of hypokalemia.moexiprilMonitor Closely (1)moexipril increases levels of potassium acid phosphate by decreasing elimination. Use Caution/Monitor. Risk of hyperkalemia.nabumetoneMonitor Closely (1)nabumetone and potassium acid phosphate both increase serum potassium. Modify Therapy/Monitor Closely.nadololMonitor Closely (1)nadolol and potassium acid phosphate both increase serum potassium. Modify Therapy/Monitor Closely.naproxenMonitor Closely (1)naproxen and potassium acid phosphate both increase serum potassium. Modify Therapy/Monitor Closely.nateglinideMinor (1)potassium acid phosphate increases effects of nateglinide by pharmacodynamic synergism. Minor/Significance Unknown. Interaction especially seen in the treatment of hypokalemia.nebivololMonitor Closely (1)nebivolol and potassium acid phosphate both increase serum potassium. Modify Therapy/Monitor Closely.noni juiceMonitor Closely (1)potassium acid phosphate and noni juice both increase serum potassium. Use Caution/Monitor.norepinephrineMonitor Closely (1)potassium acid phosphate increases and norepinephrine decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.olmesartanMonitor Closely (1)olmesartan and potassium acid phosphate both increase serum potassium. Use Caution/Monitor.oxaprozinMonitor Closely (1)oxaprozin and potassium acid phosphate both increase serum potassium. Modify Therapy/Monitor Closely.parecoxibMonitor Closely (1)parecoxib and potassium acid phosphate both increase serum potassium. Modify Therapy/Monitor Closely.penbutololMonitor Closely (1)penbutolol and potassium acid phosphate both increase serum potassium. Modify Therapy/Monitor Closely.perindoprilMonitor Closely (1)perindopril increases levels of potassium acid phosphate by decreasing elimination. Use Caution/Monitor. Risk of hyperkalemia.pindololMonitor Closely (1)pindolol and potassium acid phosphate both increase serum potassium. Modify Therapy/Monitor Closely.pioglitazoneMinor (1)potassium acid phosphate increases effects of pioglitazone by pharmacodynamic synergism. Minor/Significance Unknown. Interaction especially seen in the treatment of hypokalemia.pirbuterolMonitor Closely (1)potassium acid phosphate increases and pirbuterol decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.piroxicamMonitor Closely (1)piroxicam and potassium acid phosphate both increase serum potassium. Modify Therapy/Monitor Closely.potassium chlorideSerious - Use Alternative (1)potassium acid phosphate and potassium chloride both increase serum potassium. Avoid or Use Alternate Drug.potassium citrateSerious - Use Alternative (1)potassium acid phosphate and potassium citrate both increase serum potassium. Avoid or Use Alternate Drug.potassium citrate/citric acidMonitor Closely (1)potassium acid phosphate and potassium citrate/citric acid both increase serum potassium. Use Caution/Monitor.potassium phosphates, IVSerious - Use Alternative (1)potassium acid phosphate and potassium phosphates, IV both increase serum potassium. Avoid or Use Alternate Drug.propranololMonitor Closely (1)propranolol and potassium acid phosphate both increase serum potassium. Modify Therapy/Monitor Closely.quinaprilMonitor Closely (1)quinapril increases levels of potassium acid phosphate by decreasing elimination. Use Caution/Monitor. Risk of hyperkalemia.ramiprilMonitor Closely (1)ramipril increases levels of potassium acid phosphate by decreasing elimination. Use Caution/Monitor. Risk of hyperkalemia.repaglinideMinor (1)potassium acid phosphate increases effects of repaglinide by pharmacodynamic synergism. Minor/Significance Unknown. Interaction especially seen in the treatment of hypokalemia.rosiglitazoneMinor (1)potassium acid phosphate increases effects of rosiglitazone by pharmacodynamic synergism. Minor/Significance Unknown. Interaction especially seen in the treatment of hypokalemia.sacubitril/valsartanMonitor Closely (1)sacubitril/valsartan and potassium acid phosphate both increase serum potassium. Use Caution/Monitor.salicylates (non-asa)Monitor Closely (1)salicylates (non-asa) and potassium acid phosphate both increase serum potassium. Modify Therapy/Monitor Closely.salmeterolMonitor Closely (1)potassium acid phosphate increases and salmeterol decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.salsalateMonitor Closely (1)salsalate and potassium acid phosphate both increase serum potassium. Modify Therapy/Monitor Closely.saxagliptinMinor (1)potassium acid phosphate increases effects of saxagliptin by pharmacodynamic synergism. Minor/Significance Unknown. Interaction especially seen in the treatment of hypokalemia.sitagliptinMinor (1)potassium acid phosphate increases effects of sitagliptin by pharmacodynamic synergism. Minor/Significance Unknown. Interaction especially seen in the treatment of hypokalemia.sotalolMonitor Closely (1)sotalol and potassium acid phosphate both increase serum potassium. Modify Therapy/Monitor