Oral: According to response; maximum oral dose =100 mmol in 24 hoursIV: 9–30 mmol/day (maximum 500 micromols/kg in critically ill patients); see ‘Other Information’
Volume of distribution (L/kg)       :No data
half-life – normal/ESRD (hrs)      :No data
DOSE IN RENAL IMPAIRMENT
GFR (mL/MIN)
20 to 50     : Dose as in normal renal function
10 to 20     : Dose as in normal renal function
<10           : Dose as in normal renal function
DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES
CAPD                :Dialysed. Dose as in normal renal function
HD                     :Dialysed. Dose as in normal renal function
HDF/high flux   :Dialysed. Dose as in normal renal function
CAV/VVHD      :Dialysed. Dose as in normal renal function
IMPORTANT DRUG INTERACTIONS
Potentially hazardous interactions with other drugsAvoid insoluble incompatibilities, e.g. calcium salts
ADMINISTRATION
Reconstition
–
Route
IV, oral
Rate of Administration
Usually over 6–12 hours
Comments
Phosphate polyfusor: give undiluted over 24 hours, peripherallyAddiphos: peripherally – give each vial (20 mL) diluted to 250–500 mL with glucose 5% over 6–12 hours, minimum volume 100 mL (UK Critical Care Group, Minimum Infusion Volumes for fluid restricted critically ill patients, 3rd Edition, 2006); centrally – 20 mL vial made up to 60 mL with glucose 5% over 6–8 hours via syringe driver
HD                     : patients usually need 15–20 mmol/ day in TPNCAV/VVHD patients usually need 30– 40 mmol/dayDuring IV phosphate replacement, serum calcium, potassium and phosphate should be monitored 6–12 hourly. Repeat the dose within 24 hours if an adequate level has not been achieved. Urinary output should also be monitoredThere is experience giving 15 mmol over 2 hours up to 3 times a dayExcessive doses of phosphate may cause hypocalcaemia and metastatic calcification