Potassium Phosphate

Registered South African indications:

• Proven phosphate deficiency

Contraindications

• Hypersensitivity to the active ingredient or any of its excipients
• Severe renal impairment and end-stage renal disease
• Hyperphosphatemia
• Hyperkalemia
• Significant hypocalcemia
• Hypercalcemia

Cautions

• Pregnancy
• Mild to moderate renal impairment
• Hepatic impairment
• Elderly
• Large doses
• Undiluted administration
• Rapid IV infusion
• Acid/base disorders
• Adrenal insufficiency
• Addison's Disease
• Cardiovascular disease
• Acute dehydration
• Myotonia congenita
• Acute pancreatitis
• Hypoparathyroidism
• Rickets
• Conditions with extensive tissue breakdown e.g. severe burns

Forms avail. in SA and covered in this monograph: inj

Phosphate deficiency

• IV: Initial: 40mmol/L; Titrate to 80mmol/L; Max infusion rate: 20mmol/hr; Max: 150mmol/24hrs

Dosage depends on the degree of hypophosphataemia

The contents of the ampoule must be diluted with a bulk parenteral solution before use. 80mmol per litre is the maximum desirable concentration of phosphate

Potassium phosphate must be given with caution to avoid excessive plasma concentration

The potassium and phosphate contents of this solution must be taken into account in patients already receiving intravenous potassium and phosphate medication

No information available

Pregnancy

• Caution
• There has been no adequate and well controlled studies carried out in this area in either humans or animals
• Data from orally administered potassium has not revealed any adverse effects. The risk to the foetus cannot be excluded. The benefits of treatment should outweigh any potential risks to the mother and foetus, before potassium phosphate is considered for use

Breastfeeding

• Compatible
• Potassium is naturally present in breast milk
• It is not known if phosphates are excreted in breast milk. However, problems in breastfeeding infants have not been documented

Renal Impairment

• Mild to moderate (eGFR ≥30ml/min/1.73m²): Caution; no dose adjustment recommended
  Without  continuous renal replacement therapy: Initial dose should be reduced by ≥50%
• Severe (eGFR <30ml/min/1.73m²) and end-stage renal disease: Contraindicated
  If use is absolutely necessary, lower doses are advised. Monitor electrolytes with greater frequency

Hepatic Impairment

• Caution; no information available

Elderly

• Caution; no dose adjustment recommended
  The elderly are more prone to renal impairment, so caution is warranted

Porphyria Information

• Not porphyrinogenic (NP)

Drugs in Sport

• Permitted - No warnings

Central Nervous System Disorders

• Confusion
• Lethargy
• Paralysis
• Paraesthesia
• Coma
• Seizures

Cardiovascular Disorders

• Bradycardia
• Cardiac arrhythmia
• Chest pain
• ECG changes
• Oedema
• Heart block
• Hypotension

Respiratory Disorders

• Dyspnoea

Gastrointestinal Disorders

• Diarrhoea
• Stomach pain

Genitourinary Disorders

• Decreased urine output
• Oliguria

Endocrine and Metabolic Disorders

• Hyperkaelemia
• Hypophosphatemia
• Hypocalcaemia

Musculoskeletal Disorders

• Hypocalcaemic tetany 
• Extraskeletal calcification
• Weakness

• Angiotensin-converting enzyme inhibitors
• Captopril
• Enalapril
• Lisinopril
• Angiotensin II receptor blockers
• Potassium-sparing diuretics
• Adrenocorticoids
• Glucocorticoids (especially those with significant mineralocorticoid activity)
• Mineralocorticoids
• Corticotropin (ACTH)
• Anabolic steroids
• Androgens
• Digitalis glycosides
• Thiazide diuretics
• Mexiletine
• Quinidine
• Salicylates

• Serum electrolytes
• ECG
• Renal function

Potassium is the principle cation in intracellular fluid. It is involved with carbohydrate metabolism, glycogen storage and protein synthesis. It is involved with transmembrane potential and profound effects on muscle. Phosphorus has many important biochemical functions in the body and is involved in many significant metabolic and enzyme reactions in almost all organs and tissues.

Monobasic potassium phosphate/ Dibasic potassium phosphate

Injection (per 10ml) 1.09g/1.05g

• Sabax Potassium Phosphate solution (Adcock Ingram)