DRUG SUPPLIED DOSE COMMENTS
PHOSPHATE (Paeds)
(Potassium phosphate [KPO4], sodium phosphate [NaPO4], PMS Phosphate Solution, Phosphate Novartis)

Mechanism of action:

Electrolyte replacement.



Ref: 1, 44, 67, 72, 329, 383



Last update: 2022-09-08
PO4 refers to phosphate

Injection:
KPO4 per mL: 3 mmol PO4 and 4.4 mEq K+
NaPO4 per mL:
3 mmol PO4 and 4 mEq Na+

Oral:
Effervescent tablet: 500 mg=16 mmol PO4 (also contains Na+ and K+)
oral solution (PMS sodium phosphates solution):
4.15 mmol/mL
tablet (K-Phos Original):
3.68 mmol PO4 (Special Access Program - patient and physician specific release only)
Acute Hypophosphatemia:
Phosphate Level < 0.8 mmol/L:
0.25 mmol/kg/dose IV over 6 hr.
Recheck phosphate level the following day and repeat infusion, if necessary.
Phosphate Level < 0.5 mmol/L:
0.33 mmol/kg/dose IV over 6 hr.
Recheck phosphate level the following day and repeat infusion, if necessary. Phosphate Level < 0.3 mmol/L (Severe):
0.5 mmol/kg/dose IV over 6 hr.
Recheck level 1 hr after infusion complete.

Maintenance: 1 mmol/kg/dose PO BID-TID

Recommended daily allowance (RDA):
1-6 months: 3 mmol/ day
7-12 months: 9 mmol/day
1-3 years: 15 mmol/day
4-8 years: 16 mmol/day
9-18 years: 40 mmol/day

Injectable phosphate should be ordered by mmol of phosphate.

1 mmol PO4 provides 31 mg elemental phosphorus.  

Consider sodium and potassium content when selecting phosphate replacement therapy.

Use with caution in renal impairment.

Individualize maintenance dosing based on underlying etiology,  RDA and dietary intake.

Phosphate salts may precipitate when mixed with calcium salts.

Dissolve effervescent phosphate tablets in water (125-250 mL) prior to administration.

May dilute oral phosphate in 25-50 mL of juice or water for palatability.





Standard Prescription:

Sodium phosphate __mmol IV (__mmol/kg/dose) Q__H x __doses

Potassium phosphate __mmol IV (__mmol/kg/dose) Q__H x __doses

**NOTE: Injectable form should be ordered by mmol of phosphate**

Phosphate tablet __mg (__mmol) PO__(frequency)
(__mmol/kg/24 h)

Phosphate solution__mL (__mmol) PO__(frequency)(__mmol/kg/24 h)