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What should I discuss with my healthcare provider before using sodium biphosphate and sodium phosphate (Fleet Enema, Fleet Enema for Children, OsmoPrep, Visicol)?

You should not use this medication if you have used it within the past 7 days, or if you have:

• kidney disease (or if you are on dialysis);
• dehydration; or
• an electrolyte imbalance (such as high or low levels of potassium, sodium, phosphorous, or magnesium in your blood).

If you have any these conditions, you could have dangerous or life-threatening side effects on your kidneys from taking sodium biphosphate and sodium phosphate.

People with eating disorders (such as anorexia or bulimia) should not use this medication without the advice of a doctor.

To make sure you can safely use sodium biphosphate and sodium phosphate, tell your doctor if you have any of these other conditions:

• congestive heart failure;
• liver problems such as cirrhosis, or ascites (fluid around your liver);
• unstable angina (chest pain);
• a heart rhythm disorder (such as "Long-QT syndrome");
• a history of recent heart attack, heart surgery, or bypass surgery;
• a history of gastric bypass surgery or stomach stapling;
• a bowel obstruction or severe constipation;
• trouble swallowing;
• a perforated bowel;
• inflammatory bowel disease, colitis or toxic megacolon;
• epilepsy or other seizure disorder;
• a recent history of drug or alcohol addiction withdrawal.
• if you have ongoing vomiting or diarrhea, or if you are sweating more than usual;
• if you are older than 56 years; or
• if you are on a low-salt diet.

FDA pregnancy category C. It is not known whether sodium biphosphate and sodium phosphate will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication.

It is not known whether sodium biphosphate and sodium phosphate passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

How should I use sodium biphosphate and sodium phosphate (Fleet Enema, Fleet Enema for Children, OsmoPrep, Visicol)?

Use exactly as directed on the label, or as prescribed by your doctor. Never use this medication in larger or smaller amounts or for longer than recommended.

To keep from getting dehydrated, drink a full glass (8 ounces) of water or other clear liquid each time you use this medication. You may be instructed not to drink or eat anything before your medical test. Follow your doctor's instructions about the type and amount of liquids you should drink for at least 24 hours after using this medicine.

If you take the tablet form of this medicine, you will most likely start taking it the evening before your colonoscopy, and finish taking it on the day of your colonoscopy.

For best results, take the oral liquid on an empty stomach when you first get out of bed, at least 30 minutes before eating. You may also take the medicine at bedtime. In most cases, it will work overnight.

Measure the oral liquid and mix it with one-half glass (4 oz) of cool water. Stir this mixture and drink all of it right away. To make sure you get the entire dose, add a little more water to the same glass, swirl gently and drink right away.

When using this medication in a child, use only the forms that are specially made for children.

• Fleet Enema For Children can be used in children from 2 to 11 years old.
• Never use an adult-strength sodium biphosphate and sodium phosphate enema in a child younger than 12 years old.
• Do not use the enema to treat a child younger than 2 years of age without the advice of a doctor.
• Fleet Phospho-Soda oral liquid can be given to children who are at least 5 years old.
• Do not give the oral solution to a child younger than 5 years of age without the advice of a doctor.
• Do not give the oral tablet (Visicol) to a child younger than 18 years old.

Do not take the rectal enema by mouth. It is for use only in your rectum.

To use the enema, lie down on your left side with your knees bent.

Remove the cap from the applicator tip and gently insert the tip into your rectum. Slowly squeeze the bottle to empty the contents into the rectum.

For best results, stay lying down until you feel the urge to have a bowel movement. This should occur within 2 to 15 minutes in most cases.

If you do not get any results after using sodium biphosphate and sodium phosphate, call your doctor before using another dose. Using too much of this medication in 24 hours can be harmful. Do not use sodium biphosphate and sodium phosphate for longer than 1 week unless your doctor has told you to.

Store at room temperature away from moisture and heat. Throw away any leftover medicine after your treatment ends.

To be sure this medication has not caused harmful effects, your doctor may want to test your blood and check your kidney function in the days after your colonoscopy. Do not miss any follow-up visits to your doctor.

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