Dose:  0.5 to 1 mM/kg/Day PO

Frequency: Q 6 to 8 hours with feedings

Comments:  Neutra-Phos is no longer commercially available. To provide supplemental phosphorous, we are currently using sodium phosphate solution. Sodium phosphate has less contamination with aluminum ion than potassium phosphate. It is useful primarily in providing a supplemental source of phosphorous to VLBW infants receiving breast milk. In addition, it is useful in providing phosphorous to infants with osteopenia and hypophosphatemia. The supplement may produce a mild laxative effect for the first two or three days; if this continues, the dose should be reduced.

Toxicity: May cause a mild laxative effect. Other adverse reactions include diarrhea, nausea, and vomiting. High phosphate levels may increase the risk of extra-skeletal calcification (Facts and Comparisons, Inc. Drug Facts and Comparisons. Olin, B.R. ed. St. Louis, MO:Facts and Comparisons, Inc; 1996, page 12).

Preparation: Phorphorous will be supplied by the pharmacy as sodium phosphate (3 mM of phosphate and 4 mEq of sodium/ml.  Injectable phosphate supplement intended for enteral use is to be packaged in a prescription bottle and oral syringes should be used so that it is apparent that it is intended to be given by the enteral route. Potassium phosphate could be used in special circumstances (3 mM of phosphate and 4.4 mEq of potassium/ml.