Please check your internet connection and try again.
# Sodium Phosphate Enema (e.g., Fleet Enema)
## Overview
Sodium phosphate enema is a hypertonic saline solution used as a stimulant laxative for bowel cleansing.
## Primary Indications
* Bowel preparation for diagnostic or surgical procedures.
* Relief of occasional constipation.
## Adult Dosing
* **Bowel Preparation:** Typically, one 4.5 oz (133 mL) enema administered 3-5 hours before the procedure. Maximum of one enema within 24 hours.
* **Constipation Relief:** One 2.25 oz (66 mL) enema administered as a single dose. Maximum of one enema within 24 hours.
## Pediatric Dosing
* **Ages 2-12 years:** Use with caution and under medical supervision. The 2.25 oz (66 mL) enema is generally used. Dosing is often based on the child's weight and clinical judgment, with the smaller volume product preferred. **Specific dosing should follow local protocol or physician guidance.**
* **Under 2 years:** Contraindicated due to the risk of severe electrolyte imbalance and dehydration.
## Dose Adjustments
No specific dose adjustments are typically required for renal or hepatic impairment, but caution is advised, especially in patients with compromised kidney function.
## Contraindications
* Congenital megacolon.
* Heart failure.
* Gastrointestinal obstruction or perforation.
* Severe renal impairment.
* Anuria.
* Children under 2 years of age.
* Hypersensitivity to sodium phosphate.
## Adverse Effects
* **Common:** Abdominal cramping, bloating, nausea, vomiting, rectal irritation.
* **Serious:**
* **Electrolyte Imbalance:** Hyperphosphatemia, hypocalcemia, hypernatremia, hypokalemia, metabolic acidosis. This is a significant risk, especially in children, elderly, and those with renal impairment.
* **Dehydration.**
* **Renal Damage:** Acute kidney injury, nephrocalcinosis.
* **Cardiac Arrhythmias.**
* **Seizures.**
## Key Drug Interactions
* **Diuretics:** Increased risk of electrolyte imbalance.
* **ACE inhibitors/ARBs:** Increased risk of hyperkalemia and renal impairment.
* **Other laxatives:** May potentiate electrolyte disturbances.
* **Calcium-containing medications:** May increase the risk of hyperphosphatemia.
## Monitoring
* Electrolyte levels (sodium, potassium, phosphate, calcium).
* Renal function (BUN, creatinine).
* Hydration status.
* Signs of severe abdominal pain or distension.
## Clinical Pearls
* This is a hypertonic solution; administration should be slow and as directed to minimize cramping and discomfort.
* Ensure adequate fluid intake before and after administration, especially for bowel preparation.
* Contraindicated in patients with conditions that increase the risk of absorption or fluid/electrolyte shifts.
* The risk of serious adverse events, including hyperphosphatemia and acute kidney injury, is well-documented, particularly with overuse or in susceptible populations.
**Please verify the current prescribing information for the specific product being used, as details may vary.**
