potassium phosphate/sodium acid phosphate (Rx)

Brand and Other Names:K-Phos M.F., K-Phos No. 2, more...K-Phos Neutral, Neutra-Phos, Uro-KP Neutral
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

potassium phosphate/sodium phosphate

tablet

  • 126mg/67mg
  • 250mg/298mg
  • 250mg/160mg

Hypophosphatemia

K-Phos Neutral: 1-2 tablets PO q4hr

Phos-NaK: 1 packet mixed with 75 mL water or juice

Low Urinary Phosphate

1-2 tablets PO q6hr

Dosage Modifications

Renal impairment: Use with caution in patients with chronic renal disease or renal function impairment

Dosage Forms & Strengths

potassium phosphate/sodium phosphate

tablet

  • 126mg/67mg
  • 250mg/298mg
  • 250mg/160mg

Hypophosphatemia

<4 years: Safety and efficacy not established

≥4 years: K-Phos Neutral, 1 tablet PO q6hr; Phos-NaK, 1 packet PO q6hr mixed with 75 mL water or juice

Low Urinary Phosphate

<4 years: Safety and efficacy not established

≥4 years: 1-2 tablets PO q6hr

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Interactions

Interaction Checker

and potassium phosphate/sodium acid phosphate

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    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Contraindicated (1)

            • sodium phosphate rectal

              sodium phosphate rectal, sodium acid phosphate. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Either increases toxicity of the other. Coadministration of various sodium phosphate preparations are known to cause electrolyte disturbances and hypovolemia.

            Serious - Use Alternative (3)

            • baloxavir marboxil

              sodium acid phosphate will decrease the level or effect of baloxavir marboxil by cation binding in GI tract. Avoid or Use Alternate Drug. Baloxavir may bind to polyvalent cations resulting in decreased absorption. Studies in monkeys showed concurrent use with calcium, aluminum, or iron caused significantly decreased plasma levels. Human studies not conducted.

            • erdafitinib

              potassium phosphate, erdafitinib. Other (see comment). Avoid or Use Alternate Drug. Comment: Avoid coadministration during initial dosing adjustment period (ie, first 21 days). Increases in serum phosphate levels are a pharmacodynamic effect of FGFR inhibition. Serum phosphate binders may obscure decisions regarding initial dosage increase.

            • potassium phosphates, IV

              potassium phosphate and potassium phosphates, IV both increase serum potassium. Avoid or Use Alternate Drug.

              sodium acid phosphate and potassium phosphates, IV both increase serum potassium. Avoid or Use Alternate Drug.

            Monitor Closely (10)

            • deflazacort

              sodium acid phosphate and deflazacort both decrease serum potassium. Use Caution/Monitor.

            • dextroamphetamine

              sodium acid phosphate decreases levels of dextroamphetamine by increasing renal clearance. Use Caution/Monitor.

            • lisdexamfetamine

              sodium acid phosphate decreases levels of lisdexamfetamine by increasing renal clearance. Use Caution/Monitor.

            • magnesium supplement

              magnesium supplement will decrease the level or effect of potassium phosphate by Other (see comment). Modify Therapy/Monitor Closely. Drug may form a chelate with divalent cations; may decrease absorption by the intestinal tract; applies to oral forms; separate administration of drugs to avoid interaction

            • methamphetamine

              sodium acid phosphate decreases levels of methamphetamine by increasing renal clearance. Use Caution/Monitor.

            • methylenedioxymethamphetamine

              sodium acid phosphate decreases levels of methylenedioxymethamphetamine by increasing renal clearance. Use Caution/Monitor.

            • omadacycline

              sodium acid phosphate will decrease the level or effect of omadacycline by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Multivalent cation-containing products may impair absorption of tetracyclines, which may decrease its efficacy. Separate dosing of tetracyclines from these products.

            • potassium iodide

              potassium iodide and potassium phosphate both increase serum potassium. Use Caution/Monitor.

            • pseudoephedrine

              potassium phosphate decreases effects of pseudoephedrine by unknown mechanism. Use Caution/Monitor. Urinary excretion of indirect acting alpha/beta agonists (eg, pseudoephedrine) may increase when administered concomitantly with urinary acidifying agents, resulting in lower serum concentrations.

            • sarecycline

              sodium acid phosphate will decrease the level or effect of sarecycline by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Multivalent cation-containing products may impair absorption of tetracyclines, which may decrease its efficacy. Separate dosing of tetracyclines from these products.

            Minor (0)

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              Adverse Effects

              Frequency Not Defined

              Confusion

              Dizziness

              Gastrointestinal (GI) upset

              Headache

              Low urine output

              Lower-extremity swelling

              Mild laxative effect

              Numbness or tingling

              Shortness of breath

              Tachycardia

              Thirst

              Weakness or heaviness of legs

              Weight gain

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              Warnings

              Contraindications

              Patients with infected phosphate stones

              Severe renal impairment

              Hyperphosphatemia

              Addison disease

              Hyperkalemia

              Infected urolithiasis

              Struvite stone formation

              Cautions

              Use caution in cardiac disease, especially in digitalized patients, adrenal insufficiency, acute dehydration, renal disease, extensive tissue breakdown, as in severe burns, myotonia congenita, cirrhosis of liver, edema, hypertension, hypoparathyroidism, acute pancreatitis, hepatic impairment, hypernatremia, metabolic alkalosis

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              Pregnancy & Lactation

              Pregnancy category: C

              Lactation: Unknown whether drug is distributed in breast milk; caution is advised

              Pregnancy Categories

              A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

              B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

              C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

              D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

              X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

              NA: Information not available.

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              Pharmacology

              Mechanism of Action

              Acidifies urine; essential in physiologic processes

              Elimination

              Excretion: Kidney

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              Administration

              Oral Administration

              Take with full glass of water

              Avoid antacids containing aluminum, magnesium, or calcium

              May precipitate passage of existing kidney stones

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              Images

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              Patient Handout

              A Patient Handout is not currently available for this monograph.
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              Formulary

              FormularyPatient Discounts

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              The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

              Tier Description
              1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
              2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
              3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
              4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              NC NOT COVERED – Drugs that are not covered by the plan.
              Code Definition
              PA Prior Authorization
              Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
              QL Quantity Limits
              Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
              ST Step Therapy
              Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
              OR Other Restrictions
              Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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              Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.