Dicalcium phosphate (generic name)
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Interactions with Drugs
Bile acid sequestrants such as cholestyramine (Questran®) and colestipol (Colestid®) can decrease oral absorption of phosphate. Therefore, oral phosphate supplements should be administered at least one hour before or four hours after these agents.
Corticosteroids may increase urinary phosphorus levels.
Alcohol (ethanol) may increase urinary phosphorus. Wine may enhance absorption of phosphorus (as well as calcium and magnesium).
Medications that may affect electrolyte levels should be used cautiously with phosphates. Examples include: amiloride (Midamor®); angiotensin-converting enzyme (ACE) inhibitors such as benazepril (Lotensin®), captopril (Capoten®), enalapril (Vasotec®), fosinopril (Monopril®), lisinopril (Zestril®, Prinivil®), quinapril (Accupril®), or ramipril (Altace®); cyclosporine; cardiac glycosides (Digoxin®); heparins; anti-inflammatory drugs; potassium-containing agents; salt substitutes; spironolactone (Aldactone®); and triamterene (Dyrenium®).
Interactions with Herbs and Dietary Supplements
Calcium may impair phosphates in the body, and result in calcium deposits in tissues.
Pumpkin seed may increase urine phosphates.
This information is based on a systematic review of scientific literature, edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com): Ethan Basch, MD, MSc, MPhil (Memorial Sloan Kettering Cancer Center); Dawn Costa, BA, BS (Natural Standard Research Collaboration); Cynthia Dacey, PharmD (Northeastern University); Shaina Tanguay-Colucci, BS (Natural Standard Research Collaboration); Catherine Ulbricht, PharmD (Massachusetts General Hospital); Christine Ulbricht, BS (University of Massachusetts); Wendy Weissner, BA (Natural Standard Research Collaboration); Jen Woods, BS (Natural Standard Research Collaboration).
BibliographyDISCLAIMER: Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.
Block GA, Hulbert-Shearon TE, Levin NW, et al. Association of serum phosphorus and calcium x phosphate product with mortality risk in chronic hemodialysis patients: a national study. Am J Kidney Dis 1998;31(4):607-617.
Bredle DL, Stager JM, Brechue WF, et al. Phosphate supplementation, cardiovascular function, and exercise performance in humans. J Appl Physiol 1988;65(4):1821-1826.
Bugg NC, Jones JA. Hypophosphataemia. Pathophysiology, effects and management on the intensive care unit. Anaesthesia 1998;53(9):895-902.
Ehrenpreis ED, Nogueras JJ, Botoman VA, et al. Serum electrolyte abnormalities secondary to Fleet's Phospho-Soda colonoscopy prep. A review of three cases. Surg Endosc 1996;10(10):1022-1024.
Fakiris AJ, Moore DH, Reddy SR, et al. Intraperitoneal radioactive phosphorus (32P) and vaginal brachytherapy as adjuvant treatment for uterine papillary serous carcinoma and clear cell carcinoma: a phase II Hoosier Oncology Group (HOG 97-01) study. Gynecol Oncol 2005;96(3):818-823.
Fine A, Patterson J. Severe hyperphosphatemia following phosphate administration for bowel preparation in patients with renal failure: two cases and a review of the literature. Am J Kidney Dis. 1997;29(1):103-105.
Finn WF, Joy MS. A long-term, open-label extension study on the safety of treatment with lanthanum carbonate, a new phosphate binder, in patients receiving hemodialysis. Curr Med Res Opin. 2005;21(5):657-664.
Fisher JN, Kitabchi AE. A randomized study of phosphate therapy in the treatment of diabetic ketoacidosis. J.Clin.Endocrinol.Metab 1983;57(1):177-180.
Garg JP, Chasan-Taber S, Blair A, et al. Effects of sevelamer and calcium-based phosphate binders on uric acid concentrations in patients undergoing hemodialysis: a randomized clinical trial. Arthritis Rheum 2005;52(1):290-295.
Heaney RP, Nordin BE. Calcium effects on phosphorus absorption: implications for the prevention and co-therapy of osteoporosis. J Am Coll Nutr 2002;21(3):239-244.
Helikson MA, Parham WA, Tobias JD. Hypocalcemia and hyperphosphatemia after phosphate enema use in a child. J Pediatr Surg 1997;32(8):1244-1246.
Kastenberg D, Chasen R, Choudhary C, et al. Efficacy and safety of sodium phosphate tablets compared with PEG solution in colon cleansing: two identically designed, randomized, controlled, parallel group, multicenter phase III trials. Gastrointest Endosc 2001;54(6):705-713.
Kemi VE, Kärkkäinen MU, Lamberg-Allardt CJ. High phosphorus intakes acutely and negatively affect Ca and bone metabolism in a dose-dependent manner in healthy young females. Br J Nutr. 2006 Sep;96(3):545-52.
Kurihara S, Tsuruta Y, Akizawa T. Effect of MCI-196 (colestilan) as a phosphate binder on hyperphosphataemia in aemodialysis patients: a double-blind, placebo-controlled, short-term trial. Nephrol Dial Transplant 2005;20(2):424-430.
National Research Council, Food and Nutrition Board. Recommended Dietary Allowances. 10th ed. Washington, D.C.: National Academy Press; 1989:184-187.
Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.