Ranolazine
  • Sevoflurane
  • Solifenacin
  • Sorafenib
  • Tetrabenazine
  • Tizanidine
  • Telithromycin
  • Zofenopril.

Warnings

It will be necessary to observe some precautions when taking phosphate supplements, and to facilitate this cautious approach, you should have a thorough review of your entire medical history with your doctor. This will help to avoid triggering a new medical condition or a worsening of an existing medical condition caused by taking phosphate supplements.

One of the first things to be aware of in this general area is the potential for an allergic reaction, and if you know you are allergic to phosphate supplements, or any other dietary supplements, you should immediately point this out to your doctor in order to avoid any such reaction. Also, if you have allergic reactions to other sources such as pets, fabrics, foods, or preservatives, you should alert your doctor to this fact as well. The signs to look for in someone who is undergoing an allergic reaction are as follows:

  • Extreme itchiness on skin services round the body
  • Swelling or puffiness in the eyelids, lips, tongue, or throat
  • The appearance of hives and/or rashes on the skin
  • Dizziness or disorientation
  • Difficulty with breathing
  • Increased heart rate.

Make sure to tell your doctor if you are aware that you have high calcium levels or high vitamin D levels, or if you have problems with the absorption of nutrition from various foods (the condition referred to as malabsorption syndrome).

If you have any history of the following medical conditions, you should alert your doctor before taking phosphate supplements:

  • Bowel diseases such as Whipple's disease or Crohn's disease
  • Deficiency of stomach acid
  • Levels of bile which are abnormally low
  • Kidney stones
  • Heart disease
  • Blood vessel disease
  • Kidney disease
  • Any kind of immune system disorders
  • Untreated phosphate imbalance.

Some forms of phosphate supplement, such as the chewable tablets, may contain aspartame or sugar, and if you have diabetes or some other medical condition that requires you to limit your sugar intake, you should consult with your doctor. It may be necessary to avoid this particular form of phosphate supplement, in favor of one which contains absolutely no traces of aspartame or sugar.

Your doctor will probably want to conduct regular checkups on you to make sure that phosphate supplements are not causing you any unwanted side effects, and is not disrupting your health in any way.

It is inadvisable to take any kind of iron supplement within two hours of also taking phosphate supplements, since this is likely to reduce the effectiveness of your iron supplement. Patients who take potassium phosphate-containing medicines should be careful to check with the family doctor before beginning any program of strenuous exertion. This is particularly true if you are currently not in good physical condition and are taking other medications, since it is known that the combination of exercise with certain medications can increase the level of potassium in the bloodstream.

Patients who are on a diet with restricted levels of potassium need to be aware that phosphate supplements generally include a high level of potassium, and this is something that should be reviewed with your doctor. You should not use salt substitutes or low-salt milk while taking phosphate supplements, unless your doctor has recommended that you do so, because these can contain elevated levels of potassium.

Patients who are on a diet with restricted sodium levels need to be aware that phosphate supplements do sometimes contain unusually large amounts of sodium, and any of these which you ingest should be carefully reviewed with your doctor.

Women who are pregnant or are thinking of becoming pregnant, should consult with their doctor prior to receiving phosphate supplements. While it is very important for pregnant women to have the appropriate levels of all vitamins and minerals in their diet throughout the entire period of pregnancy, there can be risks with taking large amounts of dietary supplement. There is a potential for health problems to occur to both mother and fetus when large amounts of any kind of dietary supplement, such as phosphate supplements, are included in the diet at any point in the pregnancy. For this reason, consultation with the family doctor is highly advisable before beginning any program of treatment with phosphate supplements.

This same warning extends to mothers who intend to be breast-feeding their infants, e.g. while it is important that breast-feeding mothers receive sufficient levels of minerals and vitamins, there is potential for harm to an infant when a breast-feeding mother receives excessive levels of dietary supplements. That makes breast-feeding a strategy which should be reviewed with the family doctor, so that risks and rewards can be considered.

Storage

The forms of phosphate supplements which are orally administered can be stored in the home, in a location which is out of direct sunlight, which is not subject to any extremes of temperature, particularly of freezing. Room temperature which does not exceed 86 degrees Fahrenheit or go lower than 46 degrees Fahrenheit is acceptable, although temporary excursions outside this range are permissible. There should also be no excess of humidity in the storage location, since this can cause condensation to form on tablets, and can degrade the effectiveness of the medication prior to use.

It is strongly advised to keep this medication out of the reach of pets and small children, since it can cause a strong reaction in youngsters. Ideally, it should be kept in a location which children cannot reach, even with the aid of any props to assist them. It is also not recommended to keep this medication in any of the weekly pill reminders being sold, because they don't have locking mechanisms which prevent access.

When this medication expires, it should not be used and should instead be discarded, according to recommended protocols for disposal. You can consult your doctor or pharmacist about proper disposal methods, and you should not simply flush the medication down a sink or down the toilet.

Summary

Phosphate supplements are a very important dietary supplement which are most commonly used to treat patients who have a deficiency of phosphorous, for whatever reason. Since phosphorous is vital to the formation and maintenance of teeth and bones, its importance can hardly be overstated, and it is known that the vast majority of phosphorous found in the human body is resident in those bones and teeth.

In young children, phosphate salts are sometimes prescribed for the treatment of osteomalacia, the condition formerly referred to as rickets, which is a situation that prevails when there is an imbalance of minerals in the body. This can lead to a softening or weakening of the bones, and needs to be addressed immediately, so as to avoid the possibility of obstructed or slow development in the young person.

There are a few other conditions which phosphate supplements are indicated for, including improved athletic performance, as a laxative which helps to evacuate the bowels before surgery, and as an antacid for patients troubled with gastroesophageal reflux disease (GERD).

There are two primary delivery routes for phosphate supplements, with the oral route being by far the most common and the most popular, and the intravenous route being the other prominent delivery route. While all usage of phosphate supplements should be under the direct supervision of a qualified medical professional, the oral form of this medication does not actually require a prescription. The intravenous injection of phosphate supplements will be done in a clinical setting, so prescriptions are not really needed for that form of treatment either.

There are a few known side effects which are possible when taking phosphate supplements, and if any of these should cause pronounced discomfort, they should be related to a doctor for possible treatment or consideration of an alternative medication. There are also a number of potential interactions between phosphate supplements and medical conditions which a patient might have, and this points up the significance of reviewing medical history with your doctor prior to taking phosphate supplements. In addition, there are a considerable number of other drugs which are known to react with phosphate supplements, as well as other dietary supplements, so this is another area which should be reviewed with the family doctor.