Closely.sparsentanMonitor Closely (1)sparsentan and potassium acid phosphate both increase serum potassium. Use Caution/Monitor. Monitor serum potassium frequently.spironolactoneSerious - Use Alternative (1)spironolactone and potassium acid phosphate both increase serum potassium. Avoid or Use Alternate Drug.succinylcholineMonitor Closely (1)potassium acid phosphate and succinylcholine both increase serum potassium. Modify Therapy/Monitor Closely.sulfasalazineMonitor Closely (1)sulfasalazine and potassium acid phosphate both increase serum potassium. Modify Therapy/Monitor Closely.sulindacMonitor Closely (1)sulindac and potassium acid phosphate both increase serum potassium. Modify Therapy/Monitor Closely.telmisartanMonitor Closely (1)telmisartan and potassium acid phosphate both increase serum potassium. Use Caution/Monitor.terbutalineMonitor Closely (1)potassium acid phosphate increases and terbutaline decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.timololMonitor Closely (1)timolol and potassium acid phosphate both increase serum potassium. Modify Therapy/Monitor Closely.tolazamideMinor (1)potassium acid phosphate increases effects of tolazamide by pharmacodynamic synergism. Minor/Significance Unknown. Interaction especially seen in the treatment of hypokalemia.tolbutamideMinor (1)potassium acid phosphate increases effects of tolbutamide by pharmacodynamic synergism. Minor/Significance Unknown. Interaction especially seen in the treatment of hypokalemia.tolfenamic acidMonitor Closely (1)tolfenamic acid and potassium acid phosphate both increase serum potassium. Modify Therapy/Monitor Closely.tolmetinMonitor Closely (1)tolmetin and potassium acid phosphate both increase serum potassium. Modify Therapy/Monitor Closely.tolvaptanMonitor Closely (1)potassium acid phosphate and tolvaptan both increase serum potassium. Modify Therapy/Monitor Closely.torsemideMonitor Closely (1)potassium acid phosphate increases and torsemide decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.trandolaprilMonitor Closely (1)trandolapril increases levels of potassium acid phosphate by decreasing elimination. Use Caution/Monitor. Risk of hyperkalemia.triamtereneSerious - Use Alternative (1)triamterene and potassium acid phosphate both increase serum potassium. Avoid or Use Alternate Drug.trimethoprimMonitor Closely (1)trimethoprim and potassium acid phosphate both increase serum potassium. Use Caution/Monitor. Trimethoprim decreases urinary potassium excretion. May cause hyperkalemia, particularly with high doses, renal insufficiency, or when combined with other drugs that cause hyperkalemia.valsartanMonitor Closely (1)valsartan and potassium acid phosphate both increase serum potassium. Use Caution/Monitor.vildagliptinMinor (1)potassium acid phosphate increases effects of vildagliptin by pharmacodynamic synergism. Minor/Significance Unknown. Interaction especially seen in the treatment of hypokalemia.voclosporinMonitor Closely (1)voclosporin and potassium acid phosphate both increase serum potassium. Use Caution/Monitor. Frequency Not Defined Diarrhea Nausea/vomiting Stomach pain Flatulence Bradycardia Hyperkalemia Local tissue necrosis with extravasation Weakness Dyspnea Hypocalcemia Tetany Phosphate intoxication Hypotension Arrhythmia Contraindications Hyperphosphatemia, severe renal impairment, hyperkalemia, infected phophate stones Cautions May cause hyperkalemia; use caution in patients who require regulation of serum potassium concentrations Patients may experience mild laxative effects within first few days of therapy; if laxation persists to unpleasant degree, reduce daily dosage until effect subsides or, if necessary, discontinue use of this product Use caution in patients with cardiac disease (particularly in digitalized patients); severe adrenal insufficiency (Addison's disease); acute dehydration; severe renal insufficiency or chronic renal disease; extensive tissue breakdown (such as severe burns); myotonia congenita; hypoparathyroidism; and acute pancreatitis Rickets may benefit from phosphate therapy, but caution should be exercised; high serum phosphate levels may increase incidence of extra-skeletal calcification Patients with kidney stones may pass old stones when phosphate therapy is started and should be warned of this possibility; patients should be advised to avoid use of antacids containing aluminum, calcium, or magnesium, which may prevent absorption of phosphate To assure against gastrointestinal injury associated with oral ingestion of concentrated potassium salt preparations, patients should be instructed to dissolve tablets completely in an appropriate amount of water before taking Drug interaction overview Use of antacids containing magnesium, calcium, or aluminum in conjunction with phosphate preparations may bind the phosphate and prevent absorption Potassium-containing medications or potassium-sparing diuretics may cause hyperkalemia when used concurrently with potassium salts; patients should have serum potassium level determinations at periodic intervals Concurrent use of salicylates may lead to increased serum salicylate levels since excretion of salicylates is reduced in acidified urine; serum salicylate levels should be closely monitored to avoid toxicity Pregnancy Not known whether this product can cause fetal harm when administered to a pregnant woman or can affect reproductive capacity; animal reproduction studies not conducted; product should be given to a pregnant woman only if clearly needed Lactation Not known whether this drug is excreted in human milk; because many drugs are excreted in human milk, exercise caution should when administered to a nursing womanPregnancy Categories A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk. B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available. Mechanism of Action Intracellular cation essential in physiological processes including transmission of nerve impulses, glucose utilization, muscle contractions, and enzyme activity Acidifies urine Pharmacokinetics Distribution: Enters cells from extracellular fluid via active transport Absorption: Well absorbed from upper GI tract Excretion: Urine (primarily); skin and feces (small amount) BRAND FORM. UNIT PRICE PILL IMAGE Phos-NaK oral- 280-160-250 mg powderPhos-NaK oral- 280-160-250 mg powderPhosphorous Supplement oral- 280-160-250 mg powderCopyright © 2010 First DataBank, Inc.Print Patient Educationpotassium and sodium phosphates oral SODIUM/POTASSIUM PHOSPHATE, MONOBASIC-DIBASIC POWDER - ORAL (SOE-de-um/poe-TAS-ee-um FOS-fate,MON-oh-BAY-sik,dye-BAY-sik) COMMON BRAND NAME(S): Neutra-Phos USES: This drug is used in people who cannot get enough phosphorus from their diets. Phosphorus is a natural body mineral that is needed for the body to work normally. It is needed for building and keeping strong bones. It also helps control the amount of calcium in the body and urine. HOW TO USE: Take this medication by mouth as directed by your doctor, usually 4 times a day with meals and at bedtime. Open the packet and mix the powder in one-third of a glass (2.5 ounces or 75 milliliters) of water or other liquid such as juice. Stir the mixture well before taking all of it.Dosage is based on your medical condition and response to treatment.Take this medication regularly in order to get the most benefit from it. To help you remember, take it at the same times each day.Take this medication 2 to 3 hours before or after taking any products containing magnesium, aluminum, or calcium. Some examples include quinapril, didanosine, vitamins/minerals, and antacids. Dairy products (such as milk, yogurt), calcium-enriched juice, iron, and zinc are also included. These products bind with phosphate, preventing its full absorption.If your doctor has recommended that you follow a special diet, it is very important to follow the diet to get the most benefit from this medication and prevent serious side effects. Do not take other supplements/vitamins unless ordered by your doctor.If you are unsure about how to take this medication, ask your doctor or pharmacist. SIDE EFFECTS: Nausea, vomiting, diarrhea, headache, dizziness, or stomach/abdominal pain may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.If your doctor has directed you to use this medication, remember that your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.When this medication is first started, there is a chance an old kidney stone will be passed. Tell your doctor right away if you develop any symptoms of a kidney stone passing, including: painful/frequent urination, sudden/severe pain in the side/back/abdomen, blood in the urine.Tell your doctor right away if you have any serious side effects, including: bone/joint pain, muscle cramps, swelling ankles/feet, sudden weight gain, fast/irregular heartbeat, signs of kidney problems (such as change in the amount of urine), tingling/numbness of the hands/feet/lips, confusion, seizures, unusual weakness/tiredness, shortness of breath.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other side effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345. PRECAUTIONS: Before taking this medication, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: high phosphate/potassium/sodium levels, adrenal gland problems (such as Addison's disease), bone problems (such as rickets, osteomalacia), kidney disease (including kidney stones), heart disease (such as heart failure), high blood pressure, a certain hormone problem (hypoparathyroidism), a certain muscle problem (myotonia congenita), liver disease, dehydration, too much body water (such as swelling of arms/legs, fluid in the lungs), severe burns/wounds, swelling of the pancreas (pancreatitis), a diet restricted in sodium or potassium.This medication contains sodium. Consult your doctor